CIC Exam Dumps - CBIC Infection Control Questions and Answers

For Sarcoptes scabiei (scabies), Contact Precautions should remain in place until 24 hours after effective treatment has been completed. The first-line treatment is 5% permethrin cream, which is applied to the entire body and left on for 8–14 hours before being washed off.

Why the Other Options Are Incorrect?

A. When the treatment cream is applied – The mite is still present and infectious until treatment has fully taken effect.

B. When the bed linen is changed – While changing linens is necessary, it does not indicate that the infestation has cleared.

D. 24 hours after the second treatment – Most cases require only one treatment with permethrin, though severe cases may need a second dose after a week.

CBIC Infection Control Reference

According to APIC guidelines, Contact Precautions can be discontinued 24 hours after effective treatment has been administered​.

When an outbreak of infectious disease is suspected, the first step is to conduct an epidemiologic investigation. This begins with characterizing the outbreak by person, place, and time to establish patterns and trends. This approach, known as descriptive epidemiology, provides critical insights into potential sources and transmission patterns.

Step-by-Step Justification:

Identify Cases and Patterns:

The infection preventionist should analyze patient demographics (person), locations of cases (place), and onset of symptoms (time). This helps in defining the outbreak scope and potential exposure sources​.

Create an Epidemic Curve:

An epidemic curve helps determine whether the outbreak is a point-source or propagated event. This can indicate whether the infection is spreading person-to-person or originating from a common source​.

Compare with Baseline Data:

Reviewing historical data ensures that the observed cases exceed the expected norm, confirming an outbreak​.

Guide Further Investigation:

Establishing basic epidemiologic patterns guides subsequent actions, such as laboratory testing, environmental sampling, and surveillance​.

Why Other Options Are Incorrect:

B. Increase surveillance facility-wide for additional cases:

While enhanced surveillance is important, it should follow the initial characterization of the outbreak. Surveillance without a defined case profile may lead to misclassification and misinterpretation​.

C. Contact the laboratory to confirm stool identification results:

Confirming lab results is essential but comes after defining the outbreak's characteristics. Without an epidemiologic link, testing may yield results that are difficult to interpret​.

D. Form a tentative hypothesis about the potential reservoir for this outbreak:

Hypothesis generation occurs after sufficient epidemiologic data have been collected. Jumping to conclusions without characterization may result in incorrect assumptions and ineffective control measures​.

CBIC Infection Control References:

APIC Text, "Outbreak Investigations," Epidemiology, Surveillance, Performance, and Patient Safety Measures​.

APIC/JCR Infection Prevention and Control Workbook, Chapter 4, Surveillance Program​.

APIC Text, "Investigating Infectious Disease Outbreaks," Guidelines for Epidemic Curve Analysis​.

The human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) are both bloodborne pathogens that pose significant risks in healthcare settings, and understanding their similarities is crucial for infection prevention and control. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the importance of recognizing transmission modes and implementing appropriate precautions in the "Prevention and Control of Infectious Diseases" domain, aligning with guidelines from the Centers for Disease Control and Prevention (CDC). Comparing these viruses involves evaluating their epidemiology, transmission routes, and occupational risks.

Option C, "Transmission may occur from asymptomatic carriers," is the correct answer. Both HIV and HBV can be transmitted by individuals who are infected but show no symptoms, making asymptomatic carriage a significant similarity. For HBV, chronic carriers (estimated at 257 million globally per WHO, 2019) can transmit the virus through blood, semen, or other bodily fluids without overt signs of disease. Similarly, HIV-infected individuals can remain asymptomatic for years during the latent phase, yet still transmit the virus through sexual contact, blood exposure, or perinatal transmission. The CDC’s "Guidelines for Prevention of Transmission of HIV and HBV to Healthcare Workers" (1987, updated 2011) and "Epidemiology and Prevention of Viral Hepatitis" (2018) highlight this shared characteristic, underscoring the need for universal precautions regardless of symptom status.

Option A, "The primary mechanism of transmission for both is maternal-fetal," is incorrect. While maternal-fetal transmission (perinatal transmission) is a significant route for both HIV and HBV—occurring in 5-10% of cases without intervention for HBV and 15-45% for HIV without antiretroviral therapy—it is not the primary mechanism. For HBV, the primary mode is horizontal transmission through unprotected sexual contact or percutaneous exposure (e.g., needlesticks), accounting for the majority of cases. For HIV, sexual transmission and intravenous drug use are the leading modes globally, with maternal-fetal transmission being a smaller proportion despite its importance. Option B, "Needlestick exposure leads to a high frequency of healthcare worker infection," is partially true but not a precise similarity. Needlestick exposures carry a high risk for HBV (transmission risk ~30% if the source is HBeAg-positive) and a lower risk for HIV (~0.3%), but the frequency of infection among healthcare workers is significantly higher for HBV due to its greater infectivity and stability outside the host. This makes the statement more characteristic of HBV than a shared trait. Option D, "The risk of infection from mucous membrane exposure is the same," is false. The risk of HIV transmission via mucous membrane exposure (e.g., splash to eyes or mouth) is approximately 0.09%, while for HBV it is higher (up to 1-2% depending on viral load and exposure type), reflecting HBV’s greater infectivity.

The CBIC Practice Analysis (2022) and CDC guidelines emphasize the role of asymptomatic transmission in shaping infection control strategies, such as routine testing and post-exposure prophylaxis. This shared feature of HIV and HBV justifies Option C as the most accurate similarity.

Pseudomonas spp., particularly Pseudomonas aeruginosa, is a common waterborne pathogen. Using tap water to rinse suction tubing has been associated with outbreaks of Pseudomonas infections.

From the APIC Text:

“Water bottles improperly filled with tap water and used for rinsing tracheal suction tubing resulted in an outbreak of P. cepacia... Tubing permanently attached to showers... implicated in a serious outbreak of P. aeruginosa bloodstream infection.”

The CBIC Certified Infection Control Exam Study Guide (6th edition) clearly distinguishes true infection from pseudo-infection and colonization, particularly when interpreting urine culture results. A pseudo-infection refers to a positive laboratory result that does not represent a true clinical infection and is often associated with asymptomatic bacteriuria, specimen contamination, or improper collection.

When a patient has a positive urine culture but reports no urinary or systemic symptoms, the most accurate interpretation is that the finding represents colonization or a pseudo-infection rather than a true urinary tract infection (UTI). The Study Guide emphasizes that UTIs must meet both microbiologic and clinical criteria. Symptoms such as dysuria, urinary frequency, urgency, suprapubic tenderness, flank pain, or costovertebral angle tenderness are required to support a diagnosis of infection.

Options A, C, and D all describe symptoms consistent with upper or lower urinary tract infection and therefore suggest true infection rather than pseudo-infection. In contrast, the absence of symptoms strongly supports a diagnosis of asymptomatic bacteriuria or pseudo-infection, for which antimicrobial treatment is generally not indicated, except in specific populations (e.g., pregnant patients or those undergoing urologic procedures).

Recognizing pseudo-infection is critical for antimicrobial stewardship, prevention of unnecessary antibiotic use, and accurate infection surveillance—key competencies tested on the CIC® exam.

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.

The Certification Study Guide (6th edition) identifies inadequate cleaning and reprocessing protocols as the primary factor contributing to the formation of bacteria-containing biofilms within endoscope channels. Endoscopes have long, narrow lumens and complex internal surfaces that are particularly vulnerable to biofilm formation when organic material is not thoroughly removed. Biofilms develop when microorganisms adhere to surfaces and become embedded within a protective extracellular matrix, which significantly reduces the effectiveness of disinfectants and sterilants.

The study guide emphasizes that cleaning is the most critical step in endoscope reprocessing. Failure to promptly and thoroughly clean channels—such as delayed cleaning, insufficient brushing, inadequate flushing, or improper detergent use—allows organic debris and moisture to remain, creating ideal conditions for microbial attachment and biofilm development. Once established, biofilms are difficult to eliminate and have been implicated in healthcare-associated infections linked to endoscopic procedures.

The incorrect options describe practices that do not promote biofilm formation. Enzymatic detergents, when used correctly, support removal of organic material. Chlorine-based products are not standard for endoscope channel reprocessing and are not the primary cause of biofilm development. Centralized reprocessing areas are considered best practice because they support standardized procedures, trained personnel, and quality control.

This concept is frequently tested on the CIC exam, reinforcing that breakdowns in basic cleaning and reprocessing practices pose the greatest risk for biofilm formation and patient harm.

Hand hygiene is a cornerstone of infection prevention, and declining compliance rates pose a significant risk for healthcare-associated infections (HAIs). The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes improving hand hygiene adherence in the "Prevention and Control of Infectious Diseases" domain, aligning with the Centers for Disease Control and Prevention (CDC) "Guideline for Hand Hygiene in Healthcare Settings" (2002). The IP’s survey identifies hand dryness as the primary barrier, likely due to the frequent use of alcohol-based hand sanitizers or soap, which can dehydrate skin. The goal is to address this barrier effectively while maintaining infection control standards.

Option B, "Provide a compatible lotion in a convenient location," is the most appropriate step. The CDC and World Health Organization (WHO) recommend using moisturizers to mitigate skin irritation and dryness, which can improve hand hygiene compliance. However, the lotion must be compatible with alcohol-based hand rubs (e.g., free of petroleum-based products that can reduce sanitizer efficacy) and placed in accessible areas (e.g., near sinks or sanitizer dispensers) to encourage use without disrupting workflow. The WHO’s "Guidelines on Hand Hygiene in Health Care" (2009) suggest providing skin care products as part of a multimodal strategy to enhance adherence, making this a proactive, facility-supported solution that addresses the root cause.

Option A, "Provide staff lotion in every patient room," is a good intention but impractical and potentially risky. Placing lotion in patient rooms could lead to inconsistent use, contamination (e.g., from patient contact), or misuse (e.g., staff applying incompatible products), compromising infection control. The CDC advises against uncontrolled lotion distribution in patient care areas. Option C, "Allow staff to bring in lotion and carry it in their pockets," introduces variability in product quality and compatibility. Personal lotions may contain ingredients (e.g., oils) that inactivate alcohol-based sanitizers, and pocket storage increases the risk of contamination or cross-contamination, which the CDC cautions against. Option D, "Allow staff to bring in lotion for use at the nurses’ station and lounge," limits the intervention to non-patient care areas, reducing its impact on hand hygiene during patient interactions. It also shares the compatibility and contamination risks of Option C, making it less effective.

The CBIC Practice Analysis (2022) and CDC guidelines emphasize evidence-based interventions, such as providing approved skin care products in strategic locations to boost compliance. Option B balances accessibility, safety, and compatibility, making it the best step to address hand dryness and improve hand hygiene rates.

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.

Chickenpox (varicella) is primarily spread through airborne transmission, and exposure is defined by being in the same airspace with a contagious person (from 1-2 days before rash onset until lesions are crusted), even if briefly.

The APIC Text states:

“Significant exposure is defined as being in the same room or airspace during the period of infectivity, regardless of duration”.

This reflects airborne precaution definitions and CDC exposure management guidelines for varicella.