CBIC Updated CIC Exam Questions and Answers by montague

Before initiating airborne precautions, the infection preventionist must first confirm the clinical suspicion of active TB.

Step-by-Step Justification:

Confirming Active TB:

A positive tuberculin skin test (TST) alone does not indicate active disease​.

A review of chest X-ray, symptoms, and risk factors is needed.

Medical Record Review:

Past TB history, imaging, and sputum testing are key to diagnosis​.

Not all TST-positive patients require isolation.

Why Other Options Are Incorrect:

A. Contact the roommate's physician to initiate TST: Premature, as no confirmation of active TB exists yet.

C. Report findings to Employee Health for staff follow-up: Should occur only after TB confirmation.

D. Transfer to airborne isolation immediately: Airborne isolation is necessary only if active TB is suspected based on clinical findings​.

CBIC Infection Control References:

The Certification Study Guide (6th edition) explains that device-associated infection rates are calculated using a standardized formula that expresses the number of infections per 1,000 device days. This allows comparison over time and between units with different patient volumes or device utilization.

The formula for ventilator-associated pneumonia (VAP) rate is:

(Number of VAPs ÷ Number of ventilator days) × 1,000

In this scenario, there were 8 ventilator-associated pneumonias and 240 ventilator days over the 6-month period.

8 ÷ 240 = 0.033

0.033 × 1,000 = 33.3 VAPs per 1,000 ventilator days

Rates are typically rounded to a whole number for reporting and benchmarking purposes, resulting in 33 per 1,000 ventilator days.

The study guide emphasizes that ventilator days—not patient days or admissions—are the correct denominator because they reflect time at risk for ventilator-associated infection. This approach ensures valid surveillance and supports accurate trend analysis and benchmarking.

The other answer choices represent incorrect calculations or decimal misplacement. Understanding rate calculations is a core CIC exam competency, particularly for interpreting device-associated infection data and guiding quality improvement initiatives in high-risk units such as NICUs.

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The CBIC Certified Infection Control Exam Study Guide (6th edition) emphasizes that effective education for adult learners is most successful when it is relevant, interactive, and role-specific. Relating the new infection prevention protocol to each department’s responsibilities using realistic scenarios is the most effective educational strategy for organization-wide adoption.

Scenario-based education is an active learning method, which engages participants in problem-solving and application of knowledge rather than passive receipt of information. By tailoring scenarios to departmental workflows—such as nursing, environmental services, laboratory, or ancillary departments—staff can clearly understand how the protocol affects their daily practice and how their actions contribute to infection prevention outcomes. This approach improves comprehension, retention, and compliance.

Option B is incorrect because passive learning methods (e.g., lectures or handouts alone) are less effective for behavior change and adult learning. Option C relies on administrative acknowledgment rather than understanding and does not ensure competency or consistent application. Option D may support accountability but does not educate staff or build understanding during initial implementation.

The Study Guide stresses that infection preventionists must act as educators and change agents, adapting teaching strategies to diverse audiences. Using scenario-based, department-specific education aligns with adult learning principles, promotes engagement, and facilitates sustainable practice change—making it the best approach and a key concept for the CIC® exam.

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Peripherally inserted central catheter (PICC)-associated bloodstream infections (BSIs) are a significant concern in healthcare settings, and identifying factors contributing to their increase is critical for infection prevention. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the "Surveillance and Epidemiologic Investigation" and "Prevention and Control of Infectious Diseases" domains, which align with the Centers for Disease Control and Prevention (CDC) guidelines for preventing intravascular catheter-related infections. The question asks for the intervention most likely to have contributed to the rise in PICC-associated BSIs over four months, requiring an evaluation of each option based on evidence-based practices.

Option C, "Replacement of the intravenous administration sets every 72 hours," is the most likely contributor to the increase. The CDC’s "Guidelines for the Prevention of Intravascular Catheter-Related Infections" (2017) recommend that intravenous administration sets (e.g., tubing for fluids or medications) be replaced no more frequently than every 72-96 hours unless clinically indicated (e.g., contamination or specific therapy requirements). Frequent replacement, such as every 72 hours as a routine practice, can introduce opportunities for contamination during the change process, especially if aseptic technique is not strictly followed. Studies cited in the CDC guidelines, including those by O’Grady et al. (2011), indicate that unnecessary manipulation of catheter systems increases the risk of introducing pathogens, potentially leading to BSIs. A change to a 72-hour replacement schedule, if not previously standard, could explain the observed increase over the past four months.

Option A, "Use of chlorhexidine skin antisepsis during insertion of the PICC," is a recommended practice to reduce BSIs. Chlorhexidine, particularly in a 2% chlorhexidine gluconate with 70% alcohol solution, is the preferred skin antiseptic for catheter insertion due to its broad-spectrum activity and residual effect, as supported by the CDC (2017). This intervention should decrease, not increase, infection rates, making it an unlikely contributor. Option B, "Daily bathing adult intensive care unit patients with chlorhexidine," is another evidence-based strategy to reduce healthcare-associated infections, including BSIs, by decolonizing the skin of pathogens like Staphylococcus aureus. The CDC and SHEA (Society for Healthcare Epidemiology of America) guidelines (2014) endorse chlorhexidine bathing in intensive care units, suggesting it should lower, not raise, BSI rates. Option D, "Use of a positive pressure device on the PICC," aims to prevent catheter occlusion and reduce the need for frequent flushing, which could theoretically decrease infection risk by minimizing manipulation. However, there is no strong evidence linking positive pressure devices to increased BSIs; if improperly used or maintained, they might contribute marginally, but this is less likely than the impact of frequent tubing changes.

The CBIC Practice Analysis (2022) and CDC guidelines highlight that deviations from optimal catheter maintenance practices, such as overly frequent administration set replacements, can increase infection risk. Given the four-month timeframe and the focus on an intervention’s potential negative impact, Option C stands out as the most plausible contributor due to the increased manipulation and contamination risk associated with routine 72-hour replacements.