Set 1 - Clinical Community Medicine MCQs

A 48-year-old man admitted in the orthopaedic ward develops fever 8 days post-open reduction internal fixation surgery. Blood culture grows Klebsiella pneumoniae. Which of the following is the MOST likely primary source of infection in a tertiary care hospital setting?

• Contaminated surgical instruments

• IV cannula-related bloodstream infection

• Infected bed linen

• Visitor-to-patient transmission

In a medical college ICU, 35% of ventilated patients develop pneumonia despite adherence to hand hygiene protocols. Which additional intervention offers the strongest evidence-based reduction in ventilator-associated pneumonia?

• Routine use of broad-spectrum antibiotics

• Elevation of head end of the bed to 30-45°

• Daily sputum culture

• Continuous oxygen humidification

A hospital reports a sudden rise in Clostridioides difficile colitis cases among postoperative patients. Which antibiotic policy change will most likely curb this outbreak?

• Ban all aminoglycosides

• Restrict fluoroquinolones and cephalosporins

• Increase metronidazole use

• Switch all patients to carbapenems

In a 1200-bed tertiary care hospital, the infection control committee decides to implement bundled care for central line-associated bloodstream infection (CLABSI) prevention. Which of the following is NOT a core component of the bundle?

• Maximal sterile barrier precautions during insertion

• Daily review of line necessity

• Routine prophylactic antibiotics for all central lines

• Use of chlorhexidine for skin antisepsis

In the paediatric ward, two infants develop late-onset sepsis with Serratia marcescens. Cultures from which hospital source are most likely to be positive?

• Tap water from handwashing sink

• Sterile gloves

• Wall paint chips

• Linen storage area

A 55-year-old diabetic man admitted for cellulitis develops sudden-onset breathlessness on day 5. ABG shows hypoxia, CXR is normal. Which hospital-acquired condition should be suspected first?

• Pulmonary embolism

• ARDS

• Hospital-acquired pneumonia

• Pleural effusion

During an NABH audit, the infection control nurse is asked to demonstrate compliance with biomedical waste segregation in the pathology lab. Histopathology tissue waste is correctly disposed in:

• Yellow bag

• Red bag

• Blue container

• Black bag

A postnatal ward nurse is found to be a chronic nasal carrier of MRSA. What is the recommended first-line decolonisation regimen?

• IV vancomycin for 7 days

• Oral doxycycline for 5 days

• Intranasal mupirocin + chlorhexidine bath

• No treatment unless symptomatic

A patient in the oncology ward develops febrile neutropenia. Blood cultures grow Pseudomonas aeruginosa. The hospital antibiogram shows 80% sensitivity to piperacillin-tazobactam. The most appropriate empirical therapy is:

• Piperacillin-tazobactam

• Meropenem

• Colistin

• Ceftriaxone

In a burns unit, a spike in Acinetobacter baumannii sepsis cases is noted. Which is the single most effective environmental measure to control the outbreak?

• Daily fumigation

• Strict dry mopping only

• Disinfection of hydrotherapy tanks

• Limiting patient visitors