LTC-CIP Surveillance and Case Definitions: 15 Free Questions
Published 2026-10-25 · 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 Surveillance and Case Definitions, part of Surveillance and Epidemiologic Investigation (22 items) on the exam. Surveillance methods, case definitions and infection rate calculations. 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).
Surveillance methods, case definitions and infection rate calculations. On the exam this is part of Surveillance and Epidemiologic Investigation (22 items). Open each answer to read the explanation.
Question 1Hard
A resident meets the clinical signs for UTI, and a urine culture grows two organisms. Which culture result satisfies the McGeer definition?
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Correct answer: A. One organism at 100,000 CFU/mL or more, with no more than two organisms present
The McGeer definition requires growth of no more than two organisms with at least one organism at 100,000 CFU/mL or more. Neither two organisms below that threshold nor a single organism of any amount meets the standard.
From practice test 2 of our LTC-CIP study guide (question 8). Original question, not an official exam item.
Question 2Hard
A long-term care facility wants to submit a catheter-associated urinary tract infection rate that is comparable to NHSN benchmarks. Which numerator and denominator should the infection preventionist use?
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Correct answer: A. Infections meeting NHSN UTI surveillance definitions as the numerator and all indwelling urinary catheter-days as the denominator
NHSN surveillance definitions standardize both the numerator case definition and the denominator exposure for catheter-associated UTI, which is catheter-days, not total resident-days. Clinician diagnosis and McGeer criteria do not produce the same numerator as NHSN definitions, and positive cultures alone overcount asymptomatic bacteriuria.
From practice test 3 of our LTC-CIP study guide (question 79). Original question, not an official exam item.
Question 3Hard
Last month's UTI rate was 1.6 per 1,000 resident-days. This month's rate is 3.2. The facility's rolling 6-month average before this month is 1.5, and the NHSN national median is 2.0. Which comparison best signals the need for a focused investigation?
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Correct answer: B. Compare this month to the facility's rolling 6-month average of 1.5
The facility's own rolling 6 to 12 month average is the baseline for comparison. The increase from 1.5 to 3.2 triggers a focused investigation, whereas a national median or single prior month is not the facility baseline.
From practice test 7 of our LTC-CIP study guide (question 21). Original question, not an official exam item.
Question 4Hard
A resident with chronic lung disease has new cough, increased sputum, and a temperature of 38.3°C. On auscultation, the nurse documents coarse rhonchi that clear with coughing, and a chest X-ray is not ordered. Which surveillance decision is correct under McGeer criteria?
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Correct answer: B. Do not count the event as a McGeer lower respiratory infection because rhonchi that clear with coughing are not crackles or wheezing and no infiltrate is documented.
The McGeer respiratory definition requires a physical finding of new or increased crackles or wheezing, or a chest X-ray showing a new infiltrate, consolidation, or effusion. Coarse rhonchi that clear with coughing do not meet that exam standard, and without imaging the event is not counted as a lower respiratory infection.
From practice test 9 of our LTC-CIP study guide (question 10). Original question, not an official exam item.
Question 5Hard
During the annual risk assessment, an infection preventionist finds that the ventilator unit's respiratory infection rate has exceeded the facility baseline for four consecutive months, while the rate of Clostridioides difficile infection has declined to zero. Which action best reflects the purpose of the annual risk assessment?
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Correct answer: D. Revise the surveillance plan for the coming year to list respiratory infections on the ventilator unit as a priority target with its own case definition and denominator
The annual risk assessment is the feedback loop that revises surveillance priorities according to the facility's data, so a sustained elevation on a defined unit should make that event a named priority with its own case definition and denominator. Dropping the target, leaving the plan static, or replacing it with a generic campaign would fail to act on the data.
From practice test 9 of our LTC-CIP study guide (question 78). Original question, not an official exam item.
Question 6Hard
A resident without an indwelling catheter has a fever of 38.5°C and a urine culture growing 120,000 CFU/mL of a single organism. The resident reports no urgency, frequency, dysuria, gross hematuria, costovertebral angle tenderness, suprapubic pain, or incontinence. Under McGeer criteria, this event:
Show answer and explanation
Correct answer: C. Does not meet the UTI definition because the fever/leukocytosis branch also requires an acute urinary symptom
In a resident without a catheter, the fever or leukocytosis branch must be paired with at least one acute urinary symptom. Fever and a positive culture alone do not complete the McGeer definition.
From practice test 4 of our LTC-CIP study guide (question 37). Original question, not an official exam item.
Question 7Easy
An infection preventionist at a long-term care facility wants to find infections that might be missed by laboratory reports. Which data source is most likely to reveal a suspected infection before a culture result is available?
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Correct answer: C. Antibiotic start orders
Antibiotic start orders signal that a clinician has suspected an infection and begun treatment, often before a culture result exists. Laboratory reports alone miss infections that were diagnosed clinically, so reviewing antibiotic orders is a key active case-finding method.
From practice test 2 of our LTC-CIP study guide (question 73). Original question, not an official exam item.
Question 8Medium
An infection preventionist is planning a new surveillance system. The administrator asks what should be produced first. Which document should the infection preventionist create before any data are collected?
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Correct answer: B. A one-page surveillance plan naming target conditions, case definitions, population at risk, and surveillance period
The surveillance plan is the foundational document; it commits the system to target conditions, definitions, population, and period before data are collected. A line listing or spreadsheet built before that commitment invites biased or incomplete case-finding.
From practice test 3 of our LTC-CIP study guide (question 15). Original question, not an official exam item.
Question 9Medium
A nurse asks whether to use Loeb minimum criteria to decide whether to count a possible respiratory infection in the facility's monthly surveillance report. Which response is correct?
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Correct answer: C. Use McGeer criteria because they are the surveillance standard for tracking and reporting
McGeer criteria are the surveillance standard for tracking and reporting infections; Loeb minimum criteria are a clinical tool for deciding whether to start antibiotics. Using Loeb for surveillance would overcount because it is deliberately more permissive.
From practice test 2 of our LTC-CIP study guide (question 127). Original question, not an official exam item.
Question 10Easy
An infection preventionist calculates resident-days for a 30-day month. The facility had 40 residents enrolled the entire month, and no admissions, discharges, or transfers occurred. What is the correct denominator?
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Correct answer: B. 1,200 resident-days
40 residents multiplied by 30 days equals 1,200 resident-days. The other options omit either the census or the length of the surveillance period.
From practice test 3 of our LTC-CIP study guide (question 112). Original question, not an official exam item.
Question 11Hard
A resident has a new cough and new sputum production, but does not have fever, and the physical exam is not documented yet. According to McGeer criteria, which addition would make the respiratory infection definition potentially met (assuming the required physical exam or imaging finding is also present)?
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Correct answer: D. New confusion
The McGeer respiratory definition requires at least two respiratory symptoms and at least one constitutional finding. The resident already has cough and sputum (two respiratory); new confusion is a constitutional finding, which completes the symptom criteria.
From practice test 6 of our LTC-CIP study guide (question 124). Original question, not an official exam item.
Question 12Medium
A resident with an indwelling catheter has a temperature of 38.7°C, new suprapubic pain, and a urine culture growing 120,000 CFU/mL of a single organism. Which statement about McGeer criteria for urinary tract infection is correct?
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Correct answer: C. This meets the definition: fever plus an acute urinary symptom plus a positive culture
The McGeer UTI definition requires fever or leukocytosis, at least one acute urinary symptom such as suprapubic pain, and a positive culture with no more than two organisms and at least one at 100,000 CFU/mL. This resident meets all three elements; a positive leukocyte esterase is not part of the surveillance definition.
From practice test 8 of our LTC-CIP study guide (question 124). Original question, not an official exam item.
Question 13Easy
How often should a facility's written surveillance plan be reviewed and updated when the facility changes?
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Correct answer: A. Annually
The written surveillance plan should be reviewed at least annually and updated whenever the facility changes, such as when services, resident populations, or risks change. Quarterly review is not the established minimum requirement for the plan itself.
From practice test 2 of our LTC-CIP study guide (question 116). Original question, not an official exam item.
Question 14Medium
A resident vomits twice within six hours. According to McGeer criteria, how is this classified if no other symptoms are present?
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Correct answer: A. It is an event because two or more episodes of vomiting occur within 24 hours.
McGeer gastroenteritis defines vomiting as two or more episodes within a 24-hour period. Two episodes six hours apart meet that definition, and no additional symptoms are required.
From practice test 8 of our LTC-CIP study guide (question 89). Original question, not an official exam item.
Question 15Easy
According to the standard structure for a monthly surveillance report, which set of questions should the report answer in plain language?
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Correct answer: A. How many infections occurred, where they occurred, and whether the rate is higher than the facility's baseline
The report must answer how many infections, where they occurred, and whether the rate exceeds the facility's baseline. Those three items let stakeholders interpret the month's data and decide whether to act.
From practice test 2 of our LTC-CIP study guide (question 77). Original question, not an official exam item.
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