Multidrug-Resistant Organisms (MDROs)

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A change was made to this test on August 5. If you printed this test before August 5, you will find that question 9 in your printed copy has been dropped from the online test below.

Test Question

1. Multidrug-resistant organisms (MDROs) are defined as microorganisms that are resistant to one or more classes of antimicrobial agents. These organisms are:

a. Predominantly viruses and fungi.
b. Usually resistant to only one class of antibiotics.
c. Not treatable with any antibiotic.
d. Predominantly bacteria.

Test Question

2. MDROs have been linked to:

a. Poverty, overcrowded living conditions, and malnutrition.
b. Increased lengths of stay, increased costs, and even mortality.
c. Insufficient use of the array of antibiotics available today.
d. Sexual contact with more than six individuals over the past year.

Test Question

3. Multidrug-resistant S. aureus (MRSA) may behave differently from other multidrug-resistant organisms. Please select the one false statement below.

a. MRSA-colonized patients more frequently develop symptomatic infections.
b. Higher case fatality rates have been observed for certain MRSA infections.
c. Some hospitals have reported a decrease in staph infections following the introduction of MRSA.
d. There may be an association between MRSA infections and increased length of stay.

Test Question

4. Selective pressure refers to:

a. Any phenomena that alter the behavior of living organisms and influence their survival.
b. The targeting of healthcare personnel in attempts to explain growing infection rates.
c. Any phenomenon that targets a particular organism.
d. An array of settings on equipment used to treat laboratory cultures.

Test Question

5. Once multidrug-resistant organisms are introduced into a healthcare setting, transmission and persistence of the resistant strain is determined by several factors. One of those factors is:

a. The size of the healthcare facility
b. The number of blood transfusions performed in the hospital
c. The availability of vulnerable patients
d. The type and number of surgeries performed

Test Question

6. Colonization pressure is:

a. Population expansion into sparsely settled areas.
b. Pressure to create satellite healthcare facilities in expanding rural areas.
c. Pressure to create more long-term care facilities as the populations ages.
d. Increased potential for transmission of MDROs as the proportion of colonized patients increases.

Test Question

7. The risk than an ICU patient will acquire VRE increases significantly when:

a. More than 50% of the patients have it or they have been exposed for >15 days.
b. They have had more than five courses of vancomycin.
c. They have been blood donors for more than five years.
d. Staff is lax in reporting incidents to the health department.

Test Question

8. All of the following have been shown to increase transmission rates in healthcare facilities except:

a. Poor hand hygiene practices among healthcare workers.
b. Greater than 15 days of exposure to an MDRO in an ICU.
c. Patients receiving care at multiple healthcare facilities.
d. Increased adherence to and monitoring of hand hygiene guidelines.

Test Question

9. Community-associated MRSA (CA-MRSA) is distinct from that found in the hospital setting. Which statement about CA-MRSA is true?

a. Transmission of CA-MRSA is being reported in hospitals with increasing frequency.
b. CA-MRSA likely arose in the healthcare setting and moved into the community.
c. CA-MRSA commonly presents as a severe skin or soft-tissue infection.
d. There is really no connection between MRSA strains in hospitals and CA-MRSA.

Test Question

10. Prevention and control of MDROs depend upon several key elements. These include all of the following except:

a. Infection prevention.
b. Accurate and prompt diagnosis and treatment.
c. Liberal use of antimicrobials.
d. Transmission prevention.

Test Question

11. It has not been possible to determine the effectiveness of individual interventions, or a specific combination of interventions, that would be appropriate for all healthcare facilities in controlling their target MDROs.

a. True
b. False

Test Question

12. Which one statement about judicious use of antimicrobials is true?

a. Limiting antimicrobial use is a good way to control resistance.
b. Treat contaminants, not infections.
c. Avoid excessive duration of therapy.
d. If the pathogen is not known, treat aggressively with broad-spectrum antimicrobials.

Test Question

13. The simplest form of MDRO surveillance is by:

a. Monitoring microbiology isolates that result from tests ordered during routine clinical care.
b. Obtaining skin and nasal cultures from all hospitalized patients upon admission.
c. Sending all hospital microbiology isolates reports to a regional lagoratory for review.
d. Obtaining yearly nasal, skin, and rectal cultures from hospital personnel.

Test Question

14. Surveillance is an important part of an MDRO control program for all of the following reasons except:

a. Detection of newly emerging pathogens.
b. Monitoring epidemiologic trends.
c. Identifying healthcare workers colonized with an MDRO.
d. Measuring the effectiveness of interventions.

Test Question

15. Studies suggest that most patients with MRSA can be identified by culturing their:

a. Skin.
b. Nares.
c. Urethra.
d. Sputum.

Test Question

16. Active surveillance cultures refers to:

a. Surveillance cultures ordered by the health department.
b. Routine cultures of MDROs.
c. Use of routine culturing to monitor spread and isolation of colonized patients.
d. Cultures of police, fire, and other first responder personnel.

Test Question

17. In one study, use of gloves when in contact with MDRO patients:

a. Had no effect on the control of MDROs.
b. Was no better than results from improved adherence to hand hygiene practices.
c. Improved control of MDROs.
d. Had no effect, but improved morale of healthcare personnel.

Test Question

18. Standard Precautions:

a. Have an essential role in preventing MDRO transmission.
b. Are not needed when contact precautions are used.
c. Are used only when a MDRO has been positively identified.
d. Are not necessary in facilities using ASC.

Test Question

19. In general, it seems reasonable to discontinue Contact Precautions when:

a. A single surveillance culture is negative and the patient is transferred from a private room to a shared room.
b. Three or more surveillance cultures are negative over the course of 1–2 weeks in a patient who has not received antimicrobial therapy for several weeks.
c. The surveillance culture is negative even in the presence of draining wound or respiratory secretions.
d. It is never prudent to discontinue Contact Precautions.

Test Question

20. Some studies show patients who are placed on Contact Precaution isolation:

a. Have decreased anxiety and depression scores.
b. Express greater satisfaction with their treatment.
c. Have less documented care then control patients.
d. Have less preventable adverse reactions.

Test Question

21. Which of the following environmental measures have been shown to control transmission of MDROs and other pathogens in the environment?

a. Surveillance of potentially infected healthcare workers
b. Routine use of antimicrobial cleaning solutions
c. Monitoring for adherence to recommended environmental cleaning practices
d. Routine use of negative pressure isolation rooms

Test Question

22. Decolonization is:

a. Not effective for person carrying MRSA in their nares.
b. Sufficiently effective to warrant routine use.
c. Treatment of persons colonized with a specific MDRO, usually MRSA, to eradicate carriage of that organism.
d. Not recommended for healthcare personnel implicated in transmission of MRSA.

Test Question

23. Control programs that focus on only one organism or one antimicrobial drug are unlikely to succeed because:

a. Vulnerable patients will continue to serve as a magnet for other MDROs.
b. More than one organism is always present in vulnerable patients.
c. It is not possible to isolate one organism.
d. Vulnerable patients probably have several undetectable organisms.

Test Question

24. Because of a lack of evidence-based research on controlling MDROs in healthcare facilities:

a. Administrators should wait until more evidence is available before starting a prevention program.
b. Interventions should be based on assessments of the local problem, the prevalence of various MDROs, and feasibility.
c. Contact Precautions should be emphasized rather than ASC.
d. There is no pressing need for smaller facilities to copy procedures used at larger facilities.

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