APIC CIC Practice Exam 2
A new Environmental Services employee has been asked to clean a large blood spill on
the floor in the OR. How should he proceed?
A. He should mix an EPA-registered disinfectant with water in a bucket and mop up the
spill.
B. He should place absorbent material over the spill and pour the correct dilution of
disinfectant over the material for the recommended contact time.
C. He should pour diluted bleach directly on the blood spill, wait 10 minutes and then
mop up the spill.
D. He should place absorbent material over the spill, dispose of the material after
absorption, and then mop the floor with an EPA-registered disinfectant. - ANS-B. He
should place absorbent material over the spill and pour the correct dilution of
disinfectant over the material for the recommended contact time.
Rationale: Cleaning of a large blood spill may be a risk for acquisition of bloodborne
pathogens, so immediate inactivation of any pathogens before cleaning is important to
reduce this risk.
Event-related storage of sterile items allows packaged, sterile items to be used any time
after processing provided that:
1. The expiration date has not passed.
2. The packaging wrapper is intact.
3. The item has not gotten wet.
4. The storage area is well-ventilated, dry, and free of dust and insects.
A. 1
B. 1, 2, 3
C. 2, 3, 4
D. 1, 2, 3, 4 - ANS-C. 2, 3, 4
Rationale: Event-related storage of sterile items allows for items to be used at any time
after processing, provided the sterile packaging has not been compromised. Items must
be stored in a dry, well-ventilated, dust-free, insect-free, and temperature controlled
area. Packages must be inspected before use to ensure that the wrapping is still intact,
with no tears, punctures, or evidence of water intrusion.
, In a published study of the risk factors associated with an outbreak of Serratia
marcescens in a Neonatal ICU (NICU) the authors present the following table:
Risk Factor: P Value Odds Ratio
Birth Weight 0.07 1.93 (1.62-4.86)
Mechanical Ventilation <0.001 4.24 (2.76-6.33)
Central Venus Catheter 0.008 3.38 (1.97-9.74)
Previous antibiotic use 0.02 1.32 (0.079-5.97)
Given the list of risk factors below, which ones are statistically significant for Serratia
infection in this outbreak?
1. Birth Weight
2. Mechanical Ventilation
3. Central Venus Catheter
4. Previous antibiotic use
A. 1, 2
B. 1, 3
C. 2, 3
D. 3, 4 - ANS-C. 2, 3
Mechanical Ventilation
Central Venus Catheter
Rationale: The odds ratio (OR) is the probability of having a particular risk factor if a
condition or disease is present divided by the probability of having the risk factor if the
disease or condition is not present.
If there is no association between the variables, the OR =1.
An OR either > or < 1 indicates a possible statistical relationship between the variables.
Confidence intervals may be used to determine the statistical significance of the
relationship. If the confidence interval does not contain the value 1.0, the association is
statistically significant at a=0.05. If the p value is less than or equal to a, REJECT the
null hypothesis that there is no relationship between the variables.
In this table, Mechanical ventilation and Central Venus catheter have p values below
0.05 and have confidence intervals that do not contain the value 1.0. The conclusion is
that there is a statistical association between these variables and outbreak of Serratia
marcescens.