The MOST important characteristic to include when using a template for a comprehensive annual risk assessment is
system strategic goals and objectives.
cost savings attributed to the infection prevention and control program.
facility specific demographics end healthcare-associated Infection data
statewide communicable disease and healthcare-associated infection data
The Answer Is:
CExplanation:
A comprehensive annual risk assessment should focus on facility-specific factors, including patient population, infection trends, and operational risks.
Why the Other Options Are Incorrect?
A. System strategic goals and objectives – While important, goals should align with facility-specific infection risks.
B. Cost savings attributed to infection control – Cost considerations are secondary to risk assessment.
D. Statewide communicable disease and HAI data – Broader epidemiological data is useful but should complement, not replace, facility-specific data.
CBIC Infection Control Reference
APIC emphasizes that facility-specific infection data is essential for an effective risk assessment.
Which of the following is an essential element of practice when sending biohazardous samples from one location to another?
Ship using triple-containment packaging
Electronically log and send via overnight delivery
Transport by an authorized biohazard transporter
Store in a cooler that is labeled as a health hazard
The Answer Is:
AExplanation:
The safe transport of biohazardous samples, such as infectious agents, clinical specimens, or diagnostic materials, is a critical aspect of infection prevention and control to prevent exposure and environmental contamination. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes adherence to regulatory and safety standards in the "Prevention and Control of Infectious Diseases" domain, which includes proper handling and shipping of biohazardous materials. The primary guideline governing this practice is the U.S. Department of Transportation (DOT) Hazardous Materials Regulations (HMR) and the International Air Transport Association (IATA) Dangerous Goods Regulations, which align with global biosafety standards.
Option A, "Ship using triple-containment packaging," is the essential element of practice. Triple-containment packaging involves three layers: a primary watertight container holding the sample, a secondary leak-proof container with absorbent material, and an outer rigid packaging (e.g., a box) that meets shipping regulations. This system ensures that biohazardous materials remain secure during transport, preventing leaks or breaches that could expose handlers or the public. The CDC and WHO endorse this method as a fundamental requirement for shipping Category A (high-risk) and Category B (moderate-risk) infectious substances, making it the cornerstone of safe transport practice.
Option B, "Electronically log and send via overnight delivery," is a useful administrative and logistical step to track shipments and ensure timely delivery, but it is not the essential element. While documentation and rapid delivery are important for maintaining chain of custody and sample integrity, they are secondary to the physical containment provided by triple packaging. Option C, "Transport by an authorized biohazard transporter," is a necessary step to comply with regulations, as only trained and certified transporters can handle biohazardous materials. However, this is contingent on proper packaging; without triple containment, transport authorization alone is insufficient. Option D, "Store in a cooler that is labeled as a health hazard," may be part of preparation (e.g., maintaining sample temperature), but labeling alone does not address the containment or transport safety required during shipment. Coolers are often used, but the focus on labeling as a health hazard is incomplete without the triple-containment structure.
The CBIC Practice Analysis (2022) supports compliance with federal and international shipping regulations, which prioritize triple-containment packaging as the foundational practice to mitigate risks. The CDC’s Biosafety in Microbiological and Biomedical Laboratories (BMBL, 6th Edition, 2020) and IATA guidelines further specify that triple packaging is mandatory for all biohazardous shipments, reinforcing Option A as the correct answer.
Infection Prevention and Control identified a cluster of Aspergillus fumigatus infections in the transplant unit. The infection preventionist (IP) meets with the unit director and Environmental Services director to begin investigation. What information does the IP need from the Environmental Services director?
Date of last terminal clean of the infected patient rooms
Hospital grade disinfectant used on the transplant unit
Use of dust mitigating strategies during floor care
Date of the last cleaning of the fish tank in the waiting room
The Answer Is:
AExplanation:
The correct answer is A, "Date of last terminal clean of the infected patient rooms," as this is the most critical information the infection preventionist (IP) needs from the Environmental Services director to begin the investigation of a cluster of Aspergillus fumigatus infections in the transplant unit. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, Aspergillus fumigatus is an environmental fungus that thrives in areas with poor ventilation, construction dust, or inadequate cleaning, posing a significant risk to immunocompromised patients, such as those in transplant units. A terminal clean—thorough disinfection and cleaning of a patient room after discharge or transfer—is a key infection control measure to eliminate fungal spores and other pathogens (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.4 - Implement environmental cleaning and disinfection protocols). Determining the date of the last terminal clean helps the IP assess whether lapses in cleaning schedules or procedures could have contributed to the cluster, guiding further environmental sampling or process improvements.
Option B (hospital grade disinfectant used on the transplant unit) is relevant to the investigation but is secondary; the IP would need to know the cleaning schedule first to contextualize the disinfectant’s effectiveness. Option C (use of dust mitigating strategies during floor care) is important, as Aspergillus spores can be aerosolized during floor maintenance, but this is a specific procedural detail that follows the initial focus on cleaning history. Option D (date of the last cleaning of the fish tank in the waiting room) is unlikely to be a priority unless evidence suggests a direct link to the transplant unit, which is not indicated here; Aspergillus is more commonly associated with air quality and room cleaning rather than fish tanks.
The focus on the date of the last terminal clean aligns with CBIC’s emphasis on investigating environmental factors in healthcare-associated infection (HAI) clusters, enabling the IP to collaborate with Environmental Services to pinpoint potential sources and implement corrective actions (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.2 - Analyze surveillance data). This step is foundational to controlling the outbreak and protecting vulnerable patients.
Which of the following is NOT valuable when using a graph to display data?
Title with topic of data
Facility and time frame for data
Published trends for data comparison
X and Y axes labels and annotation where indicated
The Answer Is:
CExplanation:
The Certification Study Guide (6th edition) explains that graphs are most effective when they clearly communicate who, what, when, and how regarding the data being presented. Essential elements include a descriptive title, identification of the facility and time frame, and properly labeled X and Y axes with annotations as needed. These components ensure that the viewer can accurately interpret the data without additional explanation.
Published trends for data comparison, while potentially useful in separate analyses or reports, are not required elements of an individual graph and do not inherently improve the clarity of data display. Including external published trends can actually confuse interpretation if definitions, populations, or surveillance methodologies differ from the local data being presented. The study guide cautions against mixing datasets with different assumptions or collection methods in a single visual display unless clearly contextualized.
Titles clarify the subject of the graph, facility and time frame provide essential context, and axis labels ensure the viewer understands what is being measured. These are foundational principles of data visualization emphasized in infection prevention reporting and communication.
CIC exam questions frequently test the ability to distinguish between essential graph components and supplementary analytical tools. Recognizing that published comparison trends are not required—and may be misleading—reinforces good data communication practices and supports accurate interpretation by leadership and frontline staff.
A family, including an infant of 8 months, is going on a vacation to Europe. An infection preventionist would recommend:
Exposure to rabies should be avoided.
Family members should be vaccinated for yellow fever.
The infant should not travel until at least 12 months of age.
Family immunization records should be reviewed by their provider.
The Answer Is:
DExplanation:
When advising a family, including an 8-month-old infant, planning a vacation to Europe, an infection preventionist (IP) must consider travel-related health risks and vaccination recommendations tailored to the destination and age-specific guidelines. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the "Education and Training" domain, which includes providing evidence-based advice to prevent infections, aligning with the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) travel health recommendations.
Option D, "Family immunization records should be reviewed by their provider," is the most appropriate recommendation. Europe, as a region, includes countries with varying health risks, but it is generally considered a low-risk area for many vaccine-preventable diseases compared to tropical regions. The CDC’s "Travelers’ Health" guidelines (2023) recommend that all travelers, including infants, have their immunization status reviewed by a healthcare provider prior to travel to ensure compliance with routine vaccinations (e.g., measles, mumps, rubella [MMR], diphtheria, tetanus, pertussis [DTaP], and polio) and to assess any destination-specific needs. For an 8-month-old, the review would confirm that the infant has received age-appropriate vaccines (e.g., the first doses of DTaP, Hib, PCV, and IPV, typically starting at 2 months) and is on schedule for the 6- and 12-month doses. This step ensures the family’s overall protection and identifies any gaps, making it a proactive and universally applicable recommendation.
Option A, "Exposure to rabies should be avoided," is a general travel safety tip applicable to any destination where rabies is endemic (e.g., parts of Eastern Europe or rural areas with wildlife). However, rabies risk in most European countries is low, and pre-exposure vaccination is not routinely recommended for travelers unless specific high-risk activities (e.g., handling bats) are planned. The CDC advises avoiding animal bites rather than vaccinating unless indicated, making this less specific and urgent than a records review. Option B, "Family members should be vaccinated for yellow fever," is incorrect. Yellow fever is not endemic in Europe, and vaccination is not required or recommended for travel to any European country. The WHO International Health Regulations (2005) and CDC list yellow fever vaccination as mandatory only for travelers from or to certain African and South American regions, rendering this irrelevant. Option C, "The infant should not travel until at least 12 months of age," lacks a clear evidence base. While some vaccines (e.g., MMR) are typically given at 12 months, the 8-month-old can travel safely if up-to-date on age-appropriate immunizations. The CDC allows travel for infants as young as 6 weeks with medical clearance, and delaying travel to 12 months is not a standard recommendation unless specific risks (e.g., disease outbreaks) are present, which are not indicated here.
The CBIC Practice Analysis (2022) and CDC Travelers’ Health resources prioritize pre-travel health assessments, including immunization reviews, as the foundation for safe travel. Option D ensures a comprehensive approach tailored to the family’s needs, making it the best recommendation for a trip to Europe.
During an outbreak of ventilator-associated pneumonia (VAP), the infection preventionist should FIRST:
Review adherence to ventilator bundle elements.
Implement preemptive antibiotic therapy in all ventilated patients.
Isolate all ventilated patients in negative pressure rooms.
Perform bacterial cultures from ventilator circuits.
The Answer Is:
AExplanation:
Reviewing compliance with VAP prevention bundles (e.g., head-of-bed elevation, oral care, sedation breaks) is the first step in outbreak control.
Preemptive antibiotics (B) are not recommended due to antibiotic resistance risks.
Negative pressure rooms (C) are not required for VAP.
Ventilator circuit cultures (D) do not guide patient management.
CBIC Infection Control References:
APIC Text, "VAP Prevention Measures," Chapter 11.
Steam sterilization should be validated with which of the following organisms?
Geobacillus stearothermophilus
Staphylococcus aureus
Bacillus anthracis
Bacillus atrophaeus
The Answer Is:
AExplanation:
The CBIC Certified Infection Control Exam Study Guide (6th edition) clearly states that steam sterilization (moist heat sterilization) must be validated using biological indicators containing Geobacillus stearothermophilus spores. This organism is selected because its spores are highly resistant to moist heat, making them an ideal challenge organism for assessing the effectiveness of steam sterilization processes.
Biological indicators are used to confirm that sterilization conditions—such as temperature, pressure, and exposure time—are sufficient to achieve microbial inactivation. Geobacillus stearothermophilus thrives at high temperatures and demonstrates strong resistance to steam, so if these spores are destroyed, it provides high confidence that other less-resistant microorganisms, including bacteria, viruses, and fungi, have also been eliminated.
The other options are incorrect for steam sterilization validation. Staphylococcus aureus is a vegetative bacterium and is far less resistant than bacterial spores. Bacillus anthracis is not used as a biological indicator due to safety concerns and lack of standardization. Bacillus atrophaeus is used as the biological indicator for dry heat and ethylene oxide sterilization, not steam.
Understanding which biological indicators correspond to specific sterilization modalities is a high-yield topic on the CIC® exam and is essential for ensuring compliance with evidence-based sterilization and disinfection standards.
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A patient who is pregnant has multidrug-resistant tuberculosis. She presents to the hospital for delivery. She continues to have a productive cough and has sputum smears positive for acid-fast bacilli (AFB), despite treatment. An infection preventionist should recommend which of the following?
Immediately separate the infant from the mother at delivery and place the infant in Airborne Precautions until discharge.
The infant should “room in” with the mother and the mother should wear a mask at all times.
The infant may go from Airborne Precautions in the nursery to the mother’s room, as long as the mother wears a mask when the infant is in the room.
No isolation is required for the infant; however, the mother should be placed in Airborne Precautions.
The Answer Is:
CExplanation:
The CBIC Certified Infection Control Exam Study Guide (6th edition) addresses management of tuberculosis (TB) in the peripartum setting, emphasizing protection of the neonate while supporting maternal–infant bonding when safely possible. In this scenario, the mother has active, infectious multidrug-resistant TB, as evidenced by persistent productive cough and positive AFB smears, and therefore requires Airborne Precautions.
Newborns are at high risk for TB infection due to immature immune systems; however, complete and prolonged separation is not always required. The recommended approach is to initially place the infant in Airborne Precautions in the nursery and allow limited, controlled contact with the mother once appropriate safeguards are in place. When the infant is brought to the mother’s room, the mother must wear a surgical mask to reduce droplet nuclei exposure, and exposure time should be minimized.
Option A is overly restrictive and not required unless safe controls cannot be maintained. Option B is incorrect because unrestricted rooming-in places the infant at unacceptable risk. Option D is incorrect because the infant does require protection when the mother is infectious.
For the CIC® exam, it is critical to recognize that TB management balances infection prevention with family-centered care. Controlled infant exposure with maternal masking is the recommended practice when mothers remain infectious at delivery.
What inflammatory reaction may occur in the eye after cataract surgery due to a breach in disinfection and sterilization of intraocular surgical instruments?
Endophthalmitis
Bacterial conjunctivitis
Toxic Anterior Segment Syndrome
Toxic Posterior Segment Syndrome
The Answer Is:
CExplanation:
The correct answer is C, "Toxic Anterior Segment Syndrome," as this is the inflammatory reaction that may occur in the eye after cataract surgery due to a breach in disinfection and sterilization of intraocular surgical instruments. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, Toxic Anterior Segment Syndrome (TASS) is a sterile, acute inflammatory reaction that can result from contaminants introduced during intraocular surgery, such as endotoxins, residues from improper cleaning, or chemical agents left on surgical instruments due to inadequate disinfection or sterilization processes (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). TASS typically presents within 12-48 hours post-surgery with symptoms like pain, redness, and anterior chamber inflammation, and it is distinct from infectious causes because it is not microbial in origin. A breach in reprocessing protocols, such as failure to remove detergents or improper sterilization, is a known risk factor, making it highly relevant to infection prevention efforts in surgical settings.
Option A (endophthalmitis) is an infectious inflammation of the internal eye structures, often caused by bacterial or fungal contamination, which can also result from poor sterilization but is distinguished from TASS by its infectious nature and longer onset (days to weeks). Option B (bacterial conjunctivitis) affects the conjunctiva and is typically a surface infection unrelated to intraocular surgery or sterilization breaches of surgical instruments. Option D (toxic posterior segment syndrome) is not a recognized clinical entity in the context of cataract surgery; inflammation in the posterior segment is more commonly associated with infectious endophthalmitis or other conditions, not specifically linked to reprocessing failures.
The focus on TASS aligns with CBIC’s emphasis on ensuring safe reprocessing to prevent adverse outcomes in surgical patients, highlighting the need for rigorous infection control measures (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.5 - Evaluate the environment for infection risks). This is supported by CDC and American Academy of Ophthalmology guidelines, which identify TASS as a preventable complication linked to reprocessing errors (CDC Guidelines for Disinfection and Sterilization, 2019; AAO TASS Task Force Report, 2017).
The Infection Control Department is notified of possible contamination of one lot of dressings. Which of the following actions should be taken?
Instruct the Purchasing Department to remove the manufacturer’s dressings and similar dressings from the hospital.
Notify discharged patients on whom the dressings were used to be alert for signs of infection.
Identify where the implicated dressings are in the hospital so that they can be returned to the manufacturer.
Arrange to purchase new dressings from a different manufacturer.
The Answer Is:
CExplanation:
The Certification Study Guide (6th edition) emphasizes that when a specific product lot is suspected or confirmed to be contaminated, the first priority is containment and traceability. The infection preventionist must promptly identify where the implicated lot is located within the facility so it can be removed from use, quarantined, and managed according to recall or manufacturer instructions. This step prevents further patient exposure and preserves the ability to conduct an accurate risk assessment.
Locating the affected dressings allows the facility to determine how widely the product has been distributed, whether it is still in use, and which clinical areas may be affected. This information is essential before taking additional actions such as patient notification or broad product removal. The study guide stresses that responses must be proportionate and evidence-based, avoiding unnecessary disruption or alarm.
The other options represent actions that may be considered later, depending on findings. Removing all dressings from the same manufacturer is overly broad when only one lot is implicated. Notifying discharged patients is premature unless patient exposure and risk have been confirmed. Purchasing from a different manufacturer does not address the immediate need to control and investigate the current issue.
CIC exam questions often focus on sequencing of actions during product contamination events. Correctly identifying and isolating the affected product lot is the foundational step that enables safe, effective follow-up and regulatory compliance.