What should an infection preventionist prioritize when designing education programs?
Marketing research
Departmental budgets
Prior healthcare experiences
Learning and behavioral science theories
The correct answer is D, "Learning and behavioral science theories," as this is what an infection preventionist (IP) should prioritize when designing education programs. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, effective education programs in infection prevention and control are grounded in evidence-based learning theories and behavioral science principles. These theories, such as adult learning theory (andragogy), social learning theory, and the health belief model, provide a framework for understanding how individuals acquire knowledge, develop skills, and adopt behaviors (CBIC Practice Analysis, 2022, Domain IV: Education and Research, Competency 4.1 - Develop and implement educational programs). Prioritizing these theories ensures that educational content is tailored to the learners’ needs, enhances engagement, and promotes sustained behavior change—such as adherence to hand hygiene or proper use of personal protective equipment (PPE)—which are critical for reducing healthcare-associated infections (HAIs).
Option A (marketing research) is more relevant to commercial strategies and audience targeting outside the healthcare education context, making it less applicable to the IP’s role in designing clinical education programs. Option B (departmental budgets) is an important logistical consideration for resource allocation, but it is secondary to the design process; financial constraints should influence implementation rather than the foundational design based on learning principles. Option C (prior healthcare experiences) can inform the customization of content by identifying learners’ backgrounds, but it is not the primary priority; it should be assessed within the context of applying learning and behavioral theories to address those experiences effectively.
The focus on learning and behavioral science theories aligns with CBIC’s emphasis on developing and evaluating educational programs that drive measurable improvements in infection control practices (CBIC Practice Analysis, 2022, Domain IV: Education and Research, Competency 4.2 - Evaluate the effectiveness of educational programs). By prioritizing these theories, the IP can create programs that are scientifically sound, learner-centered, and impactful, ultimately enhancing patient and staff safety.
An infection preventionist is informed that there is a possible cluster of streptococcal meningitis in the neonatal intensive care unit. Which of the following streptococcal serogroops is MOST commonly associated with meningitis in neonates beyond one week of age?
Group A
Group B
Group C
Group D
Group B Streptococcus (Streptococcus agalactiae) is the most common cause of neonatal bacterial meningitis beyond one week of age.
Step-by-Step Justification:
Group B Streptococcus (GBS) and Neonatal Infections:
GBS is a leading cause of late-onset neonatal meningitis (occurring after 7 days of age).
Infection typically occurs through vertical transmission from the mother or postnatal exposure.
Neonatal Risk Factors:
Premature birth, prolonged rupture of membranes, and maternal GBS colonization increase risk.
Why Other Options Are Incorrect:
A. Group A: Rare in neonates and more commonly associated with pharyngitis and skin infections.
C. Group C: Typically associated with animal infections and rarely affects humans.
D. Group D: Includes Enterococcus, which can cause neonatal infections but is not the most common cause of meningitis.
CBIC Infection Control References:
APIC Text, "Group B Streptococcus and Neonatal Meningitis".
A family, including an infant of 8 months, is going on a vacation to Europe. An infection preventionist would recommend:
Exposure to rabies should be avoided.
Family members should be vaccinated for yellow fever.
The infant should not travel until at least 12 months of age.
Family immunization records should be reviewed by their provider.
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.
An infection preventionist has been asked to participate in a process improvement team to standardize disinfection and sterilization practices. Team activities should include all of the following EXCEPT:
Observing disinfection and sterilization practices.
Asking central supply and operating room managers to join the team.
Performing a literature review on central supply and sterilization.
Conducting outcome measurement after all changes are implemented.
The CBIC Certified Infection Control Exam Study Guide (6th edition) emphasizes that effective process improvement relies on a structured, data-driven approach that includes baseline assessment, intervention, and ongoing evaluation. A key principle of quality improvement is that outcomes must be measured before and after changes are implemented in order to determine whether an intervention resulted in improvement.
Option D is the correct “EXCEPT” choice because limiting outcome measurement to only after changes are implemented prevents meaningful comparison and makes it impossible to determine effectiveness. Without baseline data, improvements cannot be quantified, trends cannot be assessed, and unintended consequences may go unrecognized. The Study Guide stresses that baseline measurements are essential to evaluate process performance and to support evidence-based decision-making.
Options A, B, and C are all appropriate and expected activities. Direct observation helps identify workflow gaps and variation in practice. Inclusion of central supply and operating room leadership ensures multidisciplinary engagement and operational insight. Conducting a literature review supports alignment with current evidence, standards, and best practices for disinfection and sterilization.
For the CIC® exam, it is important to recognize that continuous measurement throughout the improvement cycle—not only after implementation—is required for successful standardization and sustainability of infection prevention practices.
An infection preventionist is asked by the Central Supply department to review its process for assigning expiration dates to sterile supplies. Which of the following is the MOST important consideration?
Sterility is related to package integrity.
Items must have 30- to 90-day expiration dates.
The expiration date depends on the type of packaging.
The expiration date depends on the type of sterilization.
The CBIC Certified Infection Control Exam Study Guide (6th edition) emphasizes that the most important consideration in assigning expiration dates to sterile supplies is package integrity, reflecting the principle of event-related sterility. Modern infection prevention practice recognizes that sterility is not determined by time alone but by whether an event has occurred that compromises the sterile barrier system.
Sterile items remain sterile indefinitely as long as the packaging remains intact, dry, and properly stored, and no contamination event (such as tearing, puncture, moisture exposure, or improper handling) has occurred. Therefore, the presence or absence of a printed expiration date is less important than assurance that the package integrity has been maintained throughout storage and handling.
Option A is correct because it captures the foundational concept that sterility is directly linked to the integrity of the packaging, not an arbitrary time frame. Option B is incorrect because fixed time-based expiration dates (e.g., 30–90 days) are outdated and not evidence-based. Options C and D may influence packaging durability or compatibility with sterilization methods, but they are secondary considerations and do not override the primary determinant of sterility.
For the CIC® exam, this question reinforces a critical sterilization principle: event-related shelf life is the standard, and infection preventionists should focus on policies that emphasize package integrity, proper storage conditions, and handling practices rather than routine time-based expiration dating.
The infection preventionist observes a nurse obtaining a wound culture and notes which of the following steps is correct?
The specimen is refrigerated to maintain integrity.
The nurse uses aseptic technique to collect the specimen.
The specimen container is labeled with the patient’s initials.
The specimen is obtained after the antibiotics have been started.
The CBIC Certified Infection Control Exam Study Guide (6th edition) emphasizes that aseptic technique is essential when obtaining clinical specimens, including wound cultures, to ensure accurate results and prevent contamination. Using aseptic technique minimizes the introduction of skin flora or environmental microorganisms that could lead to false-positive cultures and inappropriate clinical management.
Correct wound culture collection includes cleansing the wound as indicated, using sterile equipment, and avoiding contact with surrounding skin or nonsterile surfaces. This approach ensures that organisms identified in the culture are representative of true pathogens rather than contaminants. Proper specimen collection is a foundational infection prevention practice and directly affects diagnostic accuracy, antimicrobial stewardship, and patient outcomes.
Option A is incorrect because wound specimens are typically transported promptly at room temperature; refrigeration is not routinely recommended and may compromise certain organisms. Option C is incorrect because specimen containers must be labeled with at least two patient identifiers (such as full name and medical record number), not initials alone, to meet patient safety standards. Option D is incorrect because specimens should be obtained before initiation of antibiotic therapy whenever possible, as antibiotics can suppress bacterial growth and lead to false-negative results.
For CIC® exam preparation, it is critical to recognize that aseptic technique during specimen collection is the key correct practice, ensuring reliable laboratory results and supporting effective infection prevention and control efforts.
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Which of the following active surveillance screening cultures would be appropriate for carbapenem-resistant Enterobacterales (previously known as carbapenem-resistant Enterobacteriaceae) (CRE)?
Rectal or peri-rectal cultures
Nares or axillary cultures
Abscess or blood cultures
Throat or nasopharyngeal cultures
Carbapenem-resistant Enterobacterales (CRE) colonization is most commonly found in the gastrointestinal (GI) tract. Therefore, rectal or peri-rectal cultures are recommended for active surveillance screening.
Why the Other Options Are Incorrect?
B. Nares or axillary cultures – CRE is not primarily found in the nasal or axillary region; this method is more relevant for detecting MRSA.
C. Abscess or blood cultures – While CRE may be present in clinical infections, these cultures are not used for screening asymptomatic carriers.
D. Throat or nasopharyngeal cultures – CRE does not commonly colonize the upper respiratory tract, so these are not ideal for active screening.
CBIC Infection Control Reference
The CDC and APIC guidelines emphasize rectal or peri-rectal swabbing as the most effective active surveillance method for CRE detection.
What is the correct order of steps for reprocessing critical medical equipment?
Clean, sterilize, disinfect
Disinfect, clean, sterilize
Disinfect, sterilize
Clean, sterilize
The correct answer is D, "Clean, sterilize," as this represents the correct order of steps for reprocessing critical medical equipment. According to the Certification Board of Infection Control and Epidemiology (CBIC) guidelines, critical medical equipment—items that enter sterile tissues or the vascular system (e.g., surgical instruments, implants)—must undergo a rigorous reprocessing cycle to ensure they are free of all microorganisms, including spores. The process begins with cleaning to remove organic material, debris, and soil, which is essential to allow subsequent sterilization to be effective. Sterilization, the final step, uses methods such as steam, ethylene oxide, or hydrogen peroxide gas to achieve a sterility assurance level (SAL) of 10⁻⁶, eliminating all microbial life (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.3 - Ensure safe reprocessing of medical equipment). Disinfection, while important for semi-critical devices, is not a step in the reprocessing of critical items, as it does not achieve the sterility required; it is a separate process for non-critical or semi-critical equipment.
Option A (clean, sterilize, disinfect) is incorrect because disinfecting after sterilization is unnecessary and redundant, as sterilization already achieves a higher level of microbial kill. Option B (disinfect, clean, sterilize) reverses the logical sequence; cleaning must precede any disinfection or sterilization to remove bioburden, and disinfection is not appropriate for critical items. Option C (disinfect, sterilize) omits cleaning and incorrectly prioritizes disinfection, which is insufficient for critical equipment requiring full sterility.
The focus on cleaning followed by sterilization aligns with CBIC’s emphasis on evidence-based reprocessing protocols to prevent healthcare-associated infections (HAIs), ensuring that critical equipment is safe for patient use (CBIC Practice Analysis, 2022, Domain III: Infection Prevention and Control, Competency 3.4 - Implement environmental cleaning and disinfection protocols). This sequence is supported by standards such as AAMI ST79, which outlines the mandatory cleaning step before sterilization to ensure efficacy and safety.
An infection preventionist (IP) encounters a surgeon at the nurse’s station who loudly disagrees with the IP’s surgical site infection findings. The IP’s BEST response is to:
Report the surgeon to the chief of staff.
Calmly explain that the findings are credible.
Ask the surgeon to speak in a more private setting to review their concerns.
Ask the surgeon to change their tone and leave the nurses’ station if they refuse.
The scenario involves a conflict between an infection preventionist (IP) and a surgeon regarding surgical site infection (SSI) findings, occurring in a public setting (the nurse’s station). The IP’s response must align with professional communication standards, infection control priorities, and the principles of collaboration and conflict resolution as emphasized by the Certification Board of Infection Control and Epidemiology (CBIC). The “best” response should de-escalate the situation, maintain professionalism, and facilitate a constructive dialogue. Let’s evaluate each option:
A. Report the surgeon to the chief of staff: Reporting the surgeon to the chief of staff might be considered if the behavior escalates or violates policy (e.g., harassment or disruption), but it is an escalation that should be a last resort. This action does not address the immediate disagreement about the SSI findings or attempt to resolve the issue collaboratively. It could also strain professional relationships and is not the best initial response, as it bypasses direct communication.
B. Calmly explain that the findings are credible: Explaining the credibility of the findings is important and demonstrates the IP’s confidence in their work, which is based on evidence-based infection control practices. However, doing so in a public setting like the nurse’s station, especially with a loud disagreement, may not be effective. The surgeon may feel challenged or defensive, potentially worsening the situation. While this response has merit, it lacks consideration of the setting and the need for privacy to discuss sensitive data.
C. Ask the surgeon to speak in a more private setting to review their concerns: This response is the most appropriate as it addresses the immediate need to de-escalate the public confrontation and move the discussion to a private setting. It shows respect for the surgeon’s concerns, maintains professionalism, and allows the IP to review the SSI findings (e.g., data collection methods, definitions, or surveillance techniques) in a controlled environment. This aligns with CBIC’s emphasis on effective communication and collaboration with healthcare teams, as well as the need to protect patient confidentiality and maintain a professional atmosphere. It also provides an opportunity to educate the surgeon on the evidence behind the findings, which is a key IP role.
D. Ask the surgeon to change their tone and leave the nurses’ station if they refuse: Requesting a change in tone is reasonable given the loud disagreement, but demanding the surgeon leave if they refuse is confrontational and risks escalating the conflict. This approach could damage the working relationship and does not address the underlying disagreement about the SSI findings. While maintaining a respectful environment is important, this response prioritizes control over collaboration and is less constructive than seeking a private discussion.
The best response is C, as it promotes a professional, collaborative approach by moving the conversation to a private setting. This allows the IP to address the surgeon’s concerns, explain the SSI surveillance methodology (e.g., NHSN definitions or CBIC guidelines), and maintain a positive working relationship, which is critical for effective infection prevention programs. This strategy reflects CBIC’s focus on leadership, communication, and teamwork in healthcare settings.
CBIC Infection Prevention and Control (IPC) Core Competency Model (updated 2023), Domain V: Management and Communication, which stresses effective interpersonal communication and conflict resolution.
CBIC Examination Content Outline, Domain V: Leadership and Program Management, which includes collaborating with healthcare personnel and addressing disagreements professionally.
CDC Guidelines for SSI Surveillance (2023), which emphasize the importance of clear communication of findings to healthcare teams.
It is determined that the Infection Prevention and Control Program has inadequate resources to accomplish the required tasks. What is the FIRST step?
Review studies and recommendations on resource allowances for staffing decisions
Contact hospitals in the region to determine their staffing guidelines
Schedule a meeting with supervisor to discuss current job duties
Update the Infection Prevention and Control Plan
The CBIC Certified Infection Control Exam Study Guide (6th edition) emphasizes that when an Infection Prevention and Control (IPC) Program identifies inadequate resources, the first and most critical step is internal assessment and communication. Scheduling a meeting with the supervisor to discuss current job duties allows the infection preventionist to clearly define workload demands, regulatory requirements, and gaps between assigned responsibilities and available resources.
This initial discussion establishes a shared understanding of scope of practice, priority tasks, and compliance obligations, such as surveillance, reporting, education, emergency preparedness, and performance improvement. The Study Guide highlights that resource justification must begin with a clear inventory of required functions versus available staffing, time, and tools. Without this foundational step, subsequent actions—such as benchmarking, literature review, or plan updates—lack context and organizational alignment.
Option A is an important later step, used to support justification once internal expectations and gaps are defined. Option B may provide benchmarking data but should not precede internal role clarification. Option D is premature, as program plans should be updated only after leadership agreement on scope, priorities, and resources.
For CIC® exam preparation, it is essential to recognize that effective advocacy for IPC resources begins with direct supervisor engagement, role clarification, and documentation of unmet needs. This structured approach aligns with leadership principles and ensures that requests for additional resources are credible, data-driven, and organizationally relevant.
