CIC Exam Dumps - CBIC Certified Infection Control Exam

In an outbreak investigation, the first critical step is to notify facility administration and other key stakeholders. This ensures the rapid mobilization of resources, coordination with infection control teams, and compliance with regulatory reporting requirements.

Why the Other Options Are Incorrect?

A. Conduct environmental cultures – While environmental sampling may be necessary, it is not the first step. The outbreak must first be confirmed and administration alerted.

B. Plan to prevent future outbreaks – Prevention planning happens later after the outbreak has been investigated and controlled.

D. Perform analytical studies – Data analysis occurs after case definition and initial response measures are in place.

CBIC Infection Control Reference

APIC guidelines state that the first step in an outbreak investigation is confirming the outbreak and notifying key stakeholders​.

The proper use of chemical disinfectants is a critical aspect of infection control, as outlined by the Certification Board of Infection Control and Epidemiology (CBIC). Chemical disinfectants are used to eliminate or reduce pathogenic microorganisms on inanimate objects, and their effective application requires adherence to specific protocols to ensure safety and efficacy. Let’s evaluate each option based on infection control standards:

A. All items to be processed must be cleaned prior to being submerged in solution.: This statement is a fundamental principle of disinfectant use. Cleaning (e.g., removing organic material such as blood, tissue, or dirt) is a prerequisite before disinfection because organic matter can inactivate or reduce the effectiveness of chemical disinfectants. The CBIC emphasizes that proper cleaning is the first step in the disinfection process to ensure that disinfectants can reach and kill microorganisms. This step is universally required for all levels of disinfection (low, intermediate, and high), making it a characterizing feature of proper use.

B. The label on the solution being used must indicate that it kills all viable micro-organisms.: This statement is misleading. No disinfectant can be guaranteed to kill 100% of all viable microorganisms under all conditions, as efficacy depends on factors like contact time, concentration, and the presence of organic material. Disinfectant labels typically indicate the types of microorganisms (e.g., bacteria, viruses, fungi) and the level of disinfection (e.g., high-level, intermediate-level) they are effective against, based on standardized tests (e.g., EPA or FDA guidelines). Claiming that a solution kills all viable microorganisms is unrealistic and not a requirement for proper use; instead, the label must specify the intended use and efficacy, which varies by product.

C. The solution should be adaptable for use as an antiseptic.: An antiseptic is a chemical agent used on living tissue (e.g., skin) to reduce microbial load, whereas a disinfectant is used on inanimate surfaces. While some chemicals (e.g., alcohol) can serve both purposes, this is not a requirement for proper disinfectant use. The adaptability of a solution for antiseptic use is irrelevant to its classification or application as a disinfectant, which focuses on environmental or equipment decontamination. This statement does not characterize proper disinfectant use.

D. A chemical indicator must be used with items undergoing high-level disinfection.: Chemical indicators (e.g., test strips or tapes) are used to verify that the disinfection process has met certain parameters (e.g., concentration or exposure time), particularly in sterilization or high-level disinfection (HLD). While this is a recommended practice for quality assurance in HLD (e.g., with glutaraldehyde or hydrogen peroxide), it is not a universal requirement for all chemical disinfectant use. HLD applies specifically to semi-critical items (e.g., endoscopes), and the need for indicators depends on the protocol and facility standards. This statement is too narrow and specific to characterize the proper use of chemical disinfectants broadly.

The correct answer is A, as cleaning prior to disinfection is a foundational and universally applicable step in the proper use of chemical disinfectants. This aligns with CBIC guidelines, which stress the importance of a clean surface to maximize disinfectant efficacy and prevent infection transmission in healthcare settings.

References:

CBIC Infection Prevention and Control (IPC) Core Competency Model (updated 2023), Domain IV: Environment of Care, which mandates cleaning as a prerequisite for effective disinfection.

CBIC Examination Content Outline, Domain III: Prevention and Control of Infectious Diseases, which includes protocols for the proper use of disinfectants, emphasizing pre-cleaning.

CDC Guidelines for Disinfection and Sterilization in Healthcare Facilities (2021), which reinforce that cleaning must precede disinfection to ensure efficacy.

Peripherally inserted central catheter (PICC)-associated bloodstream infections (BSIs) are a significant concern in healthcare settings, and identifying factors contributing to their increase is critical for infection prevention. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the "Surveillance and Epidemiologic Investigation" and "Prevention and Control of Infectious Diseases" domains, which align with the Centers for Disease Control and Prevention (CDC) guidelines for preventing intravascular catheter-related infections. The question asks for the intervention most likely to have contributed to the rise in PICC-associated BSIs over four months, requiring an evaluation of each option based on evidence-based practices.

Option C, "Replacement of the intravenous administration sets every 72 hours," is the most likely contributor to the increase. The CDC’s "Guidelines for the Prevention of Intravascular Catheter-Related Infections" (2017) recommend that intravenous administration sets (e.g., tubing for fluids or medications) be replaced no more frequently than every 72-96 hours unless clinically indicated (e.g., contamination or specific therapy requirements). Frequent replacement, such as every 72 hours as a routine practice, can introduce opportunities for contamination during the change process, especially if aseptic technique is not strictly followed. Studies cited in the CDC guidelines, including those by O’Grady et al. (2011), indicate that unnecessary manipulation of catheter systems increases the risk of introducing pathogens, potentially leading to BSIs. A change to a 72-hour replacement schedule, if not previously standard, could explain the observed increase over the past four months.

Option A, "Use of chlorhexidine skin antisepsis during insertion of the PICC," is a recommended practice to reduce BSIs. Chlorhexidine, particularly in a 2% chlorhexidine gluconate with 70% alcohol solution, is the preferred skin antiseptic for catheter insertion due to its broad-spectrum activity and residual effect, as supported by the CDC (2017). This intervention should decrease, not increase, infection rates, making it an unlikely contributor. Option B, "Daily bathing adult intensive care unit patients with chlorhexidine," is another evidence-based strategy to reduce healthcare-associated infections, including BSIs, by decolonizing the skin of pathogens like Staphylococcus aureus. The CDC and SHEA (Society for Healthcare Epidemiology of America) guidelines (2014) endorse chlorhexidine bathing in intensive care units, suggesting it should lower, not raise, BSI rates. Option D, "Use of a positive pressure device on the PICC," aims to prevent catheter occlusion and reduce the need for frequent flushing, which could theoretically decrease infection risk by minimizing manipulation. However, there is no strong evidence linking positive pressure devices to increased BSIs; if improperly used or maintained, they might contribute marginally, but this is less likely than the impact of frequent tubing changes.

The CBIC Practice Analysis (2022) and CDC guidelines highlight that deviations from optimal catheter maintenance practices, such as overly frequent administration set replacements, can increase infection risk. Given the four-month timeframe and the focus on an intervention’s potential negative impact, Option C stands out as the most plausible contributor due to the increased manipulation and contamination risk associated with routine 72-hour replacements.

References:

CBIC Practice Analysis, 2022.

CDC Guidelines for the Prevention of Intravascular Catheter-Related Infections, 2017.

O’Grady, N. P., et al. (2011). Guidelines for the Prevention of Intravascular Catheter-Related Infections. Clinical Infectious Diseases.

SHEA Compendium, Strategies to Prevent Central Line-Associated Bloodstream Infections, 2014.

The scenario involves a surgical patient with a purulent abdominal wound culture growing Staphylococcus aureus, a common pathogen in surgical site infections (SSIs). The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes accurate interpretation of culture results and antibiotic therapy in the "Identification of Infectious Disease Processes" and "Prevention and Control of Infectious Diseases" domains, aligning with the Centers for Disease Control and Prevention (CDC) guidelines for managing SSIs. The question requires assessing the sensitivity pattern and current treatment to determine the correct statement.

Option B, "The current therapy is not effective," is true. The wound culture shows Staphylococcus aureus resistant to oxacillin, indicating methicillin-resistant S. aureus (MRSA). The sensitivity pattern lists resistance to penicillin, oxacillin, cephalothin, and erythromycin, with susceptibility to clindamycin and vancomycin. Cefazolin, a first-generation cephalosporin, is ineffective against MRSA because resistance to oxacillin (a penicillinase-resistant penicillin) implies cross-resistance to cephalosporins like cefazolin due to altered penicillin-binding proteins (PBPs). The CDC’s "Guidelines for the Prevention of Surgical Site Infections" (2017) and the Clinical and Laboratory Standards Institute (CLSI) standards confirm that MRSA strains are not susceptible to cefazolin, meaning the current therapy is inappropriate and unlikely to resolve the infection, supporting Option B.

Option A, "The wound is not infected," is incorrect. The presence of purulent drainage, a clinical sign of infection, combined with a positive culture for S. aureus, confirms an active wound infection. The CBIC and CDC define purulent discharge as a key indicator of SSI, ruling out this statement. Option C, "Droplet Precautions should be initiated," is not applicable. Droplet Precautions are recommended for pathogens transmitted via respiratory droplets (e.g., influenza, pertussis), not for S. aureus, which is primarily spread by contact. The CDC’s "Guideline for Isolation Precautions" (2007) specifies Contact Precautions for MRSA, not Droplet Precautions, making this false. Option D, "This is a methicillin-sensitive S. aureus (MSSA) strain," is incorrect. Methicillin sensitivity is determined by susceptibility to oxacillin, and the resistance to oxacillin in the culture result classifies this as MRSA, not MSSA. The CDC and CLSI use oxacillin resistance as the defining criterion for MRSA.

The CBIC Practice Analysis (2022) and CDC guidelines stress the importance of aligning antimicrobial therapy with sensitivity patterns to optimize treatment outcomes. The mismatch between cefazolin and the MRSA sensitivity profile confirms that Option B is the correct statement, indicating ineffective current therapy.

References:

CBIC Practice Analysis, 2022.

CDC Guidelines for the Prevention of Surgical Site Infections, 2017.

CDC Guideline for Isolation Precautions, 2007.

CLSI Performance Standards for Antimicrobial Susceptibility Testing, 2022.

The pneumococcal vaccine is designed to protect against infections caused by Streptococcus pneumoniae, a bacterium responsible for diseases such as pneumonia, meningitis, and bacteremia. The appropriateness of this vaccine depends on the population's risk profile, particularly their susceptibility to invasive pneumococcal disease (IPD). The Certification Board of Infection Control and Epidemiology (CBIC) highlights the role of infection preventionists as educators in promoting vaccination as a key risk reduction strategy, aligning with the "Education and Training" domain (CBIC Practice Analysis, 2022). The Centers for Disease Control and Prevention (CDC) provides specific guidelines on pneumococcal vaccination, recommending it for individuals at higher risk due to underlying medical conditions or immunologic status.

Option A, asplenic patients, refers to individuals who have had their spleen removed (e.g., due to trauma or disease) or have a nonfunctional spleen (e.g., in sickle cell disease). The spleen plays a critical role in clearing encapsulated bacteria like Streptococcus pneumoniae from the bloodstream. Without a functioning spleen, these patients are at significantly increased risk of overwhelming post-splenectomy infection (OPSI), with pneumococcal disease being a leading cause. The CDC and Advisory Committee on Immunization Practices (ACIP) strongly recommend pneumococcal vaccination, including both PCV15/PCV20 and PPSV23, for asplenic patients, making this group the most appropriate for the vaccine in this context. The infection preventionist should prioritize educating these patients and their families about the vaccine's importance and timing.

Option B, international travelers, may benefit from various vaccines depending on their destination (e.g., yellow fever or typhoid), but pneumococcal vaccination is not routinely recommended unless they have specific risk factors (e.g., asplenia or chronic illness) or are traveling to areas with high pneumococcal disease prevalence. This group is not inherently a priority for pneumococcal vaccination. Option C, immunocompromised newborns, includes infants with congenital immunodeficiencies or other conditions, who may indeed require pneumococcal vaccination as part of their routine immunization schedule (e.g., PCV15 or PCV20 starting at 2 months). However, newborns are generally covered under universal childhood vaccination programs, and the question’s focus on "MOST appropriate" suggests a group with a more specific, elevated risk, which asplenic patients fulfill. Option D, patients in behavioral health settings, may have varied health statuses, but this group is not specifically targeted for pneumococcal vaccination unless they have additional risk factors (e.g., chronic diseases), making it less appropriate than asplenic patients.

The CBIC emphasizes tailoring education to high-risk populations, and the CDC’s Adult and Pediatric Immunization Schedules (2023) identify asplenic individuals as a top priority for pneumococcal vaccination due to their extreme vulnerability. Thus, the infection preventionist should focus on asplenic patients as the group for whom the pneumococcal vaccine is most appropriate.

References:

CBIC Practice Analysis, 2022.

CDC Adult Immunization Schedule, 2023.

CDC Pediatric Immunization Schedule, 2023.

ACIP Recommendations for Pneumococcal Vaccination, 2022.

10% lipid emulsions are the most likely to promote microbial growth because they provide an ideal environment for bacterial and fungal proliferation, especially Staphylococcus aureus, Pseudomonas aeruginosa, and Candida species. Lipids support rapid bacterial multiplication due to their high nutrient content.

Why the Other Options Are Incorrect?

A. 50% hypertonic glucose – High glucose concentrations inhibit bacterial growth due to osmotic pressure effects.

B. 5% dextrose – While it can support some bacterial growth, it is less favorable than lipid emulsions.

C. Synthetic amino acids – These solutions do not support microbial growth as well as lipid emulsions.

CBIC Infection Control Reference

APIC guidelines confirm that lipid-based solutions support rapid microbial growth and should be handled with strict aseptic technique​.

The correct answer is A, "Type of floor material," as it is the least important operating suite design feature for the prevention of infection compared to the other options. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, the design of operating suites plays a critical role in infection prevention, particularly for surgical site infections (SSIs). While the type of floor material (e.g., vinyl, tile, or epoxy) can affect ease of cleaning and durability, its impact on infection prevention is secondary to other design elements that directly influence air quality, hygiene practices, and personnel movement (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.5 - Evaluate the environment for infection risks). Modern flooring materials are generally designed to be non-porous and easily disinfected, mitigating their role as a primary infection risk factor when proper cleaning protocols are followed.

Option B (positive pressure air handling) is highly important because it prevents the influx of contaminated air into the operating suite, reducing the risk of airborne pathogens, including those causing SSIs. This is a standard feature in operating rooms to maintain a sterile environment (AORN Guidelines for Perioperative Practice, 2023). Option C (placement of sinks for surgical scrubs) is critical for ensuring that surgical staff can perform effective hand and forearm antisepsis, a key step in preventing SSIs by reducing microbial load before surgery. Option D (control of traffic and traffic flow patterns) is essential to minimize the introduction of contaminants from outside the operating suite, as excessive or uncontrolled movement can increase the risk of airborne and contact transmission (CDC Guidelines for Environmental Infection Control in Healthcare Facilities, 2019).

The relative unimportance of floor material type stems from the fact that infection prevention relies more on consistent cleaning practices and the aforementioned design features, which directly address pathogen transmission routes. This aligns with CBIC’s focus on evaluating environmental risks based on their direct impact on infection control (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.4 - Implement environmental cleaning and disinfection protocols).

References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competencies 3.4 - Implement environmental cleaning and disinfection protocols, 3.5 - Evaluate the environment for infection risks. AORN Guidelines for Perioperative Practice, 2023. CDC Guidelines for Environmental Infection Control in Healthcare Facilities, 2019.

The correct answer is D, "Study," as this is the step in the Shewhart/Deming cycle (commonly known as the Plan-Do-Study-Act [PDSA] cycle) where the results of the interventions are compared with the original goal. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, the PDSA cycle is a systematic approach to quality improvement, widely used in infection control programs to test and refine interventions. The cycle consists of four stages: Plan (designing the intervention and setting goals), Do (implementing the intervention on a small scale), Study (analyzing the data and comparing outcomes against the original goal), and Act (standardizing successful changes or adjusting based on findings) (CBIC Practice Analysis, 2022, Domain IV: Education and Research, Competency 4.2 - Evaluate the effectiveness of educational programs). The Study phase is critical for assessing whether the intervention achieved the intended reduction in infection rates or other performance metrics, providing evidence to guide the next steps.

Option A (Do) involves the execution of the planned intervention, focusing on implementation rather than evaluation, so it does not include comparing results. Option B (Act) is the final step where successful interventions are implemented on a broader scale or adjustments are made, but it follows the comparison made in the Study phase. Option C (Plan) is the initial stage of setting objectives and designing the intervention, which occurs before any results are available for comparison.

The emphasis on the Study phase aligns with CBIC’s focus on using data to evaluate the effectiveness of infection prevention strategies, ensuring that performance improvement projects are evidence-based and goal-oriented (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.4 - Evaluate the effectiveness of infection prevention and control interventions). This step enables the infection preventionist to determine if the original goal—such as reducing healthcare-associated infections—was met, facilitating continuous improvement.

References: CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.4 - Evaluate the effectiveness of infection prevention and control interventions; Domain IV: Education and Research, Competency 4.2 - Evaluate the effectiveness of educational programs.