[TEST] Postexposure evaluation and follow up

All of the following statements are correct with reference to occupational exposure of healthcare personnel (HCP), EXCEPT for one. Which one is the exception?

A. Healthcare facilities should have the organizational infrastructure that promotes a seamless response following an occupational exposure of HCP.

B. The term HCP refers to all paid and unpaid persons working in healthcare settings who have the potential for exposure to blood and OPIM.

C. The term HCP include emergency medical service personnel, dental personnel, laboratory personnel, nurses, nursing assistants, physicians, technicians, therapists, pharmacists, and students and trainees.

D. The term HCP excludes persons not directly involved in patient care (e.g., clerical, dietary, housekeeping, security, maintenance, and volunteer personnel).

All of the following statements related to an exposure that might place HCP at risk for HAIs are correct, EXCEPT for one. Which one is the exception? The transfer of pathogenic organisms from a source to a host may be the result of _______________.

A. direct contact transmission

B. indirect contact transmission

C. respiratory transmission, i.e., inhalation of droplets or droplet nuclei (airborne transmission)

D. droplets and droplet nuclei only generated by medical/dental devices, such as high-speed handpieces, ultrasonic instruments, or by lasers and electrosurgical units. Not as a result of talking, breathing, coughing or sneezing.

All of the following statements related to a source person are correct, EXCEPT for one. Which one is the exception?

A. The source person may be a patient, another HCP, a visitor to the healthcare facility, or a house-hold member.

B. A person with asymptomatic acute or chronic infections, in general, is non-infectious and does not qualify as a source person.

C. The source person may have acute infection or may be transiently or chronically colonized by pathogenic organisms.

D. The source person with an acute or chronic infection may be asymptomatic.

All of the following statements are correct with reference to postexposure management strategies, EXCEPT for one. Which one is the exception?

A. All HCP should be familiar with postexposure management strategies such as procedures for proper wound care.

B. In a dental office, postexposure evaluation, initiation of postexposure prophylaxis (PEP), and postexposure follow-up is the responsibility of the dentist.

C. PEP is any preventive medical treatment, e.g., administration of vaccines, immune globulins, or antibacterial agents.

D. PEP started in a timely manner after exposure to a pathogenic virus or bacteria is intended to prevent infection and the development of disease.

An exposure that might place HCP at risk for HAIs with bloodborne pathogens (i.e., infection with hepatitis B, hepatitis C, or human immunodeficiency viruses) may include a percutaneous injury, e.g., needlestick or cut with a sharp object contaminated with blood or OPIM; direct contact of ocular, nasal, or oral mucous membranes with blood or OPIM; direct contact of nonintact skin, e.g., dermatitis, or chapped or abraded skin with blood and OPIM.

A. True

B. False

All of the following segments related to wound care are correct, EXCEPT for one. Which one is the exception?

A. Percutaneous wounds and nonintact skin that have been in contact with blood or OPIM should be washed with soap and water.

B. Mucous membranes that have been in contact with blood or OPIM should be flushed with water.

C. Using antiseptics (e.g., chlorhexidine) for wound care or expressing fluid by squeezing the wound have been shown to reduce the risk for infection.

D. Injecting antiseptics or disinfectants into a wound and the application of caustic agents (e.g., bleach) is not recommended.

Which of the following is NOT recommended content to include in an occupational exposure report?

A. details of the procedures being performed

B. details of the exposure

C. type of exposure

D. history of high-risk behavior of the healthcare worker (other than occupation)

E. date and time of exposure

After exposure to a blood borne pathogen, all of the following elements regarding presentation for a post-exposure evaluation are true, EXCEPT for one. Which one is the exception?

A. Present within 2 days of the exposure incident

B. Present with the incident report

C. Present with all available information about the source person

D. Present with HCP’s OSHA-mandated medical record maintained by the employer

All of the following statements related to HBV PEP are correct, EXCEPT for one. Which one is the exception?

A. HBV PEP should be initiated as soon as possible (preferably within 24 hours) after exposure.

B. HBIG and the first dose of the HepB vaccine  (if indicated) can be administered simultaneously.

C. The HepB vaccine should never be administered in the deltoid muscle.

D. Expert counseling is recommended for susceptible HCP exposed to the HBV.

All of the following statements related to exposure to the HCV are correct, EXCEPT for one. Which one is the exception?

A. Recommendations for postexposure evaluation and follow-up are intended to achieve early diagnosis of HCV infection.

B. Postexposure prophylaxis (PEP) is recommended for HCP after exposure to HCV-positive blood or OPIM.

C. The exposed HCP should undergo baseline testing for anti-HCV with reflex to a NAT for HCV RNA if positive, to identify a preexisting infection.

D. The source patient should ideally undergo a nucleic acid test (NAT) for HCV RNA.

All of the following statements related to exposure to the HIV are correct, EXCEPT for one. Which one is the exception? The latest U.S. Public Health Service (PHS) guidelines emphasize the importance of _______________.

A. prompt reporting of expert management of occupational exposures

B. adherence to the recommended HIV PEP regimen

C. follow-up of exposed HCP to including careful monitoring for adverse events related to PEP and for virologic, immunologic, and serologic signs of infection

D. modified patient-care responsibilities of exposed HCP based solely on evidence of HIV exposure

All of the following statements related to exposure to measles, mumps, or rubella are correct, EXCEPT for one. Which one is the exception?

A. If measles, mumps, or rubella exposure occurs in a healthcare setting, all case-patient contacts should be evaluated immediately for presumptive evidence of measles, mumps, or rubella immunity.

B. Exposed HCP without evidence of immunity to the measles virus should be offered the MMR vaccine or a of immune globulin (IG).

C. Exposed HCP without evidence of immunity to mumps should be offered the MMR vaccine; however, antibodies develop too slowly to provide effective prophylaxis after exposure.

D. There is strong evidence that postexposure vaccination is effective in preventing rubella infection.

All of the following statements related to exposure to the varicella-zoster virus (VZV) are correct, EXCEPT for one. Which one is the exception?

A. If VZV exposure occurs in a healthcare setting, all case-patient contacts should be evaluated immediately for presumptive evidence of immunity.

B. All susceptible HCP exposed to the VZV should receive PEP with two doses (4-8 weeks apart) of the varicella-zoster vaccine (Varivax).

C. Women exposed to the VZV at any stage of pregnancy should receive the varicella-zoster vaccine (Varivax) no later than 96 hours of an exposure.

D. Susceptible HCP exposed to the VZV for whom the vaccine is contraindicated should be administered varicella-zoster immunoglobulin (VZIG)

All of following statements related to exposure to the influenza viruses and SARS-CoV-2 are correct, EXCEPT for one. Which one is the exception?

A. It is strongly recommended that HCP be vaccinated against influenza and SAR-CoV-2.

B. There are two antiviral drugs for PEP recommended for use following healthcare-associated exposure to the influenza viruses.

C. Some authorities recommend against PEP for influenza and endorse watchful waiting and prompt early treatment (within 2 days) only when signs and symptoms of infection appear.

D. There are currently no COVID-19 PEP agents proven to be effective in reducing SARS-CoV-2 infection.

All of the following statements related to exposure to Mycobacterium tuberculosis (MBT) are correct, EXCEPT for one. Which one is the exception?

A. HCP should obtain a baseline tuberculin skin test (TST), preferably a two-step TST, at the beginning of employment.

B. HCP with a negative TST, in case of unprotected occupational exposure, are susceptible to infection.

C. HCP with a previously negative TST or BAMT who subsequently have a positive TST result (a reaction ≥5 mm) or a positive BAMT result should be evaluated for treatment of LTBI.

D. An exposed person may develop latent TB infection (LTBI), which is asymptomatic but highly infectious.

All of the following statements are related to Clostridium tetani, Corynebacterium diphtheriae, or Bordetella pertussis are correct, EXCEPT for one. Which one is the exception?

A. Following exposure to C. tetani, no PEP is indicated; exposed HCP should be monitored closely and human tetanus immune globulin (TIG) should be administered at the first sign(s) of illness.

B. HCP in close contact with patients with diphtheria should be administered PEP, i.e., a dose of diphtheria toxoid booster Td) and antibacterial agents.

C. HCP exposed to B. pertussis should receive PEP, i.e., antibacterial prophylaxis within 21 days of exposure when (1) at high risk of developing severe pertussis or (2) when close contact with patients at high risk is anticipated.

D. If there is an increased risk of pertussis in a healthcare setting, evidenced by documented or suspected healthcare-associated transmission of pertussis, revaccination of HCP with Tdap should be considered.

HCP with close or lengthy contact with a patient with meningococcal disease are considered at increased risk of infection and should receive PEP, i.e., antimicrobial prophylaxis.

A. True

B. False

It is common for contacts of patients with S. pneumoniae infection to develop pneumococcal infection; PEP with an effective antibacterial agent is recommended.

A. True

B. False

Which of the following statements in reference exposure to methicillin-resistant Staphylococcus aureus (MRSA) is incorrect?

A. MRSA is primarily transmitted by direct contact with an infected skin lesion; less frequently by contact with contaminated articles and environmental surfaces.

B. PEP is highly recommended for HCP.

C. Exposed HCP should be monitored for skin lesions.

D. Incision and drainage and adjunctive antibacterial coverage are the first step in treating purulent skin infections.

All of the following statements in reference to exposure to the hepatitis A virus (HAV) are correct, EXCEPT for one. Which one is the exception?

A. The HAV is transmitted primarily by the fecal-oral route, either person-to-person, i.e., close personal contact with an infected household member or sex partner, or consumption of contaminated food or water.

B. HCP have not been demonstrated to be at increased risk for HAV infection because of occupational exposure.

C. HCP traveling to or working in countries that have high or intermediate hepatitis A endemicity should complete a 2 dose HepA vaccination regimen (Havrix or Vaqta) prior to travel.

D. There is no PEP recommended for unprotected HCP exposed to HAV.