1
Patients entering a healthcare setting are at risk of acquiring infection because of:
A. their decreased resistance to disease
B. exposure to a variety of disease-causing organisms
C. the specific course of therapy they will receive
D. all of the above
2
The agency that gathers data on healthcare-associated infections (HAIs) and publishes guide-lines for infection prevention and control is the:
A. Occupational Safety and Health Administration
B. Centers for Disease Control and Prevention
C. Joint Commission on Accreditation of Healthcare Organizations
D. U.S. Department of Health and Human Services
3
The underlying premise of the Universal Precautions is that:
A. all blood, body fluids and tissues must be handled as if they are infectious
B. all healthcare workers have the same risk of acquiring infections
C. all exposure incidents must be thoroughly investigated
D. all healthcare facilities should implement the same infection control plan
4
According to the OSHA Bloodborne Pathogens Standard, potentially infectious materials include blood and all of the following EXCEPT:
A. intact skin
B. amniotic fluid
C. organ cultures
D. semen
5
The use of mechanical devices to reduce handling of contaminated needles is an example of:
A. work practice guidelines
B. regulated waste
C. engineering controls
D. pre-exposure planning
6
All of the following statements regarding PPE are correct EXCEPT:
A. Employers must instruct employees in the proper use of PPE
B. PPE is considered acceptable by OSHA if it does not allow blood or OPIM to reach the employees work or street clothes
C. The employer must enforce use of PPE by OSHA mandate
D. When scrubs are used as PPE, they may be taken home and laundered.
7
Gloves are worn for all of the following reasons EXCEPT:
A. to reduce the healthcare worker's exposure to bloodborne pathogens
B. to minimize transmission of organisms from the healthcare professional to a patient during invasive procedures
C. to reduce transmission of infectious organisms from one patient to another
D. to decrease the need for frequent handwashing by healthcare workers
8
For procedures involving contact with mucous membranes, the healthcare professional should use:
A. sterile gloves
B. examination gloves
C. general-purpose utility gloves
D. any of the above
9
The OSHA mandated Sharps Injury Log:
A. does not require an explanation of how the injury occurred
B. may have the employee's name on the OSHA 300 Form 300
C. must be done in a manner that protects the confidentiality of any employee that is injured
D. must be completed immediately following an accidental exposure of an employee to another person's blood or OPIM
10
When an accidental needlestick exposure occurs to an employee:
A. the incident must be reported within 2 weeks
B. confidential medical evaluation and lab testing must be offered by the employer free of charge to the employee
C. the employee's blood should be tested for HIV and HBV within 90 days
D. all of the above
11
The healthcare worker can prevent an infection from spreading by:
A. using occlusive dressings
B. following facility policies for specimen collection
C. cleaning the workplace properly
D. all of the above
12
The presence of microorganisms in or on a host with growth and multiplication but without tissue invasion or damage describes:
A. contamination
B. colonization
C. secondary infection
D. inoculation
13
Alcohol-based hand rubs can effectively be used:
A. to remove dirt from hands that are visibly soiled
B. to increase the mechanical friction of plain soap
C. in the absence of running water for handwashing
D. all of the above
14
According to recommendations set forth by the CDC:
A. acrylic nails should be kept short and neatly manicured
B. the preferred method of handwashing when hands are not visibly soiled is with an alcohol-based hand rub
C. alcohol-based hand gels may be used when hands are contaminated with protein-based substances
D. the time for proper handwashing technique with soap and water is 15-20 seconds
15
Cleaning agents designated as hospital grade detergents/disinfectants must:
A. be free of harsh chemicals such as isopropyl alcohol
B. be safe for use on patients' skin
C. contain appropriate concentrations of household bleach
D. inactivate specific organisms such as streptococcus
16
Which one of the following should be used to decontaminate spilled blood or body fluids, according to OSHA?
A. a tuberculocidal agent or household bleach
B. hot water, followed by cold water
C. a diluted mixture of ammonia and lye
D. any antioxidant-based cleanser
17
According to Spaulding's classification system for sterilization of patient care equipment, critical items include:
A. urinary catheters
B. hydrotherapy tanks
C. endoscopes
D. respiratory therapy equipment
18
It may be necessary to disinfect non-critical patient care items such as blood pressure cuffs and bedpans before using them for another patient if:
A. they require substantial cleaning before reprocessing
B. the previous patient was colonized with a drug resistant organism
C. the items have been exposed to heat and moisture during use
D. the manufacturer's instructions don't prohibit it
19
In order to minimize contamination of medical supplies, storage shelves should be:
A. six to eight inches from an outside wall
B. twelve inches up from the floor
C. no more than six inches from the ceiling
D. all of the above
20
What does the CDC recommend with regard to the recapping of needles?
A. recap immediately after use
B. recap immediately prior to disposal
C. never recap with both hands
D. recap only with the aid of a helper
21
Which of the following is true regarding respiratory hygiene and cough etiquette?
A. Patients should be instructed to turn away from others and cough into their sleeves or hands
B. Hands should be washed with soap and water for at least 15 seconds, or with alcohol based hand gel after coughing or sneezing
C. Patients may be given N95 respirators if they have respiratory symptoms
D. Patients should cough or sneeze into a tissue
22
Patients known or suspected to be infected with MRSA or VRE should be placed on:
A. airborne precautions
B. droplet precautions
C. contact precautions
D. A and C
23
Contact precautions require:
A. the use of gowns and gloves at all times when working with patients
B. the use of AIIRs
C. the use of a surgical mask when having contact with patients
D. that PPE be located in each patient's room
24
Droplet precautions require:
A. special air handling and ventilation systems
B. strict isolation of the infected patient in a private room
C. use of a surgical mask when within three feet of the patient
D. gloves and gowns at all times
25
Which of the following statements is TRUE regarding airborne transmission of infective agents?
A. Airborne transmission requires being in the same room with the infected person
B. Droplet nuclei can remain suspended in the air for long periods of time
C. Patient isolation is rarely required if facility ventilation is adequate
D. Airborne precautions supersede standard precautions in dealing with transmission of tuberculosis
26
Which of the following statements is TRUE regarding respirators?
A. if a respirator is approved by NIOSH for occupational safety, it will have only the NIOSH name or logo on it
B. if a facility has AIIRs, respiratory protection programs are not necessary
C. the term N95 refers to a filter class and not the respirator itself
D. certain surgical masks can be classified as N95 respirators
27
All of the following are true regarding HBV EXCEPT:
A. the HBV vaccine has been only partially effective in preventing infection
B. infection with HBV can lead to liver failure and liver cancer
C. HBIG contains high levels of HBV antibody
D. the virus can live up to two weeks on a toothbrush
28
The most common chronic bloodborne infection in the United States is:
A. HBV
B. HCV
C. HDV
D. HIV
29
The most efficient method of transmission of HDV is through:
A. sexual contact
B. perinatal exposure
C. contaminated toothbrushes and razors
D. percutaneous exposure
30
Clinical signs of HIV infection may include all of the following except:
A. lymphadenopathy
B. chronic diarrhea
C. weight gain
D. fatigue
31
Which of the following is TRUE regarding the H1N1 infection?
A. the greatest amount of viral shedding occurs the day before onset of illness
B. viral shedding is inversely proportional to degree of fever
C. the incubation period is an average of 4 days
D. people younger than 65 are more severely affected than people older than 65
32
Which of the following is the lowest ranking in the hierarchy of controls recommended by the CDC to reduce H1N1 transmission?
A. use of N95 respirators and other PPE
B. providing vaccination programs
C. installing partitions in public areas
D. postponing elective visits in patients with confirmed influenza
33
The resurgence of tuberculosis in the United States in the 1980s and early 1990s can be attributed in part to:
A. monitoring of drug resistance through the national surveillance system
B. the HIV/AIDS epidemic
C. failures of early versions of TB vaccines
D. scarcity of medicines for TB control
34
Tuberculosis is spread primarily through:
A. contact with contaminated environmental surfaces
B. airborne particles from coughs or sneezes of infected persons
C. exposure to blood and blood products that contain the bacteria
D. all of the above
35
Patients with LTBI:
A. usually have a negative skin test
B. have coughs that are highly infectious
C. do not have symptoms of active TB
D. may have lethargy, fever, night sweats, and loss of appetite
36
OSHA mandated standard for TB include which of the following?
A. Use of Respiratory Protection
B. Recording criteria for work-related TB cases
C. Use of Personal Protective Equipment
D. All are OSHA mandated standards
37
Regarding Creutzfeldt-Jacob disease, which of the following is true?
A. healthcare workers should use droplet precautions when caring for a patient with suspected or diagnosed CJD
B. iatrogenic transmission has occurred from the use of contaminated floors, walls, or countertops
C. patients have acquired the disease from infected cattle products in the U.S
D. 85% of patients acquire CJD as a sporadic disease
38
Bacteria can develop resistance to antibiotics through mechanisms that include:
A. mutation
B. expression of a latent gene
C. exchange of DNA with other bacteria
D. all of the above
39
Increased use of broad spectrum antibiotics and high antibiotic usage in relatively small geographic areas is likely to result in:
A. development of additional antibiotic resistant organisms
B. reduction of the appearance of transient bacteria in these areas
C. proliferation of resident flora such as e. coli
D. enhanced control of staph infections in healthcare settings
40
The practice of cohorting of patients requires that:
A. medical records note all previous hospital admissions and outcomes
B. patients with the same diagnosis share a room
C. supplies used with these patients be destroyed after use
D. visitation be curtailed for a specified incubation period
41
Bioterrorism is defined as:
A. method of isolating or removing bloodborne pathogens from a workplace
B. an infection control method that defines all body fluids/substances as infectious
C. the use of a biological agent to intentionally cause disease to cause terror
D. the use of labels for hazardous blood or OPIM
42
What is an example of a traditional bioterrorism agent, a naturally occurring microbe or toxin?
A. Smallpox & Human Papilloma virus
B. SARS virus
C. Anthrax & Plague
D. Ebola & Tularemia
43
Regarding a potential bioterrorist attack:
A. usually only a short amount of time elapses between a bioweapon attack and the time a patient presents with clinical symptoms
B. external decontamination of the patient is usually necessary
C. local and state health departments are usually the first to notice a bioterrorist attack
D. PPE will vary depending on the agent and the illness
44
If exposure of the skin to an agent or an aerosol from a biological warfare attack should occur:
A. superinfections may occur
B. external decontamination may be necessary
C. the affected area should be immediately washed with soap and water
D. chemical disinfectants should be immediately used
45
Which organism has shown high rates of drug resistant colonization in LTC residents?
A. MRSA
B. Staphlococcal enterotoxin B
C. Brucella spp
D. Rikettsia prowazekii
46
Infection control can be especially problematic in the long term care setting due to all of the following factors EXCEPT:
A. the degree of functional impairment of the residents
B. the limited effectiveness of traditional infection control measures
C. the likelihood that colonization of drug resistant organisms has originated in this setting
D. the increasing admission of residents with invasive devices such as feeding tubes
47
In general, infection control practices in the home setting differ from those in hospitals and clinics in that home based practices:
A. are based on sound research and extensive research data
B. must take into consideration patients that are much sicker and more frail
C. are more frequently adapted to the specific needs of the individual patient
D. are less likely to have to deal with sanitation and ventilation problems
48
Reduction of the risk for gastrointestinal infections associated with enteral therapy in the home may require all of the following except:
A. considerable patient and family teaching
B. emphasis on refrigeration of the feedings
C. demonstration of scrupulous cleaning of items used in preparation
D. regular sterilization of kitchen appliances and tools
49
Regarding dialysis patients:
A. unused medications taken to the patient's station may be returned to a clean medication storage area if no seal is broken and the medication has not been used
B. items taken into the dialysis station can be used in common areas only after being cleaned and disinfected
C. Internal transducer filters must be changed between patient treatments
D. the dialysis station should be cleaned and disinfected once daily
50
Dialysis center policies should require that vaccinations against hepatitis B be administered to:
A. all dialysis patients
B. patients with anti-HBs> 10 ml IU/ml
C. patients with a history of hepatitis A
D. patients who are HIV positive
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