1. CIC Practice Questions
Intermountain APIC
June 28, 2019

2. #1: Fruit fly infestation
A tech reports an infestation of fruit flies in the sterile instrument storage room. The sterile packs were temporarily removed and a pest management company was called in to eradicate the flies. The or staff wants to know whether they can use the sterile packs. Which of the following is the best response?

3. The or staff can use the packs without any reprocessing because there are no flies visible on the outside of the packs.
The or staff can use the packs without any reprocessing if they open a test pack and don’t find any flies inside of it.
The or staff don’t need to repack the items, but they do need to run the packs through the sterilizer again.
They need to completely reprocess all of the items that were in the affected room.

4. D. They need to completely reprocess all of the items that were in the affected room.
Rationale:
The presence of any type of vermin can affect the integrity of the packaging and contaminate the contents. Fruit flies are small enough to crawl into the sterile packs and potentially contaminate the instruments. They could also become trapped in the packs and leave debris on the instruments.
The instruments should be unwrapped, visually inspected, cleaned if necessary, and reprocessed.
Reference: apic text, 4th edition, chapter 106 – sterile processing

5. #2: initial outbreak investigation
The primary components of an initial outbreak investigation are: (Choose all that apply)
Preparing a line list and epidemic curve
Notifying key partners about the investigation
Continuing case finding
Initiating an analytical study

6. The primary components of an initial outbreak investigation Are:
1.) Preparing a line list and epidemic curve; 4.) initiating an analytical study
2.) Notifying key partners about the investigation; 3.) continuing case finding
1.) Preparing a line list and epidemic curve 2.) notifying key partners about the investigation
3.) Continuing case finding; 4.) initiating an analytical study

7. The primary components of an initial outbreak investigation Are:
Preparing a line list and epidemic curve; initiating an analytical study
Notifying key partners about the investigation; continuing case finding
1. )Preparing a line list and epidemic curve; 2.) notifying key partners about the investigation
Continuing case finding; initiating an analytical study

8. Rationale:
In general, outbreak investigations can be divided into two major sections: the initial investigation and the follow up investigation, each having several components.
primary components of initial investigation:
confirming the presence of the outbreak;
Alerting key partners about the investigation;
Performing a literature review;
Establishing a preliminary case definition;
developing a methodology for case finding;
preparing an initial line list and epidemic curve;
observing and reviewing potentially implicated patient care activities; and,
implementing infection control measures
Reference: apic text, 4th edition, chapter 12 – outbreak investigations

9. #3: scabies!
Contact precautions for a patient with scabies can be discontinued when the patient has received effective treatment for:
10 days
7 days
48 hours
24 hours

10. Contact precautions for a patient with scabies can be discontinued when the patient has received effective treatment for:
10 days
7 days
48 hours
24 hours

11. Rationale: for hospitalized patients, contact precautions are required for 24 hours after the start of effective treatment. 24 hours may be insufficient in cases of crusted scabies because viable mites can remain on the patient after a single treatment. For crusted (Norwegian) scabies, an alternative isolation approach is suggested in institutional outbreaks: 10-day quarantine of the index patient. Reference: scabies. In: Heymann d. control of communicable diseases manual, 19th edition, Washington, dc: American public health association, 2008; APIC text, 4th edition, chapter 99 - parasites

12. #4: relevant employee exposure
A patient was admitted to the ed with severe headache, fever, and photophobia. A staff member who cared for the patient is requesting antibiotics because the patient may have meningitis. If meningococcal meningitis is confirmed, chemoprophylaxis would be indicated for all of the following individuals except:
The LPN who did not have direct contact with the patient’s oral secretions
The EMT who performed mouth to mouth resuscitation
The resident who did not wear appropriate ppe during intubation
The RN who suctioned the patient without wearing a mask

13. A patient was admitted to the ed with severe headache, fever, and photophobia. A staff member who cared for the patient is requesting antibiotics because the patient may have meningitis. If meningococcal meningitis is confirmed, chemoprophylaxis would be indicated for all of the following individuals except:
the lpn who did not have direct contact with the patient’s oral secretions
The emt who performed mouth to mouth resuscitation
The resident who did not wear appropriate ppe during intubation
The rn who suctioned the patient without wearing a mask

14. Rationale:
Hcp without direct exposure to the patient’s oral secretions are considered low risk and chemoprophylaxis is not recommended.
Reference: meningococcal infections. In: pickering lk, ed. Red book: 2012 report of the committee on infectious diseases, 29th edition. Elk grove village, il: American academy of pediatrics, 2012.; cbic core competency: identification of infectious disease processes

15. #5: the need for education
The need to include employee education for infection prevention is included in all of the following programs components except:
The facility infection prevention risk assessment
The facility’s infection prevention program plan
The annual facility budget and allocation of resources
The facility’s 5-year strategic plan

16. The facility’s 5-year strategic plan
The need to include employee education for infection prevention is included in all of the following programs components except:
The facility infection prevention risk assessment
The facility’s infection prevention program plan
The annual facility budget and allocation of resources
The facility’s 5-year strategic plan

17. Rationale:
Strategic plans determine the direction an organization will go in the future and what the organization must do to reach the goal, mission, or vision. Strategic planning includes several important steps: 1) analysis of the organization; 2) forming conclusion about what should be done about issues facing the organization; and, 3) action planning.
Actions plans determine what will be done to accomplish goals; who will take responsibility for the action; when the action will be complete; and resources and evaluation criteria.
A facility’s strategic plan does not include department-specific goals.
Reference: apic text, 4th edition, chapter 3 – education and training;
apic text, 4th edition, chapter 16 – quality concepts