CBIC Updated CIC Exam Questions and Answers by kendall

In an outbreak investigation,the first critical stepis tonotify facility administrationand other key stakeholders.This ensures the rapid mobilization of resources, coordination with infection control teams, and compliance with regulatory reporting requirements.

Why the Other Options Are Incorrect?

A. Conduct environmental cultures– Whileenvironmental sampling may be necessary, it isnot the first step. The outbreak must first be confirmed and administration alerted.

B. Plan to prevent future outbreaks–Prevention planning happens laterafter the outbreak has been investigated and controlled.

D. Perform analytical studies–Data analysis occurs after case definition and initial response measures are in place.

CBIC Infection Control Reference

APIC guidelines state thatthe first step in an outbreak investigation is confirming the outbreak and notifying key stakeholders​.

Measles is ahighly contagious airborne disease, and thebest immediate actionin an outpatient clinicwithout an Airborne Infection Isolation Room (AIIR)is tomask 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– WhileN95 respiratorsare necessary for staff,this does not address patient containment.

C. Patient should be offered the MMR vaccine– Thevaccine does not treat active measles infectionand should be givenonly as post-exposure prophylaxisto susceptible contacts.

CBIC Infection Control Reference

Measles cases in outpatient settings require immediate airborne precautionsto prevent transmission​.

When advising a family, including an 8-month-old infant, planning a vacation to Europe, an infection preventionist (IP) must consider travel-related health risks and vaccination recommendations tailored to the destination and age-specific guidelines. The Certification Board of Infection Control and Epidemiology (CBIC) emphasizes the "Education and Training" domain, which includes providing evidence-based advice to prevent infections, aligning with the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) travel health recommendations.

Option D, "Family immunization records should be reviewed by their provider," is the most appropriate recommendation. Europe, as a region, includes countries with varying health risks, but it is generally considered a low-risk area for many vaccine-preventable diseases compared to tropical regions. The CDC’s "Travelers’ Health" guidelines (2023) recommend that all travelers, including infants, have their immunization status reviewed by a healthcare provider prior to travel to ensure compliance with routine vaccinations (e.g., measles, mumps, rubella [MMR], diphtheria, tetanus, pertussis [DTaP], and polio) and to assess any destination-specific needs. For an 8-month-old, the review would confirm that the infant has received age-appropriate vaccines (e.g., the first doses of DTaP, Hib, PCV, and IPV, typically starting at 2 months) and is on schedule for the 6- and 12-month doses. This step ensures the family’s overall protection and identifies any gaps, making it a proactive and universally applicable recommendation.

Option A, "Exposure to rabies should be avoided," is a general travel safety tip applicable to any destination where rabies is endemic (e.g., parts of Eastern Europe or rural areas with wildlife). However, rabies risk in most European countries is low, and pre-exposure vaccination is not routinely recommended for travelers unless specific high-risk activities (e.g., handling bats) are planned. The CDC advises avoiding animal bites rather than vaccinating unless indicated, making this less specific and urgent than a records review. Option B, "Family members should be vaccinated for yellow fever," is incorrect. Yellow fever is not endemic in Europe, and vaccination is not required or recommended for travel to any European country. The WHO International Health Regulations (2005) and CDC list yellow fever vaccination as mandatory only for travelers from or to certain African and South American regions, rendering this irrelevant. Option C, "The infant should not travel until at least 12 months of age," lacks a clear evidence base. While some vaccines (e.g., MMR) are typically given at 12 months, the 8-month-old can travel safely if up-to-date on age-appropriate immunizations. The CDC allows travel for infants as young as 6 weeks with medical clearance, and delaying travel to 12 months is not a standard recommendation unless specific risks (e.g., disease outbreaks) are present, which are not indicated here.

The CBIC Practice Analysis (2022) and CDC Travelers’ Health resources prioritize pre-travel health assessments, including immunization reviews, as the foundation for safe travel. Option D ensures a comprehensive approach tailored to the family’s needs, making it the best recommendation for a trip to Europe.

The correct answer is C, "obtain surface cultures," as this is the best method to validate the suspicion of an environmental source for an outbreak of Serratia marcescens in the intensive care unit (ICU). According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, Serratia marcescens is an opportunistic gram-negative bacterium commonly associated with healthcare-associated infections (HAIs), often linked to contaminated water, medical equipment, or environmental surfaces in ICUs. Obtaining surface cultures allows the infection preventionist (IP) to directly test environmental samples (e.g., from sinks, ventilators, or countertops) for the presence of Serratia marcescens, providing microbiological evidence to confirm or rule out an environmental source (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.2 - Analyze surveillance data). This method is considered the gold standard for outbreak investigations when an environmental reservoir issuspected, as it offers specific pathogen identification and supports targeted interventions.

Option A (apply fluorescent gel) is a technique used to assess cleaning efficacy by highlighting areas missed during disinfection, but it does not directly identify the presence of Serratia marcescens or confirm an environmental source. Option B (use ATP system) measures adenosine triphosphate (ATP) to evaluate surface cleanliness and organic residue, which can indicate poor cleaning practices, but it is not specific to detecting Serratia marcescens and lacks the diagnostic precision of cultures. Option D (perform direct practice observation) is valuable for assessing staff adherence to infection control protocols, but it addresses human factors rather than directly validating an environmental source, making it less relevant as the initial step in this context.

The focus on obtaining surface cultures aligns with CBIC’s emphasis on using evidence-based methods to investigate and control HAIs, enabling the IP to collaborate with the committee to pinpoint the source and implement corrective measures (CBIC Practice Analysis, 2022, Domain II: Surveillance and Epidemiologic Investigation, Competency 2.3 - Identify risk factors for healthcare-associated infections). This approach is supported by CDC guidelines for outbreak investigations, which prioritize microbiological sampling to guide environmental control strategies (CDC Guidelines for Environmental Infection Control in Healthcare Facilities, 2019).