In the CLABSI insertion bundle, which skin antiseptic is preferred for an adult central venous catheter?

Chlorhexidine above 0.5% in alcohol

A patient transferred from another country's hospital is found to have carbapenem-resistant Enterobacterales (CRE) in a rectal screening swab. Which action is most appropriate?

Single room on contact precautions with dedicated equipment

Droplet precautions with a surgical mask for all staff

Standard precautions in an open bay, as he has no symptoms

Start meropenem at once to clear the carriage

Hospital policy uses a chlorine solution of 1,000 ppm available chlorine for general surfaces. The stock bleach is 5% available chlorine. Which dilution gives this strength?

1 part bleach to 49 parts water

1 part bleach to 499 parts water

A 30-year-old previously healthy man has localised herpes zoster on one dermatome of the chest. The lesions can be fully covered by a dressing. Which precautions are needed?

Standard precautions with the lesions covered

Airborne and contact precautions until crusted

The indicator tape on a wrapped instrument pack has changed colour after autoclaving. This shows that the pack:

Was exposed to the sterilising process

Is free of all living organisms

Is sterile until its expiry date

Was cleaned before it was wrapped

Infection prevention and control

46 Gulf Prometric RN (DHA, DOH, MOH, SCFHS) practice questions on Infection prevention and control, part of Fundamentals and Patient Safety. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Easy
In the CLABSI insertion bundle, which skin antiseptic is preferred for an adult central venous catheter?
1. A70% isopropyl alcohol alone
2. BChlorhexidine above 0.5% in alcohol
3. CPovidone-iodine 10% in water
4. DHydrogen peroxide 3% solution
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Answer: B · Chlorhexidine above 0.5% in alcohol
CDC recommends an alcoholic chlorhexidine preparation stronger than 0.5% for skin preparation before central line insertion and at dressing changes. Chlorhexidine binds to the skin and keeps acting for hours, while the alcohol kills quickly. The skin must be allowed to dry completely before the catheter is inserted. Povidone-iodine or alcohol alone are used only when chlorhexidine is contraindicated.
- A: Alcohol alone has no lasting effect on skin flora.
- C: Aqueous povidone-iodine is an alternative only when chlorhexidine cannot be used.
- D: Hydrogen peroxide is not a skin antiseptic for line insertion.
Question 2 · Medium
A patient transferred from another country's hospital is found to have carbapenem-resistant Enterobacterales (CRE) in a rectal screening swab. Which action is most appropriate?
1. ADroplet precautions with a surgical mask for all staff
2. BStandard precautions in an open bay, as he has no symptoms
3. CStart meropenem at once to clear the carriage
4. DSingle room on contact precautions with dedicated equipment
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Answer: D · Single room on contact precautions with dedicated equipment
Carriers of CRE spread the organism through hands and shared equipment, even without infection. They are placed in a single room on contact precautions, with dedicated equipment and rigorous hand hygiene and environmental cleaning. Screening of patients transferred from hospitals abroad is common for this reason. Colonisation is not treated with antibiotics.
- A: CRE is not spread by respiratory droplets.
- B: Asymptomatic carriers still spread CRE to other patients.
- C: Antibiotics do not clear colonisation, and the organism is resistant to carbapenems.
Question 3 · Hard
Hospital policy uses a chlorine solution of 1,000 ppm available chlorine for general surfaces. The stock bleach is 5% available chlorine. Which dilution gives this strength?
1. A1 part bleach to 499 parts water
2. B1 part bleach to 9 parts water
3. C1 part bleach to 49 parts water
4. D1 part bleach to 4 parts water
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Answer: C · 1 part bleach to 49 parts water
5% available chlorine is 50,000 ppm, since 1% is 10,000 ppm. To get 1,000 ppm, the bleach is diluted 50,000 / 1,000 = 50 times. That means 1 part bleach in 50 parts of total solution, which is 1 part bleach to 49 parts water. A 1 in 10 dilution would give 5,000 ppm, a strength some policies use for spills.
- A: 1 to 499 gives 100 ppm, too weak to disinfect.
- B: 1 to 9 gives 5,000 ppm, five times too strong.
- D: 1 to 4 gives 10,000 ppm, ten times too strong.
Question 4 · Medium
A 30-year-old previously healthy man has localised herpes zoster on one dermatome of the chest. The lesions can be fully covered by a dressing. Which precautions are needed?
1. AContact precautions only
2. BDroplet precautions only
3. CAirborne and contact precautions until crusted
4. DStandard precautions with the lesions covered
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Answer: D · Standard precautions with the lesions covered
Localised zoster in a patient with a normal immune system spreads only by contact with lesion fluid. When the lesions are covered, CDC advises standard precautions. Staff who are not immune to varicella should still avoid caring for him if possible. Disseminated zoster, or localised zoster in an immunocompromised patient, needs airborne and contact precautions until the lesions crust.
- A: Covered localised lesions do not need contact precautions in CDC guidance.
- B: Zoster is not spread by large droplets.
- C: Airborne and contact precautions are for disseminated or immunocompromised zoster.
Question 5 · Easy
The indicator tape on a wrapped instrument pack has changed colour after autoclaving. This shows that the pack:
1. AIs free of all living organisms
2. BIs sterile until its expiry date
3. CWas cleaned before it was wrapped
4. DWas exposed to the sterilising process
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Answer: D · Was exposed to the sterilising process
External chemical indicators change colour when exposed to one or more conditions of the cycle, such as heat or steam. They separate processed packs from unprocessed ones but do not prove sterility. Proof that a cycle killed resistant spores comes from a biological indicator. A pack also stays usable only while its wrap is intact and dry.
- A: Only a biological indicator shows that the cycle killed resistant spores.
- B: Sterility also depends on the pack staying intact and dry, not on the tape.
- C: The tape gives no information about cleaning before packing.
Question 6 · Easy
To meet JCI International Patient Safety Goal 5, hospitals must reduce the risk of health care-associated infections mainly by:
1. AAdopting an evidence-based hand hygiene programme
2. BIsolating every patient admitted from another hospital
3. CScreening all staff for nasal MRSA each month
4. DPrescribing antibiotics before every procedure
Answer and explanation in LearnFree account
Question 7 · Hard
The infection control nurse watches a nurse leaving the room of a patient on contact and droplet precautions. She removes her gloves, then her gown, then her face shield, and leaves her surgical mask on as she walks out. Which step was out of order?
1. AThe mask should come off before the face shield
2. BThe face shield should come off before the gown
3. CThe gloves should come off after leaving the room
4. DThe gown should come off before the gloves
Answer and explanation in LearnFree account
Question 8 · Easy
The preferred method for sterilising heat- and moisture-stable surgical instruments is:
1. AEthylene oxide gas
2. BGlutaraldehyde 2% soak
3. CBoiling for 20 minutes
4. DSteam under pressure (autoclave)
Answer and explanation in LearnFree account
Question 9 · Hard
A doctor is inserting a subclavian central line in the ICU. The nurse checking the CLABSI insertion checklist notes: hand hygiene done, chlorhexidine-alcohol applied and allowed to dry, a sterile gown and gloves worn, a mask and cap worn, and a small drape over the insertion site. What should she do?
1. AAsk for povidone-iodine to be added over the chlorhexidine
2. BSuggest moving the line to the femoral vein instead
3. CLet it continue, since all checklist items are met
4. DStop the procedure until a full-body sterile drape is used
Answer and explanation in LearnFree account
Question 10 · Medium
A nurse in the intensive care unit returns from leave with long acrylic nail extensions. The infection control nurse asks her to remove them because artificial nails:
1. AMake examination gloves tear far more easily than natural nails
2. BCarry more Gram-negative bacteria and yeasts
3. CAbsorb alcohol hand rub and make it evaporate too slowly
4. DAre acceptable if they are kept shorter than 0.5 cm
Answer and explanation in LearnFree account
Question 11 · Hard
An adult ICU recorded 3 CLABSIs in a month with 1,500 central line days and 2,000 patient days. What is its CLABSI rate?
1. A2.0 per 1,000 central line days
2. B20 per 1,000 central line days
3. C0.2 per 1,000 central line days
4. D1.5 per 1,000 central line days
Answer and explanation in LearnFree account
Question 12 · Medium
Which measure in a VAP prevention bundle directly reduces the number of days a patient stays on the ventilator?
1. AChanging the ventilator circuit every 48 hours
2. BRoutine antibiotic prophylaxis for all ventilated patients
3. CKeeping the patient deeply sedated to prevent extubation
4. DDaily sedation interruption with a spontaneous breathing trial
Answer and explanation in LearnFree account
Question 13 · Medium
A nurse is about to give a drug through the needleless connector of a central line. Which step most reduces the risk of CLABSI?
1. AFlush with 1 mL of normal saline before scrubbing
2. BWipe the connector briefly with dry sterile gauze
3. CScrub the connector with antiseptic and let it dry
4. DRemove the connector and inject into the hub
Answer and explanation in LearnFree account
Question 14 · Medium
Which practice for a patient with an indwelling urinary catheter follows the CAUTI prevention bundle?
1. ADisconnecting the bag at night to drain it faster
2. BDaily bladder irrigation with an antibiotic solution
3. CChanging the catheter routinely every 7 days
4. DKeeping the bag below the bladder, off the floor
Answer and explanation in LearnFree account
Question 15 · Hard
On a ward hand hygiene audit, 120 opportunities are observed. Staff clean their hands with hand rub at 66 and with soap and water at 12. On 8 more occasions they put on gloves without cleaning their hands first. What is the compliance rate?
1. A55%
2. B65%
3. C93%
4. D72%
Answer and explanation in LearnFree account
Question 16 · Easy
In the WHO 'My 5 Moments for Hand Hygiene', the moment that comes immediately before inserting a urinary catheter is:
1. ABefore touching a patient
2. BAfter touching patient surroundings
3. CAfter body fluid exposure risk
4. DBefore a clean or aseptic procedure
Answer and explanation in LearnFree account
Question 17 · Easy
Which patient should be placed on contact precautions?
1. AA patient with scabies awaiting treatment
2. BA patient with influenza A and fever
3. CA patient with pulmonary tuberculosis
4. DA patient with mumps and parotid swelling
Answer and explanation in LearnFree account
Question 18 · Medium
A patient with acute myeloid leukaemia is admitted after an allogeneic stem cell transplant. Which room is most appropriate?
1. AA positive-pressure room with HEPA-filtered air
2. BA negative-pressure airborne isolation room
3. CA shared bay with curtains always drawn
4. DA single room with the door left open
Answer and explanation in LearnFree account
Question 19 · Easy
Under standard precautions, the nurse needs to wear gloves for which task?
1. AEmptying a urinary drainage bag
2. BHelping a patient walk to the chair
3. CMeasuring an oral temperature
4. DTaking a blood pressure on intact skin
Answer and explanation in LearnFree account
Question 20 · Hard
A ventilated patient's care plan says: head of bed at 15 degrees; subglottic suction tube in place; daily sedation hold planned; ventilator circuit changed only when soiled; peptic ulcer and DVT prophylaxis given. Which item needs correcting first?
1. AThe circuit-change policy
2. BThe head of bed angle
3. CThe daily sedation hold
4. DThe subglottic suction tube
Answer and explanation in LearnFree account
Question 21 · Easy
A filled sharps container on the ward should be closed and replaced when it is:
1. AOlder than 7 days, however full it is
2. BThree-quarters full or at its fill line
3. CCompletely full to the top of the opening
4. DHalf full, whatever the type of sharps
Answer and explanation in LearnFree account
Question 22 · Hard
A ward nurse sees four infection control issues on her morning round. Which one should she act on first?
1. AA patient's catheter bag lying on the floor beside the bed
2. BA visitor sitting on the bed of a patient on contact precautions
3. CA full sharps bin with a needle sticking out of its opening
4. DA box of gloves stored on a windowsill in direct sunlight
Answer and explanation in LearnFree account
Question 23 · Medium
A nurse who had a needle-stick injury from an HIV-positive patient starts post-exposure prophylaxis 90 minutes later. For how long is the course usually taken?
1. A6 months
2. B3 days
3. C28 days
4. D7 days
Answer and explanation in LearnFree account
Question 24 · Hard
Only one negative-pressure room is free on a medical ward. Which newly admitted patient should be placed in it?
1. AA man with cough, haemoptysis and AFB-positive sputum
2. BA child with rotavirus diarrhoea who is in nappies
3. CA man with MRSA in a leg wound with heavy discharge
4. DA woman with confirmed influenza A and high fever
Answer and explanation in LearnFree account
Question 25 · Hard
A nurse has a deep needle-stick from a patient who is HBsAg positive. She had a full hepatitis B vaccine series years ago, but never had an anti-HBs test. Her anti-HBs taken today is 4 mIU/mL. What does she need?
1. AOne dose of HBIG and one vaccine booster
2. BTwo doses of HBIG one month apart
3. CA vaccine booster only, with no HBIG
4. DNo treatment, because she has been vaccinated
Answer and explanation in LearnFree account

21 more Infection prevention and control questions

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Study Fundamentals and Patient Safety

Infection prevention and control

In the CLABSI insertion bundle, which skin antiseptic is preferred for an adult central venous catheter?

A patient transferred from another country's hospital is found to have carbapenem-resistant Enterobacterales (CRE) in a rectal screening swab. Which action is most appropriate?

Hospital policy uses a chlorine solution of 1,000 ppm available chlorine for general surfaces. The stock bleach is 5% available chlorine. Which dilution gives this strength?

A 30-year-old previously healthy man has localised herpes zoster on one dermatome of the chest. The lesions can be fully covered by a dressing. Which precautions are needed?

The indicator tape on a wrapped instrument pack has changed colour after autoclaving. This shows that the pack:

To meet JCI International Patient Safety Goal 5, hospitals must reduce the risk of health care-associated infections mainly by:

The infection control nurse watches a nurse leaving the room of a patient on contact and droplet precautions. She removes her gloves, then her gown, then her face shield, and leaves her surgical mask on as she walks out. Which step was out of order?

The preferred method for sterilising heat- and moisture-stable surgical instruments is:

A nurse in the intensive care unit returns from leave with long acrylic nail extensions. The infection control nurse asks her to remove them because artificial nails:

An adult ICU recorded 3 CLABSIs in a month with 1,500 central line days and 2,000 patient days. What is its CLABSI rate?

Which measure in a VAP prevention bundle directly reduces the number of days a patient stays on the ventilator?

A nurse is about to give a drug through the needleless connector of a central line. Which step most reduces the risk of CLABSI?

Which practice for a patient with an indwelling urinary catheter follows the CAUTI prevention bundle?

On a ward hand hygiene audit, 120 opportunities are observed. Staff clean their hands with hand rub at 66 and with soap and water at 12. On 8 more occasions they put on gloves without cleaning their hands first. What is the compliance rate?

In the WHO 'My 5 Moments for Hand Hygiene', the moment that comes immediately before inserting a urinary catheter is:

Which patient should be placed on contact precautions?

A patient with acute myeloid leukaemia is admitted after an allogeneic stem cell transplant. Which room is most appropriate?

Under standard precautions, the nurse needs to wear gloves for which task?

A ventilated patient's care plan says: head of bed at 15 degrees; subglottic suction tube in place; daily sedation hold planned; ventilator circuit changed only when soiled; peptic ulcer and DVT prophylaxis given. Which item needs correcting first?

A filled sharps container on the ward should be closed and replaced when it is:

A ward nurse sees four infection control issues on her morning round. Which one should she act on first?

A nurse who had a needle-stick injury from an HIV-positive patient starts post-exposure prophylaxis 90 minutes later. For how long is the course usually taken?

Only one negative-pressure room is free on a medical ward. Which newly admitted patient should be placed in it?

A nurse has a deep needle-stick from a patient who is HBsAg positive. She had a full hepatitis B vaccine series years ago, but never had an anti-HBs test. Her anti-HBs taken today is 4 mIU/mL. What does she need?