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CBIC Certified Infection Control Exam CIC Prüfungsfragen mit Lösungen (Q217-Q222):
217. Frage
Following an outbreak of Hepatitis A, the water supply is sampled. A high count of which of the following isolates would indicate that the water was a potential source?
Antwort: D
Begründung:
Coliform bacteria are indicators of fecal contamination in water, making them a critical measure of water safety. Hepatitis A is a virus primarily transmitted via the fecal-oral route, often through contaminated food or water.
Step-by-Step Justification:
* Fecal Contamination and Hepatitis A:
* Hepatitis A virus (HAV) spreads through ingestion of water contaminated with fecal matter. High coliform counts indicate fecal contamination and increase the risk of HAV outbreaks.
* Use of Coliforms as Indicators:
* Public health agencies use total coliforms and Escherichia coli (E. coli) as primary indicators of water safety because they signal fecal pollution.
* Waterborne Transmission of Hepatitis A:
* Hepatitis A outbreaks have been traced to contaminated drinking water, ice, and improperly treated wastewater. Coliform detection signals a need for immediate action.
Why Other Options Are Incorrect:
* B. Pseudomonads:
* Pseudomonads (e.g., Pseudomonas aeruginosa) are environmental bacteria but are not indicators of fecal contamination.
* C. Legionella:
* Legionella species cause Legionnaires' disease through inhalation of contaminated aerosols, not through fecal-oral transmission.
* D. Acinetobacter:
* Acinetobacter species are opportunistic pathogens in healthcare settings but are not indicators of waterborne fecal contamination.
CBIC Infection Control References:
* APIC Text, "Water Systems and Infection Control Measures".
* APIC Text, "Hepatitis A Transmission and Waterborne Outbreaks".
218. Frage
An infection preventionist receives a call from a healthcare personnel (HCP) who is in the first trimester of pregnancy and has cared for a patient with cytomegalovirus (CMV) pneumonitis. Which of the following actions is MOST appropriate?
Antwort: A
Begründung:
The CBIC Certified Infection Control Exam Study Guide (6th edition) states that cytomegalovirus (CMV) is a common virus transmitted through direct contact with body fluids, including saliva, urine, blood, and respiratory secretions. In healthcare settings, Standard Precautions are sufficient to prevent CMV transmission, even for pregnant healthcare personnel.
Importantly, routine reassignment, work restriction, or removal from patient care is not recommended for pregnant HCP caring for patients with CMV, including those in the first trimester. The Study Guide emphasizes that the most effective preventive measure is strict adherence to Standard Precautions, particularly hand hygiene and appropriate use of personal protective equipment when contact with body fluids is anticipated. These measures have been shown to significantly reduce the risk of CMV acquisition.
Option A is incorrect because there is no indication for immediate post-exposure evaluation in the absence of a recognized exposure such as a needlestick or mucous membrane contact. Option B is not supported by evidence or guidelines and may contribute to unnecessary workforce restrictions. Option D is insufficient and misleading, as CMV is not transmitted via the airborne route and masking alone does not address the primary transmission risks.
For CIC exam preparation, it is critical to recognize that education and reinforcement of Standard Precautions-not work exclusion-are the cornerstone of CMV prevention for pregnant healthcare workers.
219. Frage
Which event increases a susceptible person's probability of an infection after an exposure?
Antwort: C
Begründung:
The Certification Study Guide (6th edition) explains that the probability of infection after an exposure is influenced by several factors, including the dose of the infectious agent, the route of exposure, and host susceptibility. Among the options provided, an unknown concentration of infectious virions introduced via a needlestick injury represents the greatest increase in infection risk.
Percutaneous injuries, such as needlesticks, provide direct access to the bloodstream, bypassing natural protective barriers like intact skin. The study guide emphasizes that when the inoculum (number of organisms) is unknown, particularly in bloodborne exposures, the risk of transmission for pathogens such as hepatitis B virus, hepatitis C virus, and human immunodeficiency virus is significantly higher. This uncertainty necessitates immediate evaluation and consideration of post-exposure prophylaxis.
The other options describe situations with lower or reduced risk. Prior immunization for hepatitis B is protective and therefore decreases susceptibility. Exposure of clothing alone does not constitute a significant transmission route unless there is penetration to skin or mucous membranes. Blood splashes onto intact skin are considered low-risk because intact skin acts as an effective barrier against infection.
CIC exam questions frequently test understanding of exposure routes and inoculum size. Recognizing that percutaneous exposure with an unknown infectious dose poses the highest risk is essential for accurate risk assessment and appropriate occupational health response.
Reference: Certification Study Guide (CBIC/CIC Exam Study Guide), 6th edition, Chapter 6: Employee
/Occupational Health; Chapter 3: Identification of Infectious Disease Processes.
220. Frage
A review of bronchoscopy specimens indicates an unusual number of Mycobacterium fortuitum-positive cultures. Which of the following observations would be the MOST likely cause of this finding?
Antwort: C
Begründung:
The CBIC Certified Infection Control Exam Study Guide (6th edition) identifies nontuberculous mycobacteria (NTM), including Mycobacterium fortuitum, as organisms commonly associated with water sources, particularly potable water systems. An unusual increase in M. fortuitum-positive bronchoscopy cultures is most often linked to waterborne contamination during endoscope reprocessing, making rinsing with tap water the most likely cause.
Tap water is not sterile and may harbor NTM, which are resistant to standard municipal water treatment and capable of forming biofilms within plumbing systems. If bronchoscopes are rinsed with tap water after high- level disinfection and not followed by appropriate sterile or filtered water rinses and thorough drying, organisms such as M. fortuitum may contaminate internal channels. This can lead to pseudo-outbreaks, where cultures are positive due to contamination rather than true patient infection.
Option B, inadequate cleaning prior to disinfection, can contribute to overall reprocessing failure but is less specifically associated with NTM contamination patterns. Option A is unlikely, as sporicidal solutions are effective disinfectants. Option D, drying with air or alcohol, is a recommended step to reduce microbial growth and would not cause contamination.
For CIC exam preparation, recognizing that tap water exposure during endoscope reprocessing is a classic source of nontuberculous mycobacteria contamination is a key concept in outbreak investigation and device reprocessing surveillance.
221. Frage
In order to ensure accurate calculation of central line days, which of the following is TRUE?
Antwort: D
Begründung:
The CBIC Certified Infection Control Exam Study Guide (6th edition) follows the standardized surveillance methodology used for calculating central line days, which is essential for accurate reporting of central line- associated bloodstream infection (CLABSI) rates. A central line day is counted for each patient who has one or more central lines in place at the time of the daily count, regardless of the number of central lines present.
Therefore, if a patient has more than one central line, the patient is still counted as one central line day, making option C the correct statement. This approach ensures consistency and comparability of CLABSI rates across units and facilities.
Option A is incorrect because tunneled central venous catheters and implanted ports are included in central line counts if they meet the definition of a central line. Option B is incorrect because a central line is counted on any day it is present, even if it has been in place for less than 24 hours. Option D is incorrect because peripheral intravenous lines are not central lines and must never be included in central line day counts.
Accurate calculation of device days is a foundational surveillance competency for infection preventionists.
Understanding these definitions is critical for valid CLABSI rate calculation, benchmarking, and performance improvement and is a frequently tested concept on the CIC exam.
222. Frage
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