LTC-CIP Infectious Diseases and Pathogens: 15 Free Questions
Published 2026-10-24 · Facts and text checked 2026-10-16 · Questions from our LTC-CIP study guide · Reviewed by Hana N., Quality Reviewer
These free LTC-CIP practice questions cover Infectious Diseases and Pathogens, part of Identification of Infectious Diseases (16 items) on the exam. The pathogens and infections that matter most in long-term care. Each question comes from a practice test in our LTC-CIP study guide and shows the correct answer with an explanation. The full exam has 150 questions (135 scored).
The pathogens and infections that matter most in long-term care. On the exam this is part of Identification of Infectious Diseases (16 items). Open each answer to read the explanation.
Question 1Hard
A urine culture grows 100,000 CFU/mL of Escherichia coli, and a prescriber wants to start antibiotics based solely on this result. Which principle most directly explains why this approach is incorrect?
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Correct answer: D. The presence of bacteria in the urine does not necessarily mean the organisms have breached tissue defenses and triggered a host response
A positive urine culture indicates bacteriuria, but infection requires that the organism has breached host defenses and triggered a clinical response. Without signs such as fever or dysuria, the resident has colonization, not infection.
From practice test 7 of our LTC-CIP study guide (question 88). Original question, not an official exam item.
Question 2Medium
A resident with norovirus has three loose stools in 24 hours. Which portal of exit requires the most containment to prevent spread to other residents?
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Correct answer: C. Stool during toileting and episodes of diarrhea
Gastrointestinal pathogens such as norovirus exit through stool, so gloves, hand hygiene, and proper handling of feces are essential. Respiratory, blood, and wound routes are not the primary portals for norovirus.
From practice test 3 of our LTC-CIP study guide (question 28). Original question, not an official exam item.
Question 3Medium
A resident is admitted to a long-term care facility. Which combination of host factors places this resident at greatest risk for acquiring a healthcare-associated infection?
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Correct answer: D. Chronic obstructive pulmonary disease and malnutrition
Chronic lung disease impairs respiratory defenses and malnutrition weakens immune function, both increasing susceptibility to infection. Controlled hypertension, intact skin, up-to-date immunizations, and functional mobility are protective rather than risk factors.
From practice test 3 of our LTC-CIP study guide (question 129). Original question, not an official exam item.
Question 4Medium
A resident with an indwelling urinary catheter is being moved from the bed to a wheelchair. The nursing assistant holds the drainage bag at waist level for a few minutes to keep the tubing from catching on the bed rail. Which adverse event is this action most likely to cause?
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Correct answer: A. Backflow of urine into the bladder
Keeping the drainage bag above the level of the bladder allows urine to flow backward through the catheter lumen into the bladder, which can introduce bacteria and cause a urinary tract infection. Contamination with floor organisms is possible if the bag touches the floor, but the primary risk of elevating the bag is reflux of urine into the bladder.
From practice test 2 of our LTC-CIP study guide (question 104). Original question, not an official exam item.
Question 5Easy
Which action is most directly aimed at interrupting the susceptible host link in the chain of infection for influenza in a long-term care facility?
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Correct answer: C. Offering influenza vaccination to all residents at the start of the season
Immunization reduces host susceptibility by enabling the immune system to recognize and respond to the virus. Droplet Precautions interrupt the portal of exit and mode of transmission, hand hygiene interrupts transmission, and staff screening identifies sources rather than host factors.
From practice test 4 of our LTC-CIP study guide (question 143). Original question, not an official exam item.
Question 6Easy
A resident has a chronic wound infected with MRSA and also tests positive for VRE colonization. Which transmission-based precautions should be used during care?
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Correct answer: C. Contact Precautions
Both MRSA and VRE spread by direct or indirect contact, so Contact Precautions (gown and gloves) are indicated. Droplet and airborne precautions do not address the primary route for these organisms.
From practice test 8 of our LTC-CIP study guide (question 143). Original question, not an official exam item.
Question 7Medium
A resident's rectal surveillance culture grows carbapenem-resistant Enterobacteriaceae (CRE), but the resident has no signs of infection. Which action is appropriate?
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Correct answer: C. No antimicrobial treatment is indicated for colonization alone
Colonization with CRE or ESBL-producing organisms does not require antimicrobial treatment; treatment is indicated only for invasive infection. Contact precautions may be used to reduce transmission, but they are not treatment.
From practice test 2 of our LTC-CIP study guide (question 75). Original question, not an official exam item.
Question 8Medium
A resident has a two-day history of productive cough, new pleuritic chest pain, and oxygen saturation of 91% on room air. Chest imaging has not been performed. Which additional element is required for this event to meet the surveillance definition for a lower respiratory infection?
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Correct answer: D. Chest imaging finding or a positive test for a specific respiratory pathogen
The NHSN definition requires a chest imaging finding or a positive test for a specific respiratory pathogen in addition to clinical criteria. A sputum Gram stain, physician diagnosis, or elevated WBC count does not fulfill this requirement.
From practice test 6 of our LTC-CIP study guide (question 72). Original question, not an official exam item.
Question 9Easy
Which symptom is an explicit criterion in the NHSN definition for a urinary tract infection in a resident without a catheter?
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Correct answer: D. New or worsening urinary frequency
New or worsening urinary frequency is an explicit symptom criterion for a non-catheter UTI. Chronic incontinence, odor, and sediment are not listed criteria.
From practice test 10 of our LTC-CIP study guide (question 40). Original question, not an official exam item.
Question 10Medium
A catheterized resident develops acute fever and suprapubic tenderness. A urine culture is reported as 'no growth.' How should this case be classified?
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Correct answer: D. Not a urinary tract infection because the culture is negative
A positive urine culture is an essential component of the NHSN definition for catheter-associated UTI. Without it, the case does not meet surveillance criteria. Asymptomatic bacteriuria also requires a positive urine culture, so that classification is also incorrect.
From practice test 7 of our LTC-CIP study guide (question 33). Original question, not an official exam item.
Question 11Easy
For a resident who is sneezing and coughing because of a respiratory viral infection, which body site is the portal of exit for the virus?
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Correct answer: D. Nose and mouth
Respiratory viruses exit the body through the nose and mouth during coughing, sneezing, or talking. Skin, the gastrointestinal tract, and the bloodstream are not the primary exit routes for a respiratory viral infection.
From practice test 8 of our LTC-CIP study guide (question 21). Original question, not an official exam item.
Question 12Medium
A resident with a nonhealing wound develops purulent drainage from the site but has no pain, swelling, erythema, or heat. Per NHSN surveillance criteria, is this a skin and soft tissue infection?
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Correct answer: A. Yes, because new purulent drainage alone meets the definition
New purulent drainage from a wound alone meets the NHSN skin and soft tissue infection criterion. Local inflammatory signs are an alternative route, not a requirement when purulent drainage is present.
From practice test 2 of our LTC-CIP study guide (question 37). Original question, not an official exam item.
Question 13Medium
During insertion of an indwelling urinary catheter, the sterile catheter accidentally touches the resident's inner thigh before insertion into the urethra. What is the correct action?
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Correct answer: B. Discard the catheter and repeat the procedure using a new sterile catheter.
The catheter touched a non-sterile skin surface, so it is contaminated. Sterile technique requires discarding the contaminated catheter and starting over with a new sterile catheter; wiping with antiseptic does not restore sterility.
From practice test 3 of our LTC-CIP study guide (question 70). Original question, not an official exam item.
Question 14Medium
An 82-year-old resident without an indwelling urinary catheter reports new burning with urination. Her urine dipstick is positive for leukocyte esterase and nitrites, but she has no fever, flank pain, or suprapubic tenderness. Which finding, when combined with a positive urine culture, meets the NHSN surveillance definition for a symptomatic urinary tract infection?
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Correct answer: C. Acute dysuria
Acute dysuria is one of the NHSN criteria for a symptomatic UTI in a resident without a catheter. Cloudy urine, nitrites, and leukocyte esterase indicate bacteriuria or pyuria but do not by themselves establish the clinical syndrome.
From practice test 5 of our LTC-CIP study guide (question 106). Original question, not an official exam item.
Question 15Easy
A staff member assists a resident with diarrhea in the toilet, does not wash their hands afterward, and then prepares a meal tray for another resident. Which transmission route is the staff member most directly enabling?
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Correct answer: C. Fecal-oral transmission by contaminated hands
Fecal pathogens from the resident's stool can be carried on the unwashed hands and then ingested by the next resident via contaminated food, which is fecal-oral transmission. The other routes require respiratory droplets, suspended particles, or blood exposure.
From practice test 9 of our LTC-CIP study guide (question 41). Original question, not an official exam item.
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