CIC Practice Questions (2026) — Free Sample Questions with Answers

Answer: C

Accept the identification and use standard precautions only.: Ignores that this result is a known misidentification of C. auris.

Call it urine colonization that needs no further action.: Colonized patients spread C. auris; colonization still needs precautions.

Start contact precautions and request confirmatory identification.: Correct. Conventional biochemical systems often misidentify C. auris as C. haemulonii or other species. With a transfer from a facility with C. auris, treat the isolate as possible C. auris: contact precautions now and confirmation by MALDI-TOF or molecular methods, often through public health.

Require a negative culture after antifungal therapy before transfer.: Treatment does not reliably clear colonization, and the urgent need is identification and precautions.

Know which reports may hide C. auris (C. haemulonii and other species on biochemical systems) and escalate them for confirmatory testing.

Answer: C

It is community onset, because Legionella is common in natural and municipal water sources.: The organism is environmental, but an 18-day continuous stay places the exposure inside the facility.

Report it to public health, but wait for a second case before investigating the water system.: Reporting is right, but the two-case threshold applies to possible cases; one presumptive healthcare-associated case is enough to start the water-system investigation now.

It is healthcare-associated, so start a water-system investigation with public health.: Correct. The usual incubation period is 2–14 days, so an 18-day continuous stay places the exposure in the facility. CDC advises that even one such presumptive case should prompt a full investigation of the water system with the health department.

It is healthcare-associated, so place the patient on droplet precautions to protect roommates.: The classification is right, but Legionella is not spread person to person; standard precautions are used, and the concern is the water source.

Compare the onset with the incubation period: Legionnaires' disease after a long continuous stay is presumed facility-acquired and calls for a water-system investigation.

Answer: B

A CLABSI, because the line was in place on the date of event: Being in place on the date of event is necessary but not enough; the line must have been in for more than 2 consecutive days.

A healthcare-associated BSI that is not central line–associated: Correct. The date of event (day 3) makes it healthcare-associated, but the line has been in place for only 2 calendar days (day of placement = device day 1). A CLABSI requires the line to be in place for more than 2 consecutive days on the date of event.

A present-on-admission BSI, because it began within 3 days of admission: POA covers the 2 days before admission, the day of admission and the next day; day 3 is healthcare-associated.

A CLABSI, because the line is the only likely source of the infection: Clinical judgment about the source does not override the device-day requirement.

Two separate counts apply: hospital days decide POA vs healthcare-associated, and device days decide whether the event is device-associated.

Answer: A

A pseudo-outbreak from contamination of Scope C or its reprocessing: Correct. Positive cultures without clinical disease, all linked to one bronchoscope, with negative same-batch specimens from other scopes, point to a pseudo-outbreak from scope contamination (e.g., tap-water rinse or a reprocessing failure).

A true outbreak of NTM pneumonia transmitted by Scope C: No patient has clinical or radiologic disease, so these are not true infections.

Laboratory cross-contamination of specimens during culture processing: Specimens from other scopes in the same batches were negative, which points away from the laboratory.

Preexisting NTM colonization of the patients' airways: Five colonized patients, all on one scope and with one organism, is far more consistent with a common device source.

Verify an apparent outbreak first: positive cultures without clinical disease, clustered around one device or process, suggest a pseudo-outbreak.

Answer: D

1. RR = [a ÷ (a + b)] ÷ [c ÷ (c + d)].
2. Risk in OR 3 = 9 ÷ 60 = 0.15; risk in other ORs = 7 ÷ 140 = 0.05.
3. 0.15 ÷ 0.05 = 3.00.
4. Procedures in OR 3 had three times the SSI risk; this supports a hypothesis to investigate, not proof of cause.

0.10: This is the risk difference (0.15 − 0.05), not a ratio.

0.33: Inverts the ratio (risk in other rooms ÷ risk in OR 3).

1.29: Divides the case counts (9 ÷ 7) without using the group sizes.

3.00: Correct. RR = (9 ÷ 60) ÷ (7 ÷ 140) = 0.15 ÷ 0.05 = 3.00: SSI risk was three times higher in OR 3.

In a cohort, compare the incidence in the exposed with the incidence in the unexposed: RR = risk exposed ÷ risk unexposed.

Answer: C

Continue prophylaxis until the drains are removed.: Drains are not a reason to continue prophylaxis; the guideline specifically addresses this.

Shorten prophylaxis to 24 hours after surgery for all procedures.: Better than 48 hours, but the guideline recommends no doses after closure.

Stop prophylaxis at incision closure, even with drains in place.: Correct. The CDC 2017 SSI guideline recommends no additional prophylactic doses after the incision is closed in clean and clean-contaminated procedures, even with a drain in place.

Switch to vancomycin for broader coverage during the 48 hours.: Changes the drug but keeps the unnecessary duration, and adds toxicity.

Surgical prophylaxis should achieve tissue levels at incision and stop at closure for clean and clean-contaminated procedures.

Answer: B

Stop precautions now, since two negative smears rule out TB.: Three negative smears are needed; two is not enough.

Continue until a third negative smear or another diagnosis.: Correct. Airborne precautions for suspected TB may be stopped when infectious TB is considered unlikely and another diagnosis explains the illness, or after three consecutive negative AFB smears collected 8–24 hours apart, with at least one early-morning specimen (TB Guideline 2005).

Stop precautions once the patient has received 48 hours of therapy.: Two days of empiric therapy does not establish that the patient is noninfectious.

Continue precautions until the sputum cultures are finalized.: Cultures take weeks; smears or an alternative diagnosis can allow earlier discontinuation.

For suspected TB, stop airborne precautions after three negative AFB smears (8–24 hours apart, one early morning) or when another diagnosis is confirmed.

Answer: B

A continent patient with MRSA nasal colonization found on screening: Contact precautions are needed, but a continent, colonized patient contaminates the environment far less.

A patient with C. difficile infection and incontinent diarrhea: Correct. Patients with conditions that heavily contaminate the environment, such as incontinence with C. difficile diarrhea, have the highest priority for single rooms (2007 Isolation Guideline).

A patient with VRE in the urine who has a closed drainage system: A closed system contains the urine; transmission risk is lower than with incontinent diarrhea.

A patient with an ESBL E. coli urinary infection who is ambulatory: Lower risk of environmental contamination; this patient can be cohorted or placed with precautions per policy.

When single rooms are scarce, give them to patients whose secretions or excretions are hardest to contain, such as incontinent C. difficile patients.

Answer: C

Replace the sharps containers more often on all units.: Overfilled containers caused 3 injuries; helpful, but not the main pattern.

Switch the facility to blunt suture needles for all closures.: Suturing caused only 2 injuries; blunt needles help but do not address most events.

Train staff to activate the safety feature right after use.: Correct. Thirteen of 17 injuries involved a safety device whose feature was not activated, most of them after use and before disposal. Immediate activation, with hands-on training and device feedback, targets the main pattern.

Reissue the policy prohibiting needle recapping by hand.: Recapping caused only 1 injury, so a policy memo addresses little.

Analyze sharps injuries by activity and device: when safety features are not being activated, the fix is training and possibly a device that activates passively.

Answer: D

Focus on the cardiac step-down unit, because it has the lowest hand hygiene compliance.: Hand hygiene there needs attention, but the unit has the lowest line use and an SIR below 1.0, so it is not the CLABSI priority.

Focus on the surgical ICU, because both its SIR and its hand hygiene results are unfavorable.: Its SIR of 1.30 has a confidence interval that includes 1.0, so it is not significantly different from predicted.

Focus on the oncology unit, because its patients have the highest risk of bloodstream infection.: Host risk is built into the predicted count, and its SIR of 0.85 shows fewer infections than predicted.

Focus on the medical ICU, because its CLABSI SIR is significantly higher than predicted.: Correct: only the medical ICU has an SIR whose 95% CI (1.15–3.01) lies entirely above 1.0, so it has significantly more CLABSIs than predicted.

An SIR above 1.0 matters only when its confidence interval excludes 1.0; process measures help explain outcomes but do not replace them.

Answer: D

A trend is present, because compliance rose in five or more consecutive months after month 9.: After month 9 the values alternate up and down (76, 78, 75, 79, 77, 80, 78, 81); a trend needs five or more consecutive rises.

No conclusion is possible until upper and lower control limits are calculated and plotted for the series.: Control limits belong to control charts; run-chart rules (shift, trend, runs, astronomical point) judge non-random change against the median without them.

Month 16 is an astronomical data point, and it is the only evidence that real change occurred.: At 81%, month 16 is barely above the other post-intervention months, so it is not an obviously different point, and it is not the only signal.

Eight consecutive points above the baseline median form a shift, signaling non-random improvement.: Correct: months 9–16 all sit above the 72% median. Six or more consecutive points on one side of the median is a shift, a signal of non-random change that coincides with the coaching.

Run-chart rules: a shift is 6 or more consecutive points on one side of the median; a trend is 5 or more consecutive rises or falls. Neither needs control limits.

Answer: C

Selection bias, because the ICU patients were not randomly assigned to receive the dressings.: Every patient on the unit was included in both periods; selection is not the main threat here.

Recall bias, because the CLABSI data were collected retrospectively from records.: Recall bias affects self-reported exposures; CLABSIs are identified from laboratory and record data.

Confounding, because the other interventions began at the same time as the dressings.: Correct: the checklist and line team started with the dressings, so their effects cannot be separated from the dressings' effect.

Chance, because two six-month periods are too short for a valid comparison.: Chance is always possible, but the stem points to a specific, larger threat: simultaneous interventions.

In before–after (quasi-experimental) studies, co-interventions and secular trends confound the apparent effect.

Answer: C

1. RR = [a ÷ (a + b)] ÷ [c ÷ (c + d)].
2. Femoral risk = 12 ÷ 150 = 0.08; non-femoral risk = 9 ÷ 300 = 0.03.
3. RR = 0.08 ÷ 0.03 = 2.67.
4. Femoral catheters carried about 2.7 times the CLABSI risk of non-femoral catheters in this cohort.

0.38: Inverts the ratio: non-femoral risk ÷ femoral risk (0.03 ÷ 0.08).

1.33: Compares case counts (12 ÷ 9) without dividing by the number of patients in each group.

2.67: Correct: (12 ÷ 150) ÷ (9 ÷ 300) = 0.08 ÷ 0.03 = 2.67.

2.81: This is the odds ratio, (12 × 291) ÷ (138 × 9); a cohort study reports risk directly as RR.

Cohort studies compare risks (RR); case-control studies compare odds (OR). Put the exposed group in the numerator.

Answer: D

Delay any change until Legionella cultures from that outlet and nearby outlets have resulted.: Wrong stage: waiting days for cultures leaves conditions that favor Legionella growth uncorrected; the program's predetermined response comes first.

Hyperchlorinate the entire potable water system before collecting any further temperature readings.: Out of proportion: one out-of-range control point calls for the planned corrective action, not system-wide remediation.

Record the reading and recheck the temperature at the next scheduled monitoring round.: Documenting without acting leaves the control measure unmet for a month; out-of-limit results need an intervention now.

Apply the plan's predetermined corrective action, recheck the reading, and document both.: Correct. CDC describes water management programs as monitoring control measures against set limits and using predetermined interventions when limits are not met, with all activities documented and communicated. The team corrects the condition and confirms the limit is met again.

A water management program monitors each control point against its limit; an out-of-range result triggers the plan's predetermined corrective action, confirmation and documentation.

Answer: C

Load 2-14 only: Ignores load 2-15 and the earlier unmonitored load; the defect may predate the positive test.

Loads 2-14 and 2-15: Misses load 2-13, which ran after the last negative BI and before the failure was detected.

Loads 2-13, 2-14 and 2-15: Correct: with a confirmed sterilizer defect, every load since the last negative BI (load 2-12) is treated as nonsterile, so loads 2-13 through 2-15 are recalled and reprocessed.

Loads 2-12 through 2-15: Over-recalls: load 2-12 carried its own negative BI, the last proof the sterilizer was working.

When a positive BI is confirmed (repeat positive or a sterilizer defect), recall every load processed since the last negative BI.

Answer: D

Continue the current process, because accessories are reprocessed the same way as the endoscope.: Accessories are classified by their own use, not by the scope they are used with.

Add a second HLD cycle for the forceps to provide an extra margin of safety.: Two HLD cycles are still not sterilization.

Change the forceps to low-level disinfection, because they are cleaned thoroughly first.: Moves in the wrong direction; LLD is for noncritical items on intact skin.

Sterilize the forceps, because they break the mucosa and enter sterile tissue.: Correct: biopsy forceps break the mucosal barrier and enter sterile tissue, which makes them critical items that must be sterilized, even though the gastroscope itself is semicritical.

Classify each item by its own contact: endoscopes are semicritical (HLD), but accessories that break the mucosa are critical (sterilize).