CIC SURVEILLANCE AND
EPIDEMIOLOGIC INVESTIGATION EXAM
QUESTIONS WITH CORRECT ANSWERS
1. Which of the following is indicative of a superficial SI?
a. Pain at the incision site 10 days after a breast reduction procedure; drainage is
culture-positive for methicillin- susceptible Staphylococcus aureus (MSSA)
b. Stitch abscess that is cultured 14 days after surgery and is positive for Enterococcus
faecalis
c. Purulent drainage from an episiotomy that occurs within 5 days of delivery
d. Burn wound that cultures positive for Acinetobacter baumannii 10 days after
debridement procedure - Answer-A Pain at the incision site 10 days after a breast
reduction procedure; drainage is culture positive for methicillin-susceptible
Staphylococcus aureus (MSSA)
Rationale: SSI continues to be a major source of morbidity, economic cost, and even
death in surgical patients. To meet the criteria for a superficial SI, the infection must
occur within 30 days after the operation and involve only skin or subcutaneous tissue. In
addition, one of the following must be met:
• Purulent drainage, with or without laboratory confirmation, from the superficial incision
• Organisms isolated from an aseptically obtained culture of fluid or tissue from the
superficial incision
• And patient has at least one of the following:
° Purulent drainage from the superficial incision
° Organisms isolated from an aseptically obtained culture of fluid or tissue from the
superficial incision
° Superficial incision that is deliberately opened by a surgeon, attending physician, or
other designee
And patient has at least one of the following signs or symptoms: pain or tenderness,
localized swelling, redness, or heat. A culture negative finding does not meet this
criterion.
° Diagnosis of superficial incisional SI by the surgeon or attending physician or other
designee
2. An appropriate indicator to monitor process compliance would be:
a. Class 1 SSI rate
b. Appropriate antibiotic dosage
c. Central line-associated bloodstream infections (CLABSIs) in the Neonatal Intensive
Care Unit (NICU)
d. Infections caused by multidrug-resistant organisms - Answer-B Appropriate antibiotic
dosage
,Rationale: A surveillance program should monitor a variety of outcomes, processes, and
events, and some indicators should focus on personnel.
3. Identify the median in the following list of numbers: 6, 2, 9, 7, 1, 4
a. 9
b. 7
c. 5
d. 4 - Answer-C 5
Rationale: The median of a data set is the number that 50 percent of values fall below
and 50 percent of values fall above. The data here are not presented in numerical order
so first they must be ordered from lowest to highest: 1, 2, 4, 6, 7, 9.
There is an even number of values in this set so to find the median one must identify the
two central numbers and then average them. The two central numbers are 4 and 6; 4 +
6 = 10 and 10/2 = 5.
4. In a study of whether Operating room A (OR A) is associated with a higher number of
surgical site infections (SSIs) than Operating room B (OR B), the infection preventionist
(IP) is testing whether:
Ho: OR A SSI rate = OR B SSI rate
Ha: OR A SSI rate ≠ OR B SSI rate
The IP concludes that the SSI rate in OR A is not equal to the SSI rate in OR B, but in
reality the two rates are equal. What type of statistical error has she committed?
a. No error has been committed
b. She committed a Type I error
c. She committed a Type II error
d. She committed an error equal to β - Answer-B She has committed a Type I error
Rationale: If the IP concluded that the SSI rate in OR A is not equal to the SSI rate in
OR B, then she rejects the null hypothesis. However, in this case the null hypothesis
was true; therefore she has committed a Type I error. This value is equal to α.
5. For which of the following procedure(s) is the surveillance period for deep incisional
or organ/space SSI 90 days?
1) Cesarean section
2) Craniotomy
3) Coronary artery bypass graft
4) Laminectomy
a. 1, 2
b. 2, 3
c. 3, 4
d. 1, 4 - Answer-B 2, 3
, Rationale: According to the Centers for Disease Control and Prevention (CDC) SSI
surveillance definitions, postoperative surveillance for deep incisional or organ/space
SSIs should be conducted for 90 days on craniotomy and coronary artery bypass
procedures. Superficial incisional SSIs are only followed for a 30-day period for all
procedure types.
6. What key infection control activity is defined as the Systematic, ongoing collection,
management, analysis, and interpretation of data followed by the dissemination of these
data to public health programs to stimulate public health action?
a. Research
b. Surveillance
c. Benchmarking
d. Accreditation - Answer-B Surveillance
Rationale: Surveillance has been defined as the ongoing collection, collation, and
analysis of data and the ongoing dissemination of information to those who need to
know so that action can be taken." Surveillance is an essential component of an
effective infection prevention and control program. Surveillance includes the collection
of data with the ultimate objective of dissemination of that data to support and improve
public health activities.
7. An IP is reading a journal article that states that the data the authors collected are
normally distributed. What does this mean?
a. When the data are plotted on a curve, it is skewed
b. The mean is less than the median
c. The skewness value is equal to 1
d. The mean, median, and mode of the data are equal - Answer-D The mean, median,
and mode of the data are equal
Rationale: If the data are normally distributed, then the mean, median, and mode are all
equal and the curve will have a bell shape, with most observations clustering at the
center and then tapering off on either side of the center.
8. An IP is preparing the quarterly report for the Infection Control Committee. What
information will be needed to calculate a CLABSI rate for the ICU?
1) The total number of patients in the unit for the time period
2) The total number of central line catheters for the time period
3) The number of patients who had bloodstream infections identifie
4) The number of device days for the time period
a. 2, 3
b. 1, 3
c. 1, 2
d. 3, 4 - Answer-D 3, 4
Rationale: The numerator would be the number of patients who had bloodstream
infections identified and who had a central line during the time period. The denominator
EPIDEMIOLOGIC INVESTIGATION EXAM
QUESTIONS WITH CORRECT ANSWERS
1. Which of the following is indicative of a superficial SI?
a. Pain at the incision site 10 days after a breast reduction procedure; drainage is
culture-positive for methicillin- susceptible Staphylococcus aureus (MSSA)
b. Stitch abscess that is cultured 14 days after surgery and is positive for Enterococcus
faecalis
c. Purulent drainage from an episiotomy that occurs within 5 days of delivery
d. Burn wound that cultures positive for Acinetobacter baumannii 10 days after
debridement procedure - Answer-A Pain at the incision site 10 days after a breast
reduction procedure; drainage is culture positive for methicillin-susceptible
Staphylococcus aureus (MSSA)
Rationale: SSI continues to be a major source of morbidity, economic cost, and even
death in surgical patients. To meet the criteria for a superficial SI, the infection must
occur within 30 days after the operation and involve only skin or subcutaneous tissue. In
addition, one of the following must be met:
• Purulent drainage, with or without laboratory confirmation, from the superficial incision
• Organisms isolated from an aseptically obtained culture of fluid or tissue from the
superficial incision
• And patient has at least one of the following:
° Purulent drainage from the superficial incision
° Organisms isolated from an aseptically obtained culture of fluid or tissue from the
superficial incision
° Superficial incision that is deliberately opened by a surgeon, attending physician, or
other designee
And patient has at least one of the following signs or symptoms: pain or tenderness,
localized swelling, redness, or heat. A culture negative finding does not meet this
criterion.
° Diagnosis of superficial incisional SI by the surgeon or attending physician or other
designee
2. An appropriate indicator to monitor process compliance would be:
a. Class 1 SSI rate
b. Appropriate antibiotic dosage
c. Central line-associated bloodstream infections (CLABSIs) in the Neonatal Intensive
Care Unit (NICU)
d. Infections caused by multidrug-resistant organisms - Answer-B Appropriate antibiotic
dosage
,Rationale: A surveillance program should monitor a variety of outcomes, processes, and
events, and some indicators should focus on personnel.
3. Identify the median in the following list of numbers: 6, 2, 9, 7, 1, 4
a. 9
b. 7
c. 5
d. 4 - Answer-C 5
Rationale: The median of a data set is the number that 50 percent of values fall below
and 50 percent of values fall above. The data here are not presented in numerical order
so first they must be ordered from lowest to highest: 1, 2, 4, 6, 7, 9.
There is an even number of values in this set so to find the median one must identify the
two central numbers and then average them. The two central numbers are 4 and 6; 4 +
6 = 10 and 10/2 = 5.
4. In a study of whether Operating room A (OR A) is associated with a higher number of
surgical site infections (SSIs) than Operating room B (OR B), the infection preventionist
(IP) is testing whether:
Ho: OR A SSI rate = OR B SSI rate
Ha: OR A SSI rate ≠ OR B SSI rate
The IP concludes that the SSI rate in OR A is not equal to the SSI rate in OR B, but in
reality the two rates are equal. What type of statistical error has she committed?
a. No error has been committed
b. She committed a Type I error
c. She committed a Type II error
d. She committed an error equal to β - Answer-B She has committed a Type I error
Rationale: If the IP concluded that the SSI rate in OR A is not equal to the SSI rate in
OR B, then she rejects the null hypothesis. However, in this case the null hypothesis
was true; therefore she has committed a Type I error. This value is equal to α.
5. For which of the following procedure(s) is the surveillance period for deep incisional
or organ/space SSI 90 days?
1) Cesarean section
2) Craniotomy
3) Coronary artery bypass graft
4) Laminectomy
a. 1, 2
b. 2, 3
c. 3, 4
d. 1, 4 - Answer-B 2, 3
, Rationale: According to the Centers for Disease Control and Prevention (CDC) SSI
surveillance definitions, postoperative surveillance for deep incisional or organ/space
SSIs should be conducted for 90 days on craniotomy and coronary artery bypass
procedures. Superficial incisional SSIs are only followed for a 30-day period for all
procedure types.
6. What key infection control activity is defined as the Systematic, ongoing collection,
management, analysis, and interpretation of data followed by the dissemination of these
data to public health programs to stimulate public health action?
a. Research
b. Surveillance
c. Benchmarking
d. Accreditation - Answer-B Surveillance
Rationale: Surveillance has been defined as the ongoing collection, collation, and
analysis of data and the ongoing dissemination of information to those who need to
know so that action can be taken." Surveillance is an essential component of an
effective infection prevention and control program. Surveillance includes the collection
of data with the ultimate objective of dissemination of that data to support and improve
public health activities.
7. An IP is reading a journal article that states that the data the authors collected are
normally distributed. What does this mean?
a. When the data are plotted on a curve, it is skewed
b. The mean is less than the median
c. The skewness value is equal to 1
d. The mean, median, and mode of the data are equal - Answer-D The mean, median,
and mode of the data are equal
Rationale: If the data are normally distributed, then the mean, median, and mode are all
equal and the curve will have a bell shape, with most observations clustering at the
center and then tapering off on either side of the center.
8. An IP is preparing the quarterly report for the Infection Control Committee. What
information will be needed to calculate a CLABSI rate for the ICU?
1) The total number of patients in the unit for the time period
2) The total number of central line catheters for the time period
3) The number of patients who had bloodstream infections identifie
4) The number of device days for the time period
a. 2, 3
b. 1, 3
c. 1, 2
d. 3, 4 - Answer-D 3, 4
Rationale: The numerator would be the number of patients who had bloodstream
infections identified and who had a central line during the time period. The denominator
