Page 6 of 8
MI10.1-5 | Healthcare-Associated Infections — Graded Quiz
Graded
12 questions · Untimed · 2 attempts
Click any question card to reveal the correct answer.
A hospital notes that 12 of 80 ICU patients developed bacteraemia during a single month. All had central venous catheters inserted by the same team. Blood cultures grew coagulase-negative staphylococci. The BEST classification for these infections is:
A
Surgical site infections (SSI) because all patients underwent invasive procedures
B
Central Line-Associated Bloodstream Infections (CLABSI) because bacteraemia developed in catheterised patients without another identifiable source
✓
C
Ventilator-Associated Pneumonia (VAP) because ICU patients are commonly ventilated
D
Community-acquired bacteraemia because coagulase-negative staphylococci are common skin commensals
Click to reveal answer
A surgical ward experiences a cluster of MRSA infections over 2 weeks. Contact tracing identifies a healthcare worker who is an asymptomatic MRSA nasal carrier. In the chain of HAI transmission, which link does this healthcare worker primarily represent?
A
Susceptible host
B
Reservoir
✓
C
Portal of entry
D
Mode of transmission
Click to reveal answer
A patient on the medical ward is diagnosed with active pulmonary tuberculosis. Which combination of precautions is MOST appropriate?
A
Standard precautions only — TB is not spread by the airborne route in hospital settings
B
Contact precautions and gown
C
Airborne precautions: negative pressure room, N95 respirator for HCWs, surgical mask on patient during transport
✓
D
Droplet precautions with surgical mask and single room
Click to reveal answer
A hospital infection control committee (HICC) reviews VAP rates and finds they exceed the national benchmark. Which bundle element is the SINGLE most evidence-based intervention to reduce VAP?
A
Routine antibiotic prophylaxis for all ventilated patients
B
Maintaining head-of-bed elevation at 30–45° (semi-recumbent positioning)
✓
C
Replacing ventilator circuits every 24 hours
D
Administering oral antifungals to reduce oropharyngeal colonisation
Click to reveal answer
A scrub nurse removes gloves contaminated with patient blood after a surgical procedure. According to doffing protocol, what is the CORRECT sequence for subsequent PPE removal?
A
Remove mask → gown → goggles → perform hand hygiene
B
Perform hand hygiene → remove gown → perform hand hygiene → remove mask → goggles → perform hand hygiene
✓
C
Remove goggles → gown → mask → perform hand hygiene at the end
D
Remove all PPE simultaneously to minimise self-contamination time, then perform hand hygiene
Click to reveal answer
A healthcare worker at a tertiary hospital in Chennai sustains a needle-stick injury with a needle from an HBsAg-positive patient. The HCW received the complete 3-dose hepatitis B vaccination series 5 years ago. What is the MOST appropriate next step?
A
No action required as the HCW is fully vaccinated
B
Administer hepatitis B immune globulin (HBIG) alone immediately
C
Check HCW's anti-HBs titre; if ≥10 mIU/mL no prophylaxis needed; if <10 mIU/mL administer HBIG ± booster
✓
D
Immediately restart the full 3-dose hepatitis B vaccine series
Click to reveal answer
The Hospital Infection Control Committee (HICC) reviews water quality data from the hospital drinking water supply. Which combination of tests is MOST appropriate for routine microbiological water surveillance?
A
Settle plate air sampling and RODAC plate contact sampling
B
Total coliform count (MPN method) and membrane filtration for E. coli
✓
C
Direct microscopy and Gram stain of water samples
D
Aerobic colony count using blood agar settle plates
Click to reveal answer
An ICU patient on broad-spectrum antibiotics for 10 days develops recurrent bacteraemia caused by Klebsiella pneumoniae resistant to imipenem and meropenem but susceptible to colistin. The resistance is confirmed to be carbapenemase-mediated (KPC). Which gene encodes the KPC carbapenemase?
A
mecA gene on SCCmec mobile element
B
blaKPC gene on self-transmissible plasmid
✓
C
vanA gene on Tn1546 transposon
D
NDM-1 gene located on the outer membrane porins
Click to reveal answer
A microbiologist reviewing antimicrobial resistance data notices that a Pseudomonas aeruginosa isolate from a VAP patient is resistant to piperacillin-tazobactam, cefepime, imipenem, and ciprofloxacin, but susceptible only to colistin and amikacin. This pattern is BEST described as:
A
Multidrug-resistant (MDR) organism
B
Extensively drug-resistant (XDR) organism
✓
C
Pandrug-resistant (PDR) organism
D
Heteroresistant organism
Click to reveal answer
An HICC audit of the surgical ward finds that alcohol-based hand rub dispensers are placed at the point-of-care but compliance with WHO Moment 1 ('Before touching a patient') is only 34%. Which intervention has the HIGHEST evidence base for improving hand hygiene compliance?
A
Mandatory disciplinary action for non-compliant healthcare workers
B
Multimodal WHO hand hygiene improvement strategy (system change + training + audit + reminders + safety culture)
✓
C
Replacing ABHR dispensers with soap-and-water sinks at every bed
D
Installing CCTV cameras to monitor hand hygiene compliance
Click to reveal answer
A teaching hospital is preparing for a joint commission accreditation visit. Which action by the HICC BEST demonstrates implementation of the standard precautions regarding respiratory hygiene/cough etiquette in the outpatient waiting area?
A
Installing UV germicidal irradiation (UVGI) units in all OPD waiting areas
B
Providing surgical masks and tissues at waiting area entry with hand hygiene stations and posted visual cues for cough etiquette
✓
C
Treating all outpatients empirically with broad-spectrum antibiotics before culture results
D
Restricting all patients with respiratory symptoms to negative-pressure isolation rooms
Click to reveal answer
An infection control nurse is validating hospital food service hygiene. Using the MPN method for coliform testing of food samples, presumptive positive tubes show gas production in lactose broth. What is the NEXT step in the MPN confirmatory procedure?
A
Report the result as confirmed coliform without further testing
B
Subculture positive lactose broth into brilliant green bile lactose (BGBL) broth and maintain at 37°C for 48 hours for confirmed test
✓
C
Perform a Gram stain directly from the positive lactose broth tube
D
Inoculate onto blood agar and incubate anaerobically for 48 hours
Click to reveal answer