Deck 7: Preventing Perioperative Disease and Transmission

Question 1

When nested basin sets are being sterilized, how should they be placed in the steam sterilizer?

A) fold side down with a towel used to separate them
B) fold side down with tape holding them together securely
C) facing upright with a towel used to separate them
D) facing upright with tape holding them together securely

Answer 1

A

Question 2

Contamination caused by passage of microorganisms through a sterilized package by way of moisture wicking is termed:

A) saturation
B) strike-through
C) solubilization
D) sequestration

Answer 2

B

Question 3

Which type of packaging system has filters and removable locking devices?

A) nonwoven wrapped
B) paper-plastic peel packs
C) rigid containers
D) woven wrapped

Answer 3

C

Question 4

Which of the following chemicals is a high-level disinfectant when items are immersed for 20 to 30 minutes and a sterilant if items remain immersed for 10 hours?

A) glutaraldehyde
B) isopropyl alcohol
C) quaternary ammonium compounds
D) sodium hypochlorite

Question 5

Which term means the number of microbes or amount of organic debris on an object at any given time?

A) asepsis
B) bioburden
C) infection
D) sepsis

Question 6

Which of the following is the type of dating system that denotes the number of the calendar day in 1 through 365/366?

A) alphanumeric
B) Cartesian
C) Julian
D) military

Question 7

What is the weight that AAMI has recommended instrument sets should NOT exceed?

A) 10 pounds
B) 15 pounds
C) 20 pounds
D) 25 pounds

Question 8

What term refers to a barrier, such as plastic-backed table cover, that does NOT allow for passage of liquid through it?

A) integral
B) insoluble
C) impervious
D) imperceptible

Question 9

Which of the following diseases is NOT a form of transmissible spongiform encephalopathy?

A) Creutzfeldt-Jakob
B) mad cow
C) scrapie
D) toxic shock

Question 10

When opening a wrapped item such as a gown on a Mayo stand, the contents and wrapper are considered sterile up to what distance from the edge of the wrapper?

A) all the way to the edge
B) 1 inch from the edge
C) 2 inches from the edge
D) Only the item itself is sterile.

Question 11

Cidex™ is the trade name for which of the following methods of sterilization?

A) ethylene oxide
B) glutaraldehyde
C) hydrogen peroxide gas plasma
D) peracetic acid

Question 12

Which sterilization method presents the greatest exposure risk to CSPD personnel, is expensive, and requires the longest total cycle time?

A) ethylene oxide
B) hydrogen peroxide gas plasma
C) peracetic acid
D) saturated steam under pressure

Question 13

Which type of wrapper material is compatible with the hydrogen peroxide gas plasma sterilization method?

A) cloth
B) muslin
C) paper
D) Tyvek

Question 14

The biological indicator (BI) for the steam sterilization method is:

A) DART
B) Bowie-Dick
C) Bacillus atrophaeus
D) Geobacillus stearothermophilus

Question 15

Which part of the instrument reprocessing cycle is performed intraoperatively?

A) mechanical decontamination
B) steam sterilization
C) ultrasonic washer
D) wiping with sterile water

Question 16

What is the relationship of steam pressure to temperature in a steam sterilizer?

A) Increased pressure increases temperature.
B) Increased temperature increases pressure.
C) Decreased pressure increases temperature.
D) Decreased temperature increases pressure.

Question 17

Which sterilization method is most commonly used, safest, least expensive, and appropriate for the majority of surgical instruments?

A) ethylene oxide
B) ionizing radiation
C) peracetic acid
D) saturated steam

Question 18

The physical or chemical process by which all living microorganisms, including spores, are killed is:

A) decontamination
B) disinfection
C) sanitization
D) sterilization

Question 19

What is the type of process the ultrasonic cleaner uses to dislodge minute particles of soil and organic debris?

A) cavitation
B) chelation
C) emulsification
D) solubilization

Question 20

How should air hoses of powered instruments or fiber-optic light cords be placed in rigid container trays for sterilization?

A) bound tightly with rubber bands
B) bound loosely with electrical tape
C) coiled loosely in perforated or mesh basket
D) coiled tightly in sealed peel-pack inside tray

Question 21

Which of the following is NOT a classification of patient care items?

A) critical
B) hypercritical
C) noncritical
D) semicritical

Question 22

During manual cleaning of surgical instruments, what type of solution should be used?

A) cold water, detergent, and enzymatic cleaner with high pH
B) lukewarm water, detergent, and enzymatic cleaner with neutral pH
C) hot water, detergent, and enzymatic cleaner with high pH
D) cold sterile water and enzymatic solution with low pH

Question 23

What is the term for the process of lubricating stiffened stainless steel surgical instruments by immersion in a water-soluble solution?

A) bathing
B) dunking
C) greasing
D) milking

Question 24

Which types of instruments must be cleaned with bristle-brushes on wires, pipe cleaners, or handheld pressure guns?

A) microsurgical scissors
B) self-retaining retractors
C) suction tip lumens
D) tissue forceps

Question 25

What is the term for inanimate objects that harbor microorganisms that contribute to environmental contamination?

A) flora
B) fomites
C) vectors
D) viruses

Question 26

All of the following are environmental specifications for the decontamination room in CSPD EXCEPT:

A) air exchange rate, minimum of 10 per hour
B) humidity between 35% and 72%
C) positive air pressure maintained
D) temperature between 64°F and 70°F

Question 27

Which of the following would be appropriate for use on animate surfaces?

A) antiseptic
B) decontaminant
C) disinfectant
D) sterilant

Question 28

Which of the following would be appropriate for soaking instruments covered with bioburden during a surgical procedure?

A) isopropyl alcohol
B) peracetic acid
C) sterile saline
D) sterile water

Question 29

What is a potential risk of placing surgical instruments of dissimilar metallic type together in a washer sterilizer cycle?

A) alarm triggered by washer sterilizer
B) bioburden contamination
C) electrolytic conduction reaction
D) static electrical spark

Question 30

Which of the following cleaning methods for surgical instrumentation relies on bubbles imploding, creating a vacuum that dislodges minute particles in crevices of instruments?

A) manual soak
B) ultrasonic cleaner
C) washer decontaminator
D) washer sterilizer

Question 31

Which type of chemical solution is made of catalysts that aid in breaking down proteinaceous debris such as blood and fat?

A) antiseptic
B) disinfectant
C) emulsifier
D) enzymatic

Question 32

Why are large steam sterilizers loaded with space between wrapped items or trays?

A) It ensures that the carts are not over-weighted.
B) It makes it easier to unload when the cycle is complete.
C) It allows adequate circulation and penetration of steam to all surfaces.
D) It allows for air to remain inside the packages to facilitate steam penetration.

Question 33

Why are items disinfected or sterilized in activated glutaraldehyde dried prior to submersion?

A) Moisture will prevent sterilant from reaching all surfaces.
B) Moisture will create a toxic chemical reaction with sterilant.
C) Moisture will cause air bubbles to form and prevent full contact.
D) Moisture will eventually dilute the concentration to ineffective levels.

Question 34

Before opening any sterilely packaged item, what is MOST important to verify about the package?

A) date sterilized
B) integrity of package
C) internal indicator/integrator
D) sterilization cycle number

Question 35

What is the term for the condition of a surgical technologist's skin after performing a surgical scrub?

A) bacteriostatic
B) nosocomial
C) surgically clean
D) terminally sterile

Question 36

What is the common name for the high-level disinfectant sodium hypochlorite?

A) ammonia
B) bleach
C) peroxide
D) vinegar

Question 37

Which type of surgical instrument must NEVER be immersed in any type of mechanical decontaminating equipment?

A) powered
B) stainless steel
C) titanium
D) tungsten-carbide

Question 38

What is another name for the intermediate-level disinfectant compound phenol?

A) amino acid
B) carbolic acid
C) muriatic acid
D) peracetic acid

Question 39

What is the term used to describe the process of removing all soiled linen, waste, and instruments from the room and cleaning of furniture, floors, or other contaminated surfaces in preparation for opening new supplies for a subsequent case?

A) changeover
B) concurrent cleaning
C) terminal cleaning
D) turnover

Question 40

Which of the following patient care items would be classified as noncritical?

A) colonoscopes
B) hypodermic needles
C) laryngoscopes
D) pulse oximeters

Question 41

A nonsterile person should approach a sterile area face forward while maintaining a distance of:

A) 6 inches
B) 12 inches
C) 2 feet
D) 6 feet

Question 42

The recommended biological indicator (BI) for hydrogen peroxide gas plasma is:

A) Bacillus atrophaeus
B) Bacillus subtilis
C) Geobacillus stearothermophilus
D) Staphylococcus aureus

Question 43

The Bowie-Dick test is performed for which sterilization method?

A) ethylene oxide gas
B) activated glutaraldehyde
C) hydrogen peroxide gas plasma
D) prevacuum air removal steam

Question 44

Which of the following concepts has replaced the previous system of assessing storage conditions and package integrity based on an arbitrary expiration designation?

A) double wrapping
B) event related
C) Julian dating
D) time related

Question 45

Where should the biological test pack be placed on the steam sterilization cart for the first run of the day?

A) top rack, back of sterilizer, under the injection valve
B) bottom rack, back of sterilizer, under the injection valve
C) top rack, front of sterilizer, over the drain
D) bottom rack, front of sterilizer, over the drain

Question 46

Which kind of quality control device consists of a paper that has been impregnated with a dye that changes color in the presence of a specified temperature and sterilant?

A) Cidex™ test strip
B) chemical indicator
C) mechanical readout
D) vial of spore population

Question 47

What would be the exposure phase time for an unwrapped instrument set with some lumens in a prevacuum/dynamic air removal steam autoclave?

A) 3 minutes
B) 4 minutes
C) 10 minutes
D) 30 minutes

Question 48

Which of the following statements regarding peracetic acid sterilized items is CORRECT?

A) Paper filters in the top lid and bottom of container must be changed for each cycle.
B) Items must be wrapped with Tyvek wrappers instead of cellulose-based wrappers.
C) Cassettes are not sealed, due to liquid immersion during the process, so they cannot be stored.
D) Aeration times will add hours to the total sterilization cycle time.

Question 49

What is the name of the outside area of an autoclave where steam is created before injection into the interior compartment?

A) aerator
B) chamber
C) gasket
D) jacket

Question 50

Which method of sterilization uses gamma rays or beta particles and is chiefly used by large manufacturing companies?

A) dry heat
B) ethylene oxide
C) hydrogen peroxide gas plasma
D) ionizing radiation

Question 51

Why are instruments placed in perforated or mesh-bottom trays for sterilization?

A) reduce tray weight
B) penetration of sterilant
C) easy grouping of instruments
D) easy removal of instruments

Question 52

When a sterilely attired surgical technologist drapes an unsterile table, he or she opens the drape:

A) away from him- or herself first
B) by shaking out folds first and laying it across table
C) toward him- or herself first
D) toward sides and pulls drape down well below edge

Question 53

Which of the following is the MOST important factor in a surgical technologist's role in preventing surgical site infections?

A) extensive knowledge of anatomy
B) high GPA while a student
C) participation in the "time out"
D) strict surgical conscience

Question 54

How long should the steam biological indicator be incubated before the reading is recorded?

A) 1 hour
B) 6 hours
C) 12 hours
D) 24 hours

Question 55

Which of the following is an acceptable position for placement of a scrubbed, gowned, and gloved surgical technologist's hands?

A) clasped together in front at waist level
B) grasping edge of draped back table with fingers coiled under table edge
C) hanging down at sides with hands below table level
D) tucked into axillary region (armpits)

Question 56

Personnel in CSPD who must move instruments from the ethylene oxide sterilizer to an aeration room should do which of the following with the cart to reduce their exposure to vented gases?

A) pull it
B) push it
C) cover it with plastic
D) open a window

Question 57

Sterilely attired surgical team members should pass one another in any of the following ways EXCEPT:

A) back to back
B) front to front
C) front to back
D) rotating 360° around

Question 58

What is the advantage of using ethylene oxide gas sterilization?

A) It is the safest method of sterilization.
B) It has the shortest total cycle time.
C) It is the least expensive method.
D) It is safe for heat- and moisture-sensitive items.

Question 59

Which of the following should NEVER be processed by immediate-use (flash) sterilization methods?

A) ebonized laser instruments
B) implantable devices
C) stainless steel suction tips
D) titanium microinstrumentation

Question 60

Which method of chemical sterilization has limitations based on the challenge of diffusion into narrow lumens?

A) ethylene oxide gas
B) glutaraldehyde
C) hydrogen peroxide gas plasma
D) peracetic acid

Question 62

Sterilization process monitors include mechanical, chemical, and biological methods to ensure all parameters were met.

Question 63

The relative humidity in an ethylene oxide sterilizer should be below 30% to aid in the penetration of the gas through bacterial spores' protective coating.

Question 64

Internal chemical indicator/integrators should be placed in the center or most challenging portion of a tray for the sterilant to reach.

Question 65

Gravity displacement steam sterilizer cycles are much shorter than prevacuum cycles.

Question 66

In steam sterilization, thermal destruction of microbes is the result of the denaturation and coagulation of protein within the cells.