Q & A session

1. Q & A session APIC Greater new York Chapter 13

2. Q1. The category 1A recommendation from the Healthcare Infection Control Practices Advisory Committee (HICPAC) of the Centers for Disease Control and Prevention (CDC) indicates that a recommendation is a. Required by state or federal regulations. b. Suggested for implementation and supported by suggestive clinical or epidemiological studies or by a theoretical rationale. c. Strongly recommended for implementation and supported by some experimental, clinical, or epidemiologic studies, and by a strong theoretical rationale. d. Strongly recommended for implementation and strongly supported by well-designed experimental, clinical, or epidemiologic studies.

3. Q1. The category 1A recommendation from the Healthcare Infection Control Practices Advisory Committee (HICPAC) of the Centers for Disease Control and Prevention (CDC) indicates that a recommendation is A. Required by state or federal regulations. - This is the definition of Category 1C B. Suggested for implementation and supported by suggestive clinical or epidemiological studies or by a theoretical rationale. - This is the definition of a Category II C. Strongly recommended for implementation and supported by some experimental, clinical, or epidemiologic studies, and by a strong theoretical rationale. - This is the definition of a Category 1B D. Strongly recommended for implementation and strongly supported by well-designed experimental, clinical, or epidemiologic studies. This is the correct definition as stated in the CDC guidelines

4. Q2. The IP receives a telephone call from the Director of Nursing about admission of a patient with Creutzfeldt-Jakob disease. The IP is unfamiliar with the disease and should do which of the following? A. Call the infectious disease specialist for instructions. B. Recommend that contact precautions be implemented. C. Notify the health department of the patient’s diagnosis. D. Check current recommendations and return the call.

5. Q2. The IP receives a telephone call from the Director of Nursing about admission of a patient with Creutzfeldt-Jakob disease. The IP is unfamiliar with the disease and should do which of the following? A. Call the infectious disease specialist for instructions. B. Recommend that contact precautions be implemented. C. Notify the health department of the patient’s diagnosis. D. Check current recommendations and return the call. A. Finding the solution on one’s own leads to better retention of knowledge. B. Contact precautions are not used for Creutzfeldt-Jakob disease. C. The health department may not be the best source to provide specific guidelines for the care of these patients within a health care facility. In addition, Creutzfeldt-Jakob disease may not be reportable in all states. D. It is always prudent to admit uncertainty. By researching the answer and returning with correct information, the IP builds credibility.

6. Q3. On the sixth hospital day, a child develops skin eruption. The child is placed in isolation on day 8 for varicella. Health care workers, without evidence of immunity, should be evaluated for treatment includes those that worked on unit from… A. Admission day to day 6 B. Day 6 to day 8 C. Day 4 to day 8 D. Day 4 to day 6

7. Q3. On the sixth hospital day, a child develops skin eruption. The child is placed in isolation on day 8 for varicella. Health care workers, without evidence of immunity, should be evaluated for treatment includes those that worked on unit from… A. Admission day to day 6 B. Day 6 to day 8 C. Day 4 to day 8 D. Day 4 to day 6 C.The period of communicability is as long as 5 days, but usually 1 to 2 days before onset of rash and continues until the lesions are crusted (about 5 days). Susceptibility is universal among those not previously infected or vaccinated.

8. Q4. A 2-month-old infant had been exposed to chickenpox on June 1 and received VZIG on June 2. The infant is admitted for surgery on June 6 and should be placed in isolation during which of the following days? A. June 6 to June 22 B. June 11 to June 22 C. June 11 to June 29 D. Isolation is not required

9. Q4. A 2-month-old infant had been exposed to chickenpox on June 1 and received VZIG on June 2. The infant is admitted for surgery on June 6 and should be placed in isolation during which of the following days? A. June 6 to June 22 B. June 11 to June 22 C. June 11 to June 29 D. Isolation is not required A. The incubation period for varicella is 10 to 21 days. This is extended to 28 days when VZIG is administered. B. See explanation A. C. This period represents the 10th to 28th day period exposure thus encompassing the lengthened incubation period of 28 days when VZIG is used. D. Airborne isolation is required during expanded incubation period as described in explanation A.

10. Q5. When evaluating pathogen trends, which of the following might be attributed to an increased use of fluconazole as antifungal prophylaxis in the facility? A. Increased numbers of Pseudomonas aeruginosa isolates B. Decreased numbers of MRSA isolates C. Increased numbers of Candida glabrata isolates D. Decreased numbers of Hemophilus influenza isolates

11. Q5. When evaluating pathogen trends, which of the following might be attributed to an increased use of fluconazole as antifungal prophylaxis in the facility? A. Increased numbers of Pseudomonas aeruginosa isolates B. Decreased numbers of MRSA isolates C. Increased numbers of Candida glabrata isolates D. Decreased numbers of Hemophilus influenza isolates C. Fluconazole is only effective on certain species of fungi. C. Glabrata is intrinsically resistant to fluconazole and is often seen more frequently when this drug is used as an anti- fungal prophylaxis.

12. Q6. Most characteristic of intravenous fluids containing dextrose is the ability to… A. Support the growth of cytomegalovirus. B. Support the growth of Staphylococcus aureus. C. Support the growth of Enterobacter aerogenes. D. Become turbid when contamination reaches 103 organisms per mL.

13. Q6. Most characteristic of intravenous fluids containing dextrose is the ability to… A. Support the growth of cytomegalovirus. B. Support the growth of Staphylococcus aureus. C. Support the growth of Enterobacter aerogenes. D. Become turbid when contamination reaches 103 organisms per mL. A. Viruses require living cells for replication, and thus, will not multiply in infusion fluids. B. Staphylococcus aureus is a gram-positive bacterium. C. Enterobacter aerogenesis a gram-negative bacterium. Dextrose best supports the growth of gram-negative bacteria. D. Turbidity may not be present even when contamination levels are high.

14. Q7. Patients are hospitalized for 7, 4, 5, 6, 10, 9, 9, 9, 8 days. The IP determines the MEDIAN length of stay to be how many days? A. 6 B. 7 C. 8 D. 9

15. Q7. Patients are hospitalized for 7, 4, 5, 6, 10, 9, 9, 9, 8 days. The IP determines the MEDIAN length of stay to be how many days? A. 6 - Six represents the range of this data set. The range is the difference between the greatest and least values. B. 7 - Seven represents the rounded mean. The mean is the mathematical average of the values in a set of data. C. 8 - Eight is the median in this data set. The median is calculated by ranking the values of a data set in either ascending or descending order, and then identifying the midpoint of the sequence. D. 9 - Nine represents the mode of this sequence of values. The mode is the value that occurs most often in the data set.

16. Q8. What is the MOST practical type of study to establish between risk factors and hospital acquired infections in outbreak situations? A. Cohort B. Descriptive C. Case-control D. Experimental

17. Q8. What is the MOST practical type of study to establish between risk factors and hospital acquired infections in outbreak situations? A. Cohort B. Descriptive C. Case-control D. Experimental A. Cohort studies first look at all patients exposed to a risk factor and then measure disease frequency which develops. B. Descriptive studies describe an occurrence by time, place, and person. C. A case-control study compares an individual group with disease to another group of individuals without disease for the purpose of identifying risk factors. D. Experimental studies are not used to evaluate the interaction of risk and disease.

18. Q9. What type of study directly measures incidence? A. Cohort B. Case-control C. Experimental D. Cross-sectional

19. Q9. What type of study directly measures incidence? A. Cohort B. Case-control C. Experimental D. Cross-sectional A. A cohort study is a prospective approach used to equate exposure and the onset of disease or infection. B. A case-control study is generally used to show association between risk factors and disease. It is a retrospective review. C. An experimental study is prospective in nature and is designed to establish causality where factors are strictly controlled. D. A cross-sectional study is designed to determine the frequency of an event over a very short period of time. It is a type of prevalence study.