Alexandria University
Medical Research Institute
Microbiology Department
Program title: Master Degree in infection control
and management
Course title: Health care associated infection
Course code: 1706798
Student name:
Final exam
Semester: spring
Academic year: 2019-2020
Time allowed: 2 hours
Date: 27/ 07/ 2020
Total marks: 60
I) Read the following MCQ questions and choose ONE correct
answer:
( 31 Marks ½ mark each)
1. What is required before you perform hand hygiene?
a)
b)
c)
d)
Remove bracelets
Fingernails should be short
Rings should not have jewels or stones
Assess hands for visible soil
2. Which of the following Hand wash techniques considered the first in the correct
order:
a)
b)
c)
d)
Check for disinfectant concentration
Wet hands
Friction of the hands
Apply soap
3. What is the appropriate flow and water temperature when washing hands?
a)
b)
c)
d)
A medium flow and hot water
A fast flow and cool water
A slow flow and warm water
A medium flow and warm water
4. How should you dry your hands?
a)
b)
c)
d)
From finger tips to wrists
From wrists to finger tips in one direction
In a circular motion covering all areas of the hands and wrists
Lightly pat and allow hands to air dry
5. How long should you wash hands?
a)
b)
c)
d)
5 - 10 seconds
10 - 15 seconds
15 - 20 seconds
20 - 25 seconds
6. According to the Centers for Disease Control, which is the single most important
way to prevent the spread of illness, including COVID 19?
a)
b)
c)
d)
Covering mouth when coughing.
Getting a flu vaccine.
Washing hands regularly throughout the day.
Maintain social distance
7. What is the purpose of personal protective equipment?
a) To protect the patient from the spread of diseases
b) To protect both the healthcare provider and the patient from being infected
with diseases.
c) To protect the healthcare provider from the spread of diseases.
d) To protect equipment from being compromised.
8. What are the three categories of transmission based precaution?
a)
b)
c)
d)
Contact, droplet, airborne
Contact, blood-borne, airborne
Blood-borne, contact, droplet
Airborne, blood-borne, droplet
9. What are the five main areas of personal protection covered by the revised PPE
Standard?
a)
b)
c)
d)
Foot, Head, Eye, Face and Hand
Head, Foot, Leg, Ear and Toe
Toe, Eye, Head, Hand and Knee
Nose, Eye, Head, Thigh and Face
10. When donning PPE, the CDC recommends this order:
a)
b)
c)
d)
Gloves, gown, eye protection, mask
Gown, mask, eye protection, gloves
Eye protection, gown, mask, gloves
Mask, eye protection, gown, gloves
11. Which type of PPE should a health care provider wear if the patient
has tuberculosis?
a)
b)
c)
d)
Eye goggles
A surgical mask
An N95, N99, or N100 respirator
Both a surgical mask and a respirator
12. The pandemic of COVID 19in 2019 outlined the importance of PPE because:
a)
b)
c)
d)
This disease is highly contagious
A significant number of those infected were healthcare staff
No vaccine were available
No treatment for COVID 19
13. Which area of the body is particularly significant in the transmission of
pathogens from healthcare staff to patients?
a)
b)
c)
d)
Mouth
Eyes
Hands
Nasal cavities
14. Gloves should be worn when:
a) Undertaking any clinical procedure that involves patient contact
b) Contact with healthcare-related equipment such as walking frames,
hoists or wheelchairs is anticipated
c) Potential exposure to blood and bodily fluid is anticipated
d) Undertaking any clinical procedure that involves contact with the
patient’s immediate environment
15. Standard Precautions does not include:
a)
b)
c)
d)
Washing hands before and after patient contact
Appropriate handling of contaminated clinical waste
Use of aseptic technique
Use of gloves and gowns at all times
16. Respiratory Hygiene/Cough Etiquette includes all EXCEPT:
a) Sign asking visitors with respiratory symptoms not to enter
b) Providing surgical masks, tissues and hand hygiene products to
patients
c) Dividing waiting rooms between respiratory symptom patients and
those without respiratory symptoms
d) Wearing a respirator and performing hand hygiene when
examining a patient with respiratory symptoms
17. When wearing sterile gloves and performing a sterile procedure, the hands
should:
a)
b)
c)
d)
be kept below the waistline.
be kept above the waistline.
rest on the patient's body.
never touch each other.
18. Cleaning and disinfection should be performed:
a)
b)
c)
d)
On equipment, instruments and devices used on or near patients
On furniture and inanimate objects in patient rooms
On toys in pediatric areas
All of the above
19. The correct Personal Protective Equipment needed to remove used bed linen is
a)
b)
c)
d)
Gloves
Gloves and apron
Gloves, apron and face mask
None
20. The correct procedure to remove used bed linen is
a) Remove all linen and take it to the laundry room
b) Put on PPE, roll and fold the linen into a bundle taking care not to
shake it and take it to the laundry room
c) Put on PPE, roll and fold the linen into a bundle taking care not to
shake it and place it in the correct laundry bag close at hand
d) Wearing gloves before removing linen
21. What is the definition of asepsis?
a)
b)
c)
d)
Asepsis is the process of reducing the number of microorganisms.
Asepsis is to be free from all microorganisms.
Asepsis is the absence of microorganisms that can cause infection.
Asepsis is the process of inhibiting the number of microorganisms.
22. Which of the following describe Aseptic Technique?
a) Aseptic Technique is a framework for aseptic practice which
includes a risk assessment and the use of infection control
measures.
b) Aseptic Technique aims to prevent pathogenic organisms, in
sufficient quantity to cause infection from being introduced to
susceptible sites by hands, surfaces and equipment.
c) Aseptic Technique protects patients during invasive clinical
procedures by using appropriate infection prevention measures.
d) All of the above.
23. The presence of only one living microorganism means an object is:
a)
b)
c)
d)
Aseptic
Sanitized
Disinfected
Contaminated
24. The safe management of linen includes:
a)
b)
c)
d)
storage & handling
bagging, transportation and laundering
a&b
handling
25. All of the following considered as high-touch Surfaces EXCEPT:
a)
b)
c)
d)
Surfaces switches
door knob
chairs
walls
26. Environmental cleaning refers to
a)
b)
c)
d)
Visibly clean of the environment
Disinfection of the environment
Sterilization of the environment
None of the above
27. Who is responsible for cleaning care equipment?
a)
b)
c)
d)
All staff providing care
Domestic staff
Housekeepers
The manager
28. Using disinfectants for environmental cleaning are
a)
b)
c)
d)
not recommended for routine use
only recommended for operating theater
recommended for routine use
None of the above
29. _______ free of microorganisms.
a)
b)
c)
d)
After hand hygiene the hands are
Clean equipment is
Non-latex gloves are
A sterile field is
30. Sterile technique is necessary:
a. for non-surgical procedures involving the vagina or gastrointestinal
tract.
b. for non-surgical procedures involving the mouth or rectum.
c. for procedures that penetrate the skin or mucous membrane.
d. only in the operating or delivery room.
31. The use of intravascular devices can be complicated by a variety of local or
systemic infectious events including;
a)
b)
c)
d)
e)
f)
local site infection
septic thrombophlebitis
endocarditis
metastatic infections.
All of the above
None of the above.
32. The incidence of catheter related blood stream infection (CRBSI) varies
according to:
a)
b)
c)
d)
e)
f)
type of catheter,
frequency of catheter manipulation
underlying disease and
Severity of illness.
All of the above
None of the above.
33. Signs of sepsis:
a)
b)
c)
d)
e)
f)
hypotension,
hypothermia,
decrease urine output
Difficult breathing.
All of the above
None of the above.
34. Process of Catheter-Related Infections include:
a) Pathogen migration along external surface more common early (<
7days).
b) Number of days of insertion.
c) Age of the patients.
d) Severity of original disease.
e) All of the above
f) None of the above.
35. When to suspect catheter related infection:
a)
b)
c)
d)
e)
f)
Non functioning catheter.
Shivering during the use of catheter.
Hypotension
a+b
All of the above
None of the above.
36. Benefits of Chlorhexidine:
a)
b)
c)
d)
e)
f)
bactericidal activity.
effective within 30 seconds after application
systemic absorption
a+b
All of the above
None of the above.
37. Site of choice for central venous line:
a)
b)
c)
d)
e)
f)
Femoral vein
Internal jugular vein
Sub clavian vein.
Radial vein
All of the above
None of the above.
38. In fungal infection in central catheter:
a)
b)
c)
d)
e)
f)
give antifungal for 14 days
remove the catheter
give local and systemic antifungal
Continue antifungal for 7 days after clearance of symptoms.
All of the above
None of the above.
39- Types of organisms closely related to CRBSI include : ( All are true Except)
a)
b)
c)
d)
coagulase-negative staphylococci
Enterococci
Candida spp
Streptococcus pneumonia
39- Urinary tract infection can occur by:
a)
b)
c)
d)
Ascending route.
Hematogenous or lymphatic route.
Through urinary catheterization.
All of the above.
40- The most important risk factor for developing catheter associated urinary tract
infection (CAUTI) is:
a)
b)
c)
d)
Diabetes mellitus.
Duration of catheterization.
Old age.
Kidney stones.
41- Common viral infection that reactivates in first month post renal
transplantation is:
a)
b)
c)
d)
Cytomegalo virus.
Epstein Barr virus.
Herpes viruses 1 and 2.
None of the above.
42- Opportunistic pathogens such as Pneumocystis jiroveci (carinii) can be
manifested post renal transplant in this time frame:
a)
b)
c)
d)
First month post-transplant.
One to six months post-transplant.
More than six months post-transplant.
b and c.
43- If any post-transplant patient who is sero-negative to varicella zoster vaccine
and exposed to someone infected with the virus. What should be done ??
( All are true EXCEPT)
a) He should receive varicella immune globulin (IG) within 96 hours
of exposure.
b) Acyclovir may be considered for post exposure prophylaxis if the
patient presents more than 96 hours following exposure .
c) If IG is not available acyclovir may be considered .
d) He should be vaccinated and receive varicella immune globulin
44- Risk factors for developing active T.B. in renal transplant recipients include .
(All are true Except)
a) Residence in regions with high endemicity.
b) The presence of other immunosuppressing conditions such as
protein malnutrition.
c) Latent TB infection
d) Significant evidence of prior T.B on chest radiograph.
e) Recent skin test conversion.
45-According to the Rule of Nines the patient,s hand is equivalent to …….. of the total
body surface area .
a) 1%
b) 9%
c) 4.5%
d) None of the above
46-The three zones of the body that the Lund and Browder Chart varies depending
on age are :
a)
b)
c)
d)
The head, thighs and lower legs.
The head, arm and lower legs
The head, arm and thighs
The head, thighs and hand
47- In burn patient , the loss of epithelium from a previously reepithelialized
surface is a called
a) Cellulitis;
b) necrotising infection-fasciitis
c) Burn wound impetigo
d) None of the above
48-The patient who has burns to …………………… will most likely require an
endotracheal or tracheostomy tube .
a)
b)
c)
d)
the face and neck
Chest and back
a+b
none of the above
49- -A patient is brought to the emergency department having been involved in
a fire while putting lighter fluid on a grill. The client sustained burns to both
arms. The nurse assesses the burns to be dry and pale white with some areas
that are brown and leathery. Which of the following types of burns does the
nurse determine are present?
a)
b)
c)
d)
First degree or superficial burns
Second degree burns
Third degree (full thickness)
Fourth degree burns
50-You receive a patient who has experienced a burn on the right leg. You note
the burn contains small blisters and is extremely pinkish red and shiny/moist.
The patient reports severe pain. You document this burn as:*
a)
b)
c)
d)
.1st Degree (superficial)
2nd Degree (partial-thickness)
3rd Degree (full-thickness)
4th Degree (deep full-thickness)
51- You have a patient who has multiple burns on their body. Using the rule of
nines, what is the estimate extent of burn injury to the following patient. The
following areas are burned: Anterior trunk, anterior left arm, and posterior left
leg.*
a)
b)
c)
d)
31.5%
36%
28.5%
30%
52-Although Urinary tract infection (UTI) has received little attention in burn
patients , But precipitating Risk factors specific to burn patients include :
a) The presence of perineal burns in certain patients and
b) The increased length of time patients require catheterization in the
treatment of extensive injuries.
c) Patients with indwelling urinary catheters.
d) All of the above
53-Infection outbreak in burn unit could be related to all of the following
Except
a)
b)
c)
d)
Hydrotherapy and common treatment rooms
Contaminated equipment such as mattresses
The hands and apron area of the care service provided person
Site of Burn
54- Routine surveillance Burn wound cultures should be obtained
a)
b)
c)
d)
On admission for patients transferred from other facilities,:
On admission throat cultures for pediatric patients,
To provide early identification of organisms colonizing the wound
All of the above
55-- Newborn or neonate refers to an infant in the first 28 days after birth, the
term applies to :
a)
b)
c)
d)
preterm infants
full term infants
post mature
all of the above
e) a+b only
56-Neonatal Sepsis is a clinical syndrome characterized by :
a)
b)
c)
d)
e)
Signs and symptoms of infection
With accompanying bacteremia in the first month of life .
Without accompanying bacteremia in the first month of life .
All of the above
A+b only
57-Ante natal screening is an ante-natal care measure to control neonatal sepsis ,
It includes screening for all the following EXCEPT
a)
b)
c)
d)
asymptomatic bacteriuria
hepatitis B ,C
group A streptococci
STDs (syphilis, HIV, gonorrhea, and chlamydia)
58-Classification of Neonatal Sepsis depends upon
a)
b)
c)
d)
the onset of symptoms
the severity of symptoms
the type of symptoms
Type of labour ( normal ,or, ceasarian )
59-If a woman found to be HBs Ag positive , in order to prevent neonatal Viral
Infection transmission :
a) the infant receives at-birth or within 24 hours after birth specific antiHBV immune globulin ,
b) HBV vaccination are effective in reducing the risk of vertical transmission
c) the infant completes the recommended hepatitis B vaccine series on
schedule
d) All of the above
60-Risk factors for developing late - onset neonatal sepsis include the following
EXCEPT :
a) Chorioamnionitis
b) prolonged duration of parenteral nutrition
c) invasive interventions, such as mechanical ventilation , Umbilical Arterial
and Venous Catheters
d) Prematurity
61- Evidence Based Bundle Approach to Prevent late onset neonatal sepsis Will
target:
a)
b)
c)
d)
Central Line-associated Bloodstream Infection
Ventilator-associated Pneumonia
Multidrug-resistant Organisms
All of the above
62-…………………… is the neonate weighing less than 1500 gm.
a) Very low birth weight
b) Extremely low birth weight
c) Low birth weight
II) Circle the letter "T” if the statement is true and "F" if the
statement is false:
( 29 Marks ½ mark each)
1. Hands and forearms should be lower than your elbows when performing hand hygiene
routine .
2. It is important to remove all the soap from wrists and hands; keeping the hands up and
elbows down to rinse away the microorganisms.
3. Health care provider should use a dry, clean paper towel when turning off the faucet .
4. Antibacterial soaps kill more germs than regular soaps do .
5. The Cold and Flu virus can be spread by coughs, sneezes and contact with surfaces and
objects contaminated with the virus.
6. A KEY SITE is the area of a PATIENT which is involved in an invasive procedure and
which must be protected from introduced microorganisms.
7. The linen bags should be used for linen only and never for clinical waste.
8. The healthcare environment contains represents a primary source for infection
transmission.
9. Environmental cleaning must be performed from cleaner to dirtier areas.
10. Medical staff must wear safety glasses and face shelled on the jobsite at all times.
11. If you wear regular eyeglasses, you never need to wear safety glasses.
12. Hard surfaces do not usually require disinfectants for effective cleaning.
13. Moist areas are not considered sterile.
14. A patient coughing considered as a reservoir, which component of the infection chain.
15. All items in a sterile field must be sterile.
16. Only areas that can be seen by the clinician are considered sterile.
17. Edges of sterile areas or fields are not considered sterile.
18. Environmental cleaning is a fundamental principle of infection prevention in
healthcare settings.
19. Personnel who wear sterile gowns must pass each other back to front.
20. It’s ok to forget to wear my PPE once in a while.
21. Hospital wastes is considered infectious agent in the chain of infection.
22. The frequency of linen change will depend on the individual case.
23. Linen not contaminated with blood or other body fluids may be segregated, placed
into appropriate laundry bags and securely closed.
24. Wet or linen saturated with body fluids should be folded with the wet areas inside.
25. After removal of linen, soiled linen must be handled with care at all times.
26. Mattresses and pillows may be a major source of contamination if not properly
protected.
27. Bleach facilitate inactivation of pathogens that might be present in the linen.
28. Health Care Wastes is all Wastes (unwanted and discarded) generated from all
Health-Care Establishments
29. All used sharps must be discarded without re-sheathing in a puncture resistant
container that is readily accessible.
30. Keeping waste containers in convenient place for users not recommended.
31- Bacteremia (BSI): is a condition where the entire body is involved in a toxic
condition, with microorganisms and their toxins spreading from one site to another.
32- Surveillance definition overestimates the true incidence of CRBSI because not all
BSIs originate from a catheter.
33- Age of the patients is one of the modifiable risk factors for catheters related blood
stream infection.
.
34- Urine analysis should not be routinely performed on all long term catheterized
patients.
35- Changing indwelling catheters or drainage bags at routine, fixed intervals is
recommended.
36- Nitrate reductase test is positive in any case of urinary tract infection.
37- Use systemic antimicrobials to prevent catheter associated UTI in patients requiring
long-term catheterization.
38- Application of topical antibiotic cream to the meatus around the urinary catheter reduce
bacteriuria.
39- Infection with herpes simplex virus in renal transplant recipients is usually caused by
reactivation of latent virus.
40- Varicella vaccine can be given for non- immune post-transplant patients.
41- It is better to focus on treatment HCV positive patients with ESRD before renal
transplantation.
42- It is recommended to screen donors and recipients for BK polyoma virus before
transplantation.
43- Renal transplantation is associated with the lowest incidence of invasive fungal
infections.
44- The recommended vaccinations prior to renal transplantation include : Hepatitis B
vaccine , Measles- Mumps - Rubella vaccine and BCG ( for TB) .
45- The Patient’s Palm technique is most effective when burns cover less than 15% or
more than 85% of TBSA.
46- The risk of burn wound infection relates directly to the extent of the burn.
47- Routine environmental surveillance culturing is generally recommended on units with
burn patients .
48- In the paediatrician’s office, Sharing of toys poses a potential health risk.
49- Empiric antimicrobial therapy to treat fever is strongly recommended In burn
patients.
50- Prophylactic antimicrobial therapy is recommended only for coverage of the
immediate perioperative to cover the documented increase in risk of transient
bacteremia.
51- The sub-categories of preterm birth are based on gestational age or birth weight .
52- The cause of infection in Early Onset Sepsis is the widespread use of broadspectrum antibiotics during pregnancy or delivery or immediately following
delivery.
53- Several vertically transmitted infections are included in the TORCH which stands
for the name of the molecular test used for diagnosis of early onset neonatal sepsis .
54- In resource-limited countries , Gram-negative bacteria are the predominant bacteria
responsible for late onset sepsis in neonatal units .
55- Maintaining neonatal skin integrity is one of the Multidrug-resistant organisms
(MDROs) Prevention Bundle.
56- Avoid femoral lines is one of the Evidence-Based Strategies Selected to Reduce
Catheters related BSIs .
57- Simultaneous quantitative cultures of blood samples with a ratio of 1 : 5
(CVC vs. peripheral) can diagnose catheter related blood stream infection.
58- Recurrent urinary tract infection is considered when more than 3 culture confirmed
UTI in 1 month with the same organism .
Good Luck
Health care associated infection
Course code: 1706798
Model answer
I) Read the following MCQ questions and choose ONE correct answer:
1. What is required before you perform hand hygiene? ( 31 Marks ½ mark each)
a. Remove bracelets
b. Fingernails should be short
c. Rings should not have jewels or stones
d. Assess hands for visible soil
2. Which of the following Hand wash techniques considered the first in the correct
order:
a. Check for disinfectant concentration
b. Wet hands
c. Friction of the hands
d. Apply soap
3. What is the appropriate flow and water temperature when washing hands?
a. A medium flow and hot water
b. A fast flow and cool water
c. A slow flow and warm water
d. A medium flow and warm water
4. How should you dry your hands?
a. From finger tips to wrists
b. From wrists to finger tips in one direction
c. In a circular motion covering all areas of the hands and wrists
d. Lightly pat and allow hands to air dry
5. How long should you wash hands?
a. 5 - 10 seconds
b. 10 - 15 seconds
c. 15 - 20 seconds
d. 20 - 25 seconds
6. According to the Centers for Disease Control, which is the single most important
way to prevent the spread of illness, including COVID 19?
a. Covering mouth when coughing.
b. Getting a flu vaccine.
c. Washing hands regularly throughout the day.
d. Maintain social distance
7. What is the purpose of personal protective equipment?
a. To protect the patient from the spread of diseases
b. To protect both the healthcare provider and the patient from being infected with
diseases.
c. To protect the healthcare provider from the spread of diseases.
d. To protect equipment from being compromised.
8. What are the three categories of transmission based precaution?
a. Contact, droplet, airborne
b. Contact, blood-borne, airborne
c. Blood-borne, contact, droplet
d. Airborne, blood-borne, droplet
9. What are the five main areas of personal protection covered by the revised PPE
Standard?
a. Foot, Head, Eye, Face and Hand
b. Head, Foot, Leg, Ear and Toe
c. Toe, Eye, Head, Hand and Knee
d. Nose, Eye, Head, Thigh and Face
10. When donning PPE, the CDC recommends this order:
a. Gloves, gown, eye protection, mask
b. Gown, mask, eye protection, gloves
c. Eye protection, gown, mask, gloves
d. Mask, eye protection, gown, gloves
11. Which type of PPE should a health care provider wear if the patient
has tuberculosis?
a. Eye goggles
b. A surgical mask
c. An N95, N99, or N100 respirator
d. Both a surgical mask and a respirator
12. The pandemic of COVID 19in 2019 outlined the importance of PPE because:
a. This disease is highly contagious
b. A significant number of those infected were healthcare staff
c. No vaccine were available
d. No treatment for COVID 19
13. Which area of the body is particularly significant in the transmission of
pathogens from healthcare staff to patients?
a. Mouth
b. Eyes
c. Hands
d. Nasal cavities
14. Gloves should be worn when:
a. Undertaking any clinical procedure that involves patient contact
b. Contact with healthcare-related equipment such as walking frames, hoists or
wheelchairs is anticipated
c. Potential exposure to blood and bodily fluid is anticipated
d. Undertaking any clinical procedure that involves contact with the patient’s
immediate environment
15. Standard Precautions does not include:
a. Washing hands before and after patient contact
b. Appropriate handling of contaminated clinical waste
c. Use of aseptic technique
d. Use of gloves and gowns at all times
16. Respiratory Hygiene/Cough Etiquette includes all EXCEPT:
a. Sign asking visitors with respiratory symptoms not to enter
b. Providing surgical masks, tissues and hand hygiene products to patients
c. Dividing waiting rooms between respiratory symptom patients and those
without respiratory symptoms
d. Wearing a respirator and performing hand hygiene when examining a patient
with respiratory symptoms
17. When wearing sterile gloves and performing a sterile procedure, the hands
should:
a. be kept below the waistline.
b. be kept above the waistline.
c. rest on the patient's body.
d. never touch each other.
18. Cleaning and disinfection should be performed:
a. On equipment, instruments and devices used on or near patients
b. On furniture and inanimate objects in patient rooms
c. On toys in pediatric areas
d. All of the above
19. The correct Personal Protective Equipment needed to remove used bed linen is
a. Gloves
b. Gloves and apron
c. Gloves, apron and face mask
d. None
20. The correct procedure to remove used bed linen is
a. Remove all linen and take it to the laundry room
b. Put on PPE, roll and fold the linen into a bundle taking care not to shake it and
take it to the laundry room
c. Put on PPE, roll and fold the linen into a bundle taking care not to shake it and
place it in the correct laundry bag close at hand
d. Wearing gloves before removing linen
21. What is the definition of asepsis?
a. Asepsis is the process of reducing the number of microorganisms.
b. Asepsis is to be free from all microorganisms.
c. Asepsis is the absence of microorganisms that can cause infection.
d. Asepsis is the process of inhibiting the number of microorganisms.
22. Which of the following describe Aseptic Technique?
a. Aseptic Technique is a framework for aseptic practice which includes a risk
assessment and the use of infection control measures.
b. Aseptic Technique aims to prevent pathogenic organisms, in sufficient quantity
to cause infection from being introduced to susceptible sites by hands, surfaces
and equipment.
c. Aseptic Technique protects patients during invasive clinical procedures by
using appropriate infection prevention measures.
d. All of the above.
23. The presence of only one living microorganism means an object is:
a. Aseptic
b. Sanitized
c. Disinfected
d. Contaminated
24. The safe management of linen includes:
a) storage & handling
b) bagging, transportation and laundering
c) a & b
d) handling
25. All of the following considered as high-touch Surfaces EXCEPT:
a. Surfaces switches
b. door knob
c. chairs
d. walls
26. Environmental cleaning refers to
a. Visibly clean of the environment
b. Disinfection of the environment
c. Sterilization of the environment
d. None of the above
27. Who is responsible for cleaning care equipment?
a. All staff providing care
b. Domestic staff
c. Housekeepers
d. The manager
28. Using disinfectants for environmental cleaning are
a. not recommended for routine use
b. only recommended for operating theater
c. recommended for routine use
d. None of the above
29. _______ free of microorganisms.
a. After hand hygiene the hands are
b. Clean equipment is
c. Non-latex gloves are
d. A sterile field is
30. Sterile technique is necessary:
a. for non-surgical procedures involving the vagina or gastrointestinal tract.
b. for non-surgical procedures involving the mouth or rectum.
c. for procedures that penetrate the skin or mucous membrane.
d. only in the operating or delivery room
31. The use of intravascular devices can be complicated by a variety of local or
systemic infectious events including;
a. local site infection
b. septic thrombophlebitis
c. endocarditis
d. metastatic infections.
e. All of the above
f. None of the above.
32. The incidence of catheter related blood stream infection (CRBSI) varies
according to:
a. type of catheter,
b. frequency of catheter manipulation
c. underlying disease and
d. Severity of illness.
e. All of the above
f. None of the above.
33. Signs of sepsis:
a. hypotension,
b. hypothermia,
c. decrease urine output
d. Difficult breathing.
e. All of the above
f. None of the above.
34. Process of Catheter-Related Infections include:
a. Pathogen migration along external surface more common early (< 7days).
b. Number of days of insertion.
c. Age of the patients.
d. Severity of original disease.
e. All of the above
f. None of the above.
35. When to suspect catheter related infection:
a. Non functioning catheter.
b. Shivering during the use of catheter.
c. Hypotension
d. a+b
e. All of the above
f. None of the above.
36. Benefits of Chlorhexidine:
a. bactericidal activity.
b. effective within 30 seconds after application
c. systemic absorption
d. a+b
e. All of the above
f. None of the above.
37. Site of choice for central venous line:
a. Femoral vein
b. Internal jugular vein
c. Sub clavian vein.
d. Radial vein
e. All of the above
f. None of the above.
38. In fungal infection in central catheter:
a. give antifungal for 14 days
b. remove the catheter
c. give local and systemic antifungal
d. Continue antifungal for 7 days after clearance of symptoms.
e. All of the above
f. None of the above.
39- Types of organisms closely related to CRBSI include : ( All are true Except)
e)
f)
g)
h)
coagulase-negative staphylococci
Enterococci
Candida spp
Streptococcus pneumonia
39- Urinary tract infection can occur by:
a. Ascending route.
b. Hematogenous or lymphatic route.
c. Through urinary catheterization.
d. All of the above.
40- The most important risk factor for developing catheter associated urinary tract
infection (CAUTI) is:
a. Diabetes mellitus.
b. Duration of catheterization.
c. Old age.
d. Kidney stones.
41- Common viral infection that reactivates in first month post renal
transplantation is:
a.
Cytomegalo virus.
b.
Epstein Barr virus.
c.
Herpes viruses 1 and 2.
d.
None of the above.
42- Opportunistic pathogens such as Pneumocystis jiroveci (carinii) can be
manifested post renal transplant in this time frame:
a.
First month post-transplant.
b.
One to six months post-transplant.
c.
More than six months post-transplant.
d.
b and c.
43- If any post-transplant patient who is sero-negative to varicella zoster vaccine
and exposed to someone infected with the virus. What should be done ??
( All are true EXCEPT)
e) He should receive varicella immune globulin (IG) within 96 hours
of exposure.
f) Acyclovir may be considered for post exposure prophylaxis if the
patient presents more than 96 hours following exposure .
g) If IG is not available acyclovir may be considered .
h) He should be vaccinated and receive varicella immune globulin
44- Risk factors for developing active T.B. in renal transplant recipients include .
(All are true except)
f) Residence in regions with high endemicity.
g) The presence of other immunosuppressing conditions such as
protein malnutrition.
h) Latent TB infection
i) Significant evidence of prior T.B on chest radiograph.
j) Recent skin test conversion.
45-According to the Rule of Nines the patient,s hand is equivalent to …….. of the
total body surface area .
a) 1%
b) 9%
c) 4.5%
d) None of the above
46-The three zones of the body that the Lund and Browder Chart varies
depending on age are :
e)
f)
g)
h)
The head, thighs and lower legs.
The head, arm and lower legs
The head, arm and thighs
The head, thighs and hand
47- In burn patient , the loss of epithelium from a previously reepithelialized
surface is a called
e) Cellulitis;
f) necrotising infection-fasciitis
g) Burn wound impetigo
h) None of the above
48-The patient who has burns to …………………… will most likely require an
endotracheal or tracheostomy tube .
e)
f)
g)
h)
the face and neck
Chest and back
a+b
none of the above
49- -A patient is brought to the emergency department having been involved in
a fire while putting lighter fluid on a grill. The client sustained burns to both
arms. The nurse assesses the burns to be dry and pale white with some areas
that are brown and leathery. Which of the following types of burns does the
nurse determine are present?
e)
f)
g)
h)
First degree or superficial burns
Second degree burns
Third degree (full thickness)
Fourth degree burns
50-You receive a patient who has experienced a burn on the right leg. You note
the burn contains small blisters and is extremely pinkish red and shiny/moist.
The patient reports severe pain. You document this burn as:*
a)
b)
c)
d)
.1st Degree (superficial)
2nd Degree (partial-thickness)
3rd Degree (full-thickness)
4th Degree (deep full-thickness)
51- You have a patient who has multiple burns on their body. Using the rule of
nines, what is the estimate extent of burn injury to the following patient. The
following areas are burned: Anterior trunk, anterior left arm, and posterior left
leg.*
e)
f)
g)
h)
31.5%
36%
28.5%
30%
52-Although Urinary tract infection (UTI) has received little attention in burn
patients , But precipitating Risk factors specific to burn patients include :
e) The presence of perineal burns in certain patients and
f) The increased length of time patients require catheterization in the
treatment of extensive injuries.
g) Patients with indwelling urinary catheters.
h) All of the above
53-Infection outbreak in burn unit could be related to all of the following
Except
a)
b)
c)
d)
Hydrotherapy and common treatment rooms
Contaminated equipment such as mattresses
The hands and apron area of the care service provided person
Site of Burn
54- Routine surveillance Burn wound cultures should be obtained
e)
f)
g)
h)
On admission for patients transferred from other facilities,:
On admission throat cultures for pediatric patients,
To provide early identification of organisms colonizing the wound
All of the above
55-- Newborn or neonate refers to an infant in the first 28 days after birth, the
term applies to :
f)
g)
h)
i)
j)
preterm infants
full term infants
post mature
all of the above
a+b only
56-Neonatal Sepsis is a clinical syndrome characterized by :
f)
g)
h)
i)
j)
Signs and symptoms of infection
With accompanying bacteremia in the first month of life .
Without accompanying bacteremia in the first month of life .
All of the above
A+b only
57-Ante natal screening is an ante-natal care measure to control neonatal sepsis ,
It includes screening for all the following EXCEPT
e)
f)
g)
h)
asymptomatic bacteriuria
hepatitis B ,C
group A streptococci
STDs (syphilis, HIV, gonorrhea, and chlamydia)
58-Classification of Neonatal Sepsis depends upon
e) the onset of symptoms
f) the severity of symptoms
g) the type of symptoms
h) Type of labour ( normal ,or, ceasarian )
59-If a woman found to be HBs Ag positive , in order to prevent neonatal Viral
Infection transmission :
e) the infant receives at-birth or within 24 hours after birth specific antiHBV immune globulin ,
f) HBV vaccination are effective in reducing the risk of vertical transmission
g) the infant completes the recommended hepatitis B vaccine series on
schedule
h) All of the above
60-Risk factors for developing late - onset neonatal sepsis include the following
EXCEPT :
e) Chorioamnionitis
f) prolonged duration of parenteral nutrition
g) invasive interventions, such as mechanical ventilation , Umbilical Arterial
and Venous Catheters
h) Prematurity
61- Evidence Based Bundle Approach to Prevent late onset neonatal sepsis Will
target:
e)
f)
g)
h)
Central Line-associated Bloodstream Infection
Ventilator-associated Pneumonia
Multidrug-resistant Organisms
All of the above
62-…………………… is the neonate weighing less than 1500 gm.
d) Very low birth weight
e) Extremely low birth weight
f) Low birth weight
1. II) Circle the letter "T” if the statement is true and "F" if
the statement is false: ( 29 Marks ½ mark each)
1. Hands and forearms should be lower than your elbows when performing hand
hygiene routine
T
2. It is important to remove all the soap from wrists and hands; keeping the hands
up and elbows down to rinse away the microorganisms.
F
3. Health care provider should use a dry, clean paper towel when turning off the
faucet
T
4. Antibacterial soaps kill more germs than regular soaps do
F
5. The Cold and Flu virus can be spread by coughs, sneezes and contact with
surfaces and objects contaminated with the virus.
T
6 A KEY SITE is the area of a PATIENT which is involved in an invasive procedure
and which must be protected from introduced microorganisms. T
7 The linen bags should be used for linen only and never for clinical waste. T
8 The healthcare environment contains represents a primary source for infection
transmission.
F
9. Environmental cleaning must be performed from cleaner to dirtier areas. T
10. Medical staff must wear safety glasses and face shelled on the jobsite at all times
F
11. If you wear regular eyeglasses, you never need to wear safety glasses.
T
12. Hard surfaces do not usually require disinfectants for effective cleaning. T
13. Moist areas are not considered sterile.
T
14. A patient coughing considered as a reservoir, which component of the infection
chain.
T
15. All items in a sterile field must be sterile. T
16. Only areas that can be seen by the clinician are considered sterile. T
17. Edges of sterile areas or fields are not considered sterile.
F
18. Environmental cleaning is a fundamental principle of infection prevention in
healthcare settings.
F
19. Personnel who wear sterile gowns must pass each other back to front. T
20. It’s ok to forget to wear my PPE once in a while.
F
21. Hospital wastes is considered infectious agent in the chain of infection. T
22. The frequency of linen change will depend on the individual case.
T
23. Linen not contaminated with blood or other body fluids may be segregated,
placed into appropriate laundry bags and securely closed.
T
24. Wet or linen saturated with body fluids should be folded with the wet areas
inside.
T
25. After removal of linen, soiled linen must be handled with care at all times. T
26. Mattresses and pillows may be a major source of contamination if not properly
protected.
T
27. Bleach facilitate inactivation of pathogens that might be present in the linen. T
28. Health Care Wastes is all Wastes (unwanted and discarded) generated from all
Health-Care Establishments
T
29. All used sharps must be discarded without re-sheathing in a puncture resistant
container that is readily accessible.
T
30. Keeping waste containers in convenient place for users not recommended.
F
31.Bacteremia (BSI): is a condition where the entire body is involved in a toxic
condition, with microorganisms and their toxins spreading from one site to another.
32. Surveillance definition overestimates the true incidence of CRBSI because not all
BSIs originate from a catheter.
T
33.Age of the patients is one of the modifiable risk factors for catheters related
blood stream infection.
F
34.Urine analysis should not be routinely performed on all long term catheterized
patients.
(True)
35.Changing indwelling catheters or drainage bags at routine, fixed intervals is
recommended.
(False)
36. Nitrate reductase test is positive in any case of urinary tract infection.
(False)
37.Use systemic antimicrobials to prevent catheter associated UTI in patients
requiring long-term catheterization.
(False)
38.Application of topical antibiotic cream to the meatus around the urinary
catheter reduce bacteriuria.
(False)
39.Infection with herpes simplex virus in renal transplant recipients is usually
caused by reactivation of latent virus.
(True)
40.Varicella vaccine can be given for non- immune post-transplant patients. (False)
41.It is better to focus on treatment HCV positive patients with ESRD before renal
transplantation.
(True)
42.It is recommended to screen donors and recipients for BK polyoma virus before
transplantation.
(False)
43. Renal transplantation is associated with the lowest incidence of invasive fungal
infections. ( True)
44.The recommended vaccinations prior to renal transplantation include : Hepatitis
B vaccine , Measles- Mumps - Rubella vaccine and BCG ( for TB) . ( False)
45.The Patient’s Palm technique is most effective when burns cover less than 15%
or more than 85% of TBSA.
(T)
46.The risk of burn wound infection relates directly to the extent of the burn(T) .
47.Routine environmental surveillance culturing is generally recommended on units
with burn patients
(F)
48.In the paediatrician’s office, Sharing of toys poses a potential health risk.
(T)
49.Empiric antimicrobial therapy to treat fever is strongly recommended In burn
patients.
(F)
50.Prophylactic antimicrobial therapy is recommended only for coverage of the
immediate perioperative to cover the documented increase in risk of transient
bacteremia.
51. The sub-categories of preterm birth are based on gestational age or birth
weight .
T
52.The cause of infection in Early Onset Sepsis is the widespread use of broadspectrum antibiotics during pregnancy or delivery or immediately following
delivery.
F
53.Several vertically transmitted infections are included in the TORCH which
stands for the name of the molecular test used for diagnosis of early onset neonatal
sepsis
(F)
54.In resource-limited countries , Gram-negative bacteria are the predominant
bacteria responsible for late onset sepsis in neonatal units,
T
55.Maintaining neonatal skin integrity is one of the Multidrug-resistant organisms
(MDROs) Prevention Bundle.
T
56. Avoid femoral lines is one of the Evidence-Based Strategies Selected to Reduce
Catheters related BSIs . (T)
57.Simultaneous quantitative cultures of blood samples with a ratio of 1 : 5 (CVC
vs. peripheral) can diagnose catheter related blood stream infection. (F)
58.Recurrent urinary tract infection is considered when more than 3 culture
confirmed UTI in 1 month with the same organism . ( F)
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