Infection Control — Practice Questions

Microbiology — Infection Prevention and Control, NMC MBBS licence examination syllabus (Nepal Medical Council).

Infection control — NMC-style practice questions

Practice questions written for this chapter. These are not past NMC papers.

📋 About these questions: These are practice questions written to test the reasoning in this chapter. They are NOT reproduced from any past Nepal Medical Council examination, and no verified past NMC questions were supplied for this chapter. Post-exposure prophylaxis regimens come from the national guideline.

Level 1–2 — recall and understanding

Q1. Which process destroys bacterial SPORES? A. Cleaning B. Low-level disinfection C. STERILISATION D. Alcohol hand rub ANSWER: C — sterilisation. Why: disinfection kills most organisms but not reliably spores. Sterilisation destroys all organisms including spores, and is required for instruments entering sterile tissue or the bloodstream. LEARNING POINT: cleaning must always come first — organic matter shields organisms from everything else.

Q2. Standard precautions should be applied: A. Only to patients known to have a transmissible infection B. To EVERY patient, ALWAYS C. Only in operating theatres D. Only when body fluid contact is expected ANSWER: B. Why: at any time a proportion of patients have an undiagnosed transmissible infection, so precautions applied only to known cases miss exactly the people you do not know about. LEARNING POINT: transmission-based precautions are ADDED to standard ones, never substituted.

Level 3–4 — application and reasoning

Q3. A doctor sees four patients wearing the same gloves, saying his hands remain clean underneath. This is: A. Acceptable practice B. WRONG — gloves transfer organisms and are not a substitute for hand hygiene C. Acceptable if the gloves are sterile D. Acceptable if no body fluids were touched ANSWER: B. Why: gloves become contaminated exactly as hands do, develop microscopic defects, and contaminate the hands during removal. LEARNING POINT: change gloves between patients and clean hands after removing them, every time.

Q4. A student sustains a needlestick and washes it with bleach, reporting it a week later. The most important errors are: A. Using bleach only B. Using a caustic agent AND the DELAY, which removes most of the benefit of assessment and PEP C. Not wearing gloves D. Reporting at all ANSWER: B. Why: caustic agents damage tissue without reducing transmission, and post-exposure prophylaxis is time-critical. Wash with soap and water, encourage bleeding, and report at once. LEARNING POINT: hepatitis B carries the highest transmission risk and is vaccine-preventable.

Q5. A patient improving on broad-spectrum intravenous antibiotics, with a sensitive organism cultured, remains on the same regimen on day five. The missed step is: A. Adding a second antibiotic B. The 48-72 HOUR REVIEW to narrow, switch to oral and set a duration C. Repeating all cultures D. Increasing the dose ANSWER: B. Why: "start smart, then focus" requires an active review. Continuing broad-spectrum therapy adds resistance pressure, line risk and cost without benefit. LEARNING POINT: the review itself is the intervention.

Level 5 — exception-based

Q6. When is soap and water required rather than alcohol hand rub? A. Always B. When hands are VISIBLY SOILED, and for SPORE-forming organisms C. Only before surgery D. Never — alcohol is always superior ANSWER: B. Why: alcohol is not reliably effective against spores, and does not remove visible soil. Otherwise alcohol rub is faster, better tolerated and improves compliance. LEARNING POINT: compliance matters as much as efficacy — the measure only works if it is actually done.

Q7. Why is early REMOVAL the most effective prevention for catheter-associated urinary infection? A. Catheters become blocked B. The device is the ROUTE OF ENTRY — risk rises with each day it remains C. Antibiotics work better without a catheter D. Patients prefer it ANSWER: B. Why: most healthcare-associated infections are device-associated, and each additional day of catheterisation increases risk. Treating the infection while leaving the device addresses half the problem. LEARNING POINT: ask daily whether every catheter, cannula and line is still needed.

Syllabus points

Recall and understanding questions
Application and reasoning questions
Exception-based questions

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