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NEW QUESTION # 61
A 2-yoar-old girl is admitted with a fractured tibia. At birth, she was diagnosed with congenital cytomegalovirus (CMV). Which of the following barrier precautions is appropriate for healthcare personnel caring for her?
Answer: C
Explanation:
Standard Precautions are sufficient for congenital cytomegalovirus (CMV), which means that gloves should be used when handling body fluids. CMV is primarily transmitted via direct contact with saliva, urine, or blood.
Why the Other Options Are Incorrect?
* A. Wear masks and gloves - Masks are not necessary unless performing high-risk aerosol- generating procedures.
* C. No barrier precautions are needed - Gloves are required when handling bodily fluids to prevent transmission.
* D. Use gowns, masks, gloves, and a private room - CMV does not require Contact or Airborne Precautions.
CBIC Infection Control Reference
APIC guidelines state that CMV transmission is prevented using Standard Precautions, primarily with glove use for body fluid contact.
NEW QUESTION # 62
A suspected measles case has been identified in an outpatient clinic without an airborne infection isolation room (AIIR). Which of the following is the BEST course of action?
Answer: A
Explanation:
Measles is a highly contagious airborne disease, and the best immediate action in an outpatient clinic without an Airborne Infection Isolation Room (AIIR) is to mask the patient and isolate them in a private room with the door closed.
Why the Other Options Are Incorrect?
* A. Patient should be sent home - While home isolation may be necessary, sending the patient home without proper precautions increases exposure risk.
* B. Staff should don a respirator, gown, and face shield - While N95 respirators are necessary for staff, this does not address patient containment.
* C. Patient should be offered the MMR vaccine - The vaccine does not treat active measles infection and should be given only as post-exposure prophylaxis to susceptible contacts.
CBIC Infection Control Reference
Measles cases in outpatient settings require immediate airborne precautions to prevent transmission.
NEW QUESTION # 63
A 36-year-old female presents to the Emergency Department with a petechial rash, meningitis, and cardiac arrest. During the resuscitation, a phlebotomist sustained a needlestick injury. The next day, blood cultures reveal Neisseria meningitidis. The exposure management for the phlebotomist is:
Answer: C
Explanation:
The scenario involves a needlestick injury sustained by a phlebotomist during the resuscitation of a patient diagnosed with Neisseria meningitidis infection, characterized by a petechial rash, meningitis, and cardiac arrest. Neisseria meningitidis is a gram-negative diplococcus that can cause meningococcal disease, including meningitis and septicemia, and is transmitted through direct contact with respiratory secretions or, in rare cases, blood exposure. The exposure management for the phlebotomist must align with infection control guidelines, such as those from the Certification Board of Infection Control and Epidemiology (CBIC) and the CDC, to prevent potential infection. Let's evaluate each option:
* A. Prophylactic rifampin plus isoniazid: Prophylactic antibiotics are recommended for close contacts of individuals with meningococcal disease to prevent secondary cases. Rifampin is a standard prophylactic agent for Neisseria meningitidis exposure, typically administered as a 2-day course (e.g., 600 mg every
12 hours for adults). Isoniazid, however, is used for tuberculosis (TB) prophylaxis and is not indicated for meningococcal disease. Combining rifampin with isoniazid is incorrect, as it reflects a confusion with TB management rather than meningococcal exposure. This option is not appropriate.
* B. A tuberculin skin test now and in ten weeks: A tuberculin skin test (TST) or interferon-gamma release assay (IGRA) is used to screen for latent tuberculosis infection, with a follow-up test at 8-10 weeks to detect conversion after potential TB exposure. Neisseria meningitidis is not related to TB, and a needlestick injury from a meningococcal patient does not warrant TB testing. This option is irrelevant to the scenario and not the correct exposure management.
* C. Work furlough from day ten to day 21 after exposure: Neisseria meningitidis has an incubation period of 2-10 days, with a maximum of about 14 days in rare cases. The CDC and WHO recommend that healthcare workers exposed to meningococcal disease via needlestick or mucosal exposure be monitored for signs of infection (e.g., fever, rash) and, if symptomatic, isolated and treated.
Additionally, a work restriction or furlough from day 10 to day 21 after exposure is advised to cover the potential incubation period, especially if prophylaxis is declined or contraindicated. This allows time to observe for symptoms and prevents transmission to vulnerable patients. This is a standard infection control measure and the most appropriate initial management step pending prophylaxis decision.
* D. A review of the phlebotomist's hepatitis B vaccine status: Reviewing hepatitis B vaccine status is a critical step following a needlestick injury, as hepatitis B can be transmitted through blood exposure.
However, this applies to bloodborne pathogens (e.g., HBV, HCV, HIV) and is not specific to Neisseria meningitidis, which is primarily a respiratory or mucosal pathogen. While hepatitis B management (e.
g., post-exposure prophylaxis with hepatitis B immunoglobulin or vaccine booster) should be addressed as part of a comprehensive needlestick protocol, it is not the first or most relevant priority for meningococcal exposure.
The best answer is C, as the work furlough from day 10 to day 21 after exposure addresses the specific risk of meningococcal disease following a needlestick injury. This aligns with CBIC's focus on timely intervention and work restriction to prevent transmission in healthcare settings. Prophylactic antibiotics (e.g., rifampin) should also be considered, but the question asks for the exposure management, and furlough is a primary control measure. Hepatitis B and TB considerations are secondary and managed separately.
References:
* CBIC Infection Prevention and Control (IPC) Core Competency Model (updated 2023), Domain III:
Prevention and Control of Infectious Diseases, which includes protocols for managing exposure to communicable diseases like meningococcal infection.
* CBIC Examination Content Outline, Domain IV: Environment of Care, which addresses work restrictions and exposure management.
* CDC Guidelines for Meningococcal Disease Prevention and Control (2023), which recommend work furlough and monitoring for exposed healthcare workers.
NEW QUESTION # 64
Which of the following processes is MOST important for the infection preventionist (IP) to review when evaluating a third-party reprocessor for single-use devices?
Answer: D
Explanation:
The correct answer is A, "Observe all steps for reprocessing," as this is the most important process for the infection preventionist (IP) to review when evaluating a third-party reprocessor for single-use devices.
According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, the reprocessing of single-use devices (SUDs) by third-party entities must adhere to stringent infection control standards to ensure they are safe for reuse and do not contribute to healthcare-associated infections (HAIs).
Observing all steps-such as cleaning, disinfection, sterilization, packaging, and quality control-allows the IP to directly assess compliance with manufacturer instructions, regulatory requirements (e.g., FDA guidelines), and best practices (e.g., AAMI ST91) (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). This hands-on evaluation is critical because any deviation in the reprocessing chain can compromise device sterility and patient safety.
Option B (review the facility's blueprints and policies) provides context about the physical layout and procedural framework, but it is a preliminary step that does not directly verify the reprocessing process's effectiveness. Option C (ensure air and water cultures are performed regularly) is important for monitoring environmental contamination risks, particularly in sterile processing areas, but it is a supportive measure rather than the primary focus of evaluating the reprocessor's core activities. Option D (obtain feedback from other IPs who use the reprocessor) offers valuable peer insights, but it is subjective and secondary to direct observation, which provides firsthand evidence of compliance and performance.
The priority on observing reprocessing steps aligns with CBIC's emphasis on ensuring the safety and efficacy of reprocessed medical devices, a key responsibility for IPs when outsourcing to third-party reprocessors (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.5 - Evaluate the environment for infection risks). This process enables the IP to identify specific weaknesses, validate adherence to standards, and make informed decisions about the reprocessor's suitability.
References: CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competencies 3.3 - Ensure safe reprocessing of medical equipment, 3.5 - Evaluate the environment for infection risks. AAMI ST91:2015, Flexible and semi-rigid endoscope processing in health care facilities.
NEW QUESTION # 65
An infection preventionist is reviewing practices in a facility's food preparation department. Which of the following practices should be revised?
Answer: A
Explanation:
Thawing raw meat at room temperature is a major food safety violation because it allows bacteria to multiply rapidly within the temperature danger zone (40-140°F or 4.4-60°C). Meat should always be thawed in the refrigerator, under cold running water, or in a microwave if cooked immediately.
Why the Other Options Are Incorrect?
* B. Using a cutting board to cut vegetables - This is safe as long as proper cleaning and sanitation procedures are followed.
* C. Maintaining hot food at 145°F (62.7°C) during serving - 145°F is an acceptable minimum temperature for certain meats like beef, fish, and pork.
* D. Discarding most perishable food within 72 hours - Many perishable foods, especially leftovers, should be discarded within 3 days, making this an appropriate practice.
CBIC Infection Control Reference
The APIC guidelines emphasize that raw meat should never be thawed at room temperature due to the risk of bacterial growth and foodborne illness.
NEW QUESTION # 66
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