1. APIC Greater NY Chapter 13 Q & A
Faith Skeete RN MSN CIC FAPIC
September 19, 2019
Lenox Hill Hospital

2. Question 1
All of the following are true and should be communicated to staff before administering influenza vaccination except: a. The vaccine is formulated annually to protect against the flu strains most likely to circulate in the US during the upcoming flu season. b. Inactivated flu vaccine contains non-infectious viral components and thus cannot cause influenza disease. c. People who received specific antivirals (e.g., acyclovir, famcyclovir, or valacyclovir) within the preceding 24 hours should not receive an influenza vaccine. d. Fever, malaise, myalgia, and other systemic symptoms can occur after getting a flu shot.
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3. Answer 1
All of the following are true and should be communicated to staff before administering influenza vaccination except: a. The vaccine is formulated annually to protect against the flu strains most likely to circulate in the US during the upcoming flu season. b. Inactivated flu vaccine contains no-infectious viral components and thus cannot cause influenza disease. c. People who received specific antivirals (e.g., acyclovir, famcyclovir, or valacyclovir) within the preceding 24 hours should not receive an influenza vaccine. d. Fever, malaise, myalgia, and other systemic symptoms can occur after getting a flu shot. Antiviral medications may be taken concurrently with inactivated vaccines like the Influenza vaccine.
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4. Question 2
Which of the following sites for central lines has been associated with a higher risk of central line-associated bloodstream infection (CLABSI)? a. Hepatic b. Femoral c. Subclavian (SC) d. Internal Jugular (IJ)
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5. Answer 2
Which of the following sites for central lines has been associated with a higher risk of central line-associated bloodstream infection (CLABSI)? a. Hepatic b. Femoral c. Subclavian (SC) d. Internal Jugular (IJ) The subclavian site has been associated with the lowest risk of CLABSI due to a decreased risk of site contamination from oral secretions in mechanically ventilated patients and being easier to maintain a clean and intact dressing.
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6. Question 3
The IP is doing a site visit at an ambulatory clinic. In reviewing the practice of safe injections, what should the IP recommend? i. Use single-dose medication vials whenever possible and avoid using multi-dose vials. ii. Use needles and syringes for only one patient. iii. If a multi-dose vial must be used, the medication should be prepared in a place away from the bedside. iv. Enter the medication vial with the same needle and syringe if drawing up additional medication for the same patient getting additional medication. a. All of the above. b. ii and iii c. i only d. i, ii, and iii
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7. Answer 3
The IP is doing a site visit at an ambulatory clinic. In reviewing the practice of safe injections, what should the IP recommend? i. Use single-dose medication vials whenever possible and avoid using multi-dose vials. ii. Use needles and syringes for only one patient. iii. If a multi-dose vial must be used, the medication should be prepared in a place away from the bedside. iv. Enter the medication vial with the same needle and syringe if drawing up additional medication for the same patient getting additional medication. a. All of the above. b. ii and iii c. i only d. i, ii, and iii Option iv is unsafe. The others are considered safe and appropriate to reduce the risk of disease transmission.
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8. Question 4
For which type of precautions must the patient be a private room? a. Airborne b. Droplet c. Contact d. Contact-Droplet (combined, eg., for pediatrics)
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9. Answer 4
For which type of precautions must the patient be a private room? a. Airborne b. Droplet c. Contact d. Contact-Droplet (combined, eg., for pediatrics) Patients on Droplet and Contact Precautions can (according to policy) be in a shared room. Airborne Precautions, however, requires one patient to a room only.
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10. Question 5
You have an apparent clustering of C. difficile infections on one inpatient unit. In evaluating the cleaning of the environment, which is the best practice to minimize the risk of spreading C. difficile to more patients? a. Make sure Environmental Services is mixing the quaternary ammonium cleaning agent properly before use (not over-diluting it). b. Make sure Environmental Services staff are changing gloves between cleaning the patient bathroom and the patient room. c. Make sure Environmental Services is using a bleach or other sporicidal product to clean the rooms that had a C. difficile patient in them. d. Make sure Environmental Services staff is cleaning frequently touched surfaces daily.
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11. Answer 5
You have an apparent clustering of C. difficile infections on one inpatient unit. In evaluating the cleaning of the environment, which is the best practice to minimize the risk of spreading C. difficile to more patients? a. Make sure Environmental Services is mixing the quaternary ammonium cleaning agent properly before use (not over-diluting it). b. Make sure Environmental Services staff are changing gloves between cleaning the patient bathroom and the patient room. c. Make sure Environmental Services is using a bleach or other sporicidal product to clean the rooms that had a C. difficile patient in them. d. Make sure Environmental Services staff is cleaning frequently touched surfaces daily. All of these are good recommendations but choice C is the most important. Quats (in choice a) are not recommended for use in these rooms because they are not usually sporicidal.
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12. Question 6
Which of the following devices should get cleaned with low level cleaning, when considering the Spaulding Criteria (critical devices, semi-critical devices, and non-critical devices) a. Bronchoscopes b. Surgical instruments c. Trans-vaginal ultrasound probes used in an outpatient clinic d. Stethoscopes
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13. Answer 6
Which of the following devices should get cleaned with low level cleaning, when considering the Spaulding Criteria (critical devices, semi-critical devices, and non-critical devices) a. Bronchoscopes b. Surgical instruments c. Trans-vaginal ultrasound probes used in an outpatient clinic d. Stethoscopes Non-critical devices such as stethoscopes only need low-level cleaning. All of the other choices require high level disinfection (HLD) or sterilization, regardless of the work location (inpatient or outpatient sites).
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14. Congratulations! Thank you very much!
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