FINAL EXAM: EXTRA QUESTIONS

When using the sequential wrapping method

Apply one wrapper followed by the second one

A coronary artery bypass surgery may be performed on patients with

Arteriosclerosis

A technician working in decontamination notices that the maintenance person working on the washer sterilizer did not remove the barrier attire when the person left the area to get additional tools. The technician should

Ask the maintenance person to remove the barrier attire when leaving the area

300 series stainless steel is also called

Austenitic

Outside shipping cartoons should NOT be brought into the SPD because they are often

Biologically contaminated

You are taking a used IV pump from a nursing unit to be reprocessed. The nurse tells you not to take it because there is an emergency admission and the patient will need it. What is ethically correct thing to do?

Call the department to have a clean pump brought to the unit right away

What would you do if a loaner set came into receiving the evening and the surgery will be performed at 7:30 am the next morning and the carrier did not bring the instructions for use?

Call the loaning facility and ask them to fax or email the instruction for use

Loose fitting clothing, jewelry should not be worn in SPD because it

Can get caught in moving equipment

What are some critical medical devices

Catheters, surgical instruments, needles

The EO biological test pack is placed

Center of the load (geometric)

Material Safety Data Sheet (MSDS) provide health and safety hazard and risk of information

Chemical

A staff member brings several contaminated trays to SPD on a cart and request that replacement trays be put on the same cart. The technician should

Clean and dry the transport cart and send it to distribution for the trays

An acceptable method of decontaminating an item that has been used on a patient is to

Clean with detergent solution and then use an appropriate disinfection agent

Supplies contaminated with blood and body fluids that require sterilization should be

Clean, dried and passed on the processing area for assembly, packaging and sterilization

Which of the following BEST describes the manual cleaning process of surgical instruments?

Cleaning and brushing the instrument beneath the water level

This organism is part of the normal flora of intestines but when a person started taking antibiotic the drugs alter the flora causing the organism to produce toxins in the colon, colitis and severe diarrhea. What is it?

Clostridium difficile

Which of the following is MOST efficient and cost-effective method in inventory control in the SPD ordering and data generation?

Computerized inventory control systems

What is the primary reason that the items are allowed to cool on a sterilizer cart before being placed in the storage?

Condensation and contamination may result if items are moved to cooler areas when they are still warm

The effectiveness of any chemical disinfection process depends on

Contact time, Concentration of the solution and Temperature of solution

High risk instrument set for prion processing

Craniotomy Set

Instruments used on patients with CJD

Decontaminated

You are wearing a scrub coat or lab coat. Where can you not go to?

Decontamination

What are the major physical areas of a typical SPD?

Decontamination, Assembly and Sterile Processing, Sterile Storage and Distribution

Which of the following generally describes the current sequence for the traffic workflow in areas in which medical devices are processed?

Decontamination, assembly, packaging, sterilization, sterile storage

Manual cleaning endoscopes should be

Deep and large enough to completely submerge the endoscope

What distribution system are requisitions filled and delivered as they are received?

Demand distribution

Every healthcare facility has an organizational structure or chart that outlines

Departmental authority relationships

A positive biological indicator test shows that the sterilization process

Did not result in the death of all the test organism

What is the first step in cleaning laparoscopic instruments?

Disassemble parts

Which of the following sterilization methods would be appropriate for petrolatum gauze

Dry heat

What would approve the disinfectants used on floors and walls in the sterile processing and distribution department?

EPA

All agencies are involved with the regulation and control of EO when it is used as a sterilant are

EPA, FDA, OSHA

Lot control numbers are used to

Enable recall following sterilization failure

PAR inventory level is also known as

Fixed inventory level

How do you kill microorganism (LTGP)

Free radicals

EtO penetration of bacterial cells (critical)

Humidity

You receive a cell phone text message from your friend while you are assembling instrument sets which of the following is the BEST action to take

Ignore the text until you are on break

"Inventory performance" is evaluated by

Inventory turnover, Percent of back orders, Availability of critical items

There are 2 pressure gauges on a steam sterilizer. These gauges measure the

Jacket and the chamber

In this system, the healthcare facility's stock keep minimal on hand and supplies are delivered when needed, usually just prior to use

Just in time

Instrument set to remove a gall bladder

Laparoscopic cholecystectomy

When lifting heavy objects which of the following muscles should bear most of the weight?

Leg

Which of the following would be an action to take if you note that a co-worker has hair hanging out of his or her surgical cap while assembling sets

Let him or her to know the hair is visible

The tech is asked to remove an arthroscopy set from the aerator 4 hours prior to completion of aeration time. The supervisor is not available. What should the tech do?

Let the set complete aeration cycle and borrow a set from another hospital

Detergent for orthopedic instruments

Lipolytic enzymatic

Cotton gauze cannot be used in which sterilizer

Low temperature gas plasma (LTGP)

If the operating room request instruments for an emergency ruptured aortic aneurysm the tech should send

Major vascular instruments

Steps in reprocessing flexible endoscope

Manual pre-clean, leak test, manual clean, HLD

400 series stainless steel is also called

Martensistic

What PPE will be the last one to be removed

Mask

Clamps used for hemostasis are also designed to

Minimize damage to tissue

Nerves are divided into two parts. One carry messages from the brain to organs and muscles and the other carry info to the brain

Motor and sensory nerve

The pH of the detergent solution that has been demonstrated to be the safest for cleaning surgical instrument is

Neutral

What regulates EtO?

OSHA, EPA, FDA

A newly sterilized surgical instrument set is to be placed at sterile storage's shelves, where do you store the set?

On the back of stored items

Surgical grade instruments, if properly cared for, usually last longer than floor grade instruments because they have a

Passivation layer

Perforated wire mesh tray placed flat in the sterilizer cart to

Permit air removal and steam penetration

This gland coordinates all the activities of the endocrine system and also known as "master gland"

Pituitary gland

When transporting sterile packaged items by hand

Place in a plastic bag or tote bin

A broken glass suction bottle is returned to decontamination should the technician do?

Place it in an appropriate rigid container

When a steam sterilizer is loaded with linen packs only, the packs should be

Placed on their edges

A bowie-dick test should be performed in what type of sterilizer

Pre-vacuum steam (dynamic air removal)

There are 3 sinks. What is the use of the middle sink?

Preliminary rinsing

What is necessary to attain the highest temperature needed in a steam sterilizer?

Pressure

Warm-up jacket are recommended to be worn in the preparation and packaging area for the purpose of

Preventing bacterial shedding from bare arms

In ambulatory surgery centers where there are no separate decontamination and preparation/packaging/sterilization areas. How do you keep from cross-contamination?

Procedural barriers

Factor for assigning an expiration date to a product

Product degradation

After you clean and disinfect laryngoscope using high level disinfectant. What do you have to do with the "paddles"?

Protect them from damage

The function of gastrointestinal system is to

Provide the body with nutrients

Sterilizer cannot print what will you do with the load?

Quarantine(enforced isolation) the load and report to your supervisor

Bacteriostatic solution used on surfaces and floors

Quarternary Ammonium Compounds

What kind of energy is used on Hydrogen Peroxide to create a Gas Plasma in LTGP sterilizer?

Radio frequency (RF)

You are in a hurry to leave for a doctor's appointment and you forget to punch your timecard. What action should be taken?

Report this to your supervisor the next day

Plastic sterilization bags are generally used to package

Respiratory therapy items

When preparing the instruments for processing the instruments should be positioned

Retractors on the bottom of the basket and the handheld instruments on the top

While delivering sterile supplies to multiple units, the SPD technician is asked by a unit secretary to an opened and used tray of instruments back to the SPD's decontamination area. What is the BEST procedure to use?

Return the used tray after completing all deliveries, using the appropriate collection cart

What kind of endoscope would a surgeon use for nasal surgery?

Rhinoscope

A tray of instruments has been brought to the decontamination area in a saline solution. What action should the tech take?

Rinse them with water and them clean them in the usual manner.

Applying PPE order

Show covers, Gown, Mask, Goggles/Face Shield, Gloves

When 2 similar basins with different sizes and nesting directly to each other. What is the best reason why basin should have a non-linting absorbent material in between them?

So that steam can penetrate adequately if metal basins are nested directly in other metal basin

If it is not possible to wash contaminated instruments immediately after use, they should be kept moist by

Spraying with an enzymatic foam, covering them with a towel moistened with water and placing them in a plastic bag

To kill the remaining microorganisms on metal surgical instruments within the SPD, the MOST cost-efficient sterilization method is generally considered to be

Steam under pressure

When heat is added to steam without increasing the moisture content, the steam is called.

Superheated steam

Containerized packaging systems are MOST commonly used to protect which of the following during steam sterilization

Surgical instrument sets

A co-worker is observed taking dressing supplies for use at home. What would be the FIRST action to take?

Tell him or her that this is not the right thing to do

Why is the routine biological testing of a flash sterilizer performed in an empty chamber?

The empty chamber presents a greater challenge to the biological indicator

Before releasing an item to fill a sterile supply order, what needs to be checked?

The expiration date, package damage, verification of chemical indicator

Controlled temperature and humidity, limited traffic

The general environmental conditions of SPD sterile storage

Which of the following is the MOST important factor in preventing bacteria from contaminating sterile packages

The handling of packages

What is the main DISADVANTAGE of using rigid sterilization container system?

They must be disassembled, processed, reassembled and checked before each use.

Effective sterilization begins with

Thorough cleaning

The first step to inspect the insulation of a laparoscopic instrument is to

Try to slide the insulation back

What is a factor affecting the dry time in a steam sterilizer

Type of packaging, weight of the sets, configuration of the load

A nosocomial infection can be prevented by

Using proper hand washing techniques, maintaining barriers to contamination and follow established isolation procedures

If a technician skin is exposed to liquid EO, what should the technician do FIRST?

Wash the exposed area with a large amount of soap and water

An instrument dropped after a HLD glutaraldehyde

Wash, rinse and disinfect

When working in the decontamination area, transmission of pathogenic organisms from used surgical instruments can BEST be minimized by

Wearing appropriate PPE

The sterility maintenance covers should be placed on sterile items

When the sterilized items cool to room temperature

Inspection and verification of adequate cleaning is difficult with instruments

With lumens

When a steam sterilizer load contains a mixture of fabric and metal items, the items should be placed?

With the metal items below the fabric items

Dirty to Clean is an SPD term to describe

Work Flow

When to remove the dust cover?

at the point of use

Which of the following scissors is designed to have the sharpest cutting edge?

black handled

When cleaning the IV pump, it is important to use a germicide on the pump surface in order to

reduce the bioburden present in the equipment

After manually cleaning contaminated surgical instruments with an disinfectant solution, the NEXT step in the decontamination process is

rinsing

Lot control numbers should be placed on each packaged sterilized, and on the

sterilization load record

Drains in pre-vacuum and gravity displacement sterilizers are placed at the bottom front of the sterilizers because

the air tends to concentrate at the bottom of the chamber

The following steps in the hand washing is

-Rotational rubbing palm, finger -Wetting hands, with water and soap -Turned off faucet using disposable towel

Exposure time for Ortho-phthalaldehyde (CIDEX OPA)

12 minutes

Temperature to incubate spores (LTGP)

131 F- 140 F

CJD case cycle for processing

18 minutes, 273 degrees, pre vac cycle

Which of the following solution is generally considered MOST appropriate for high level disinfections of semi-critical devices

2% activated glutaraldehyde

Change sharp container when (OSHA)

2/3 full

Which of the following would be the appropriate sterilization cycle for an autoclave load containing basin set, a minor surgery set and 12 towel packs?

270 F (132 C) for 4 mins 30 psi and 30min drying time

How much weight should be the limit of a basin set

7lbs

All of the following items of PPE should be worn when manually decontaminating flexible fiber optics endoscopes EXCEPT

A lead apron

Simultaneous wrapping means to wrap an instrument set

A single non-woven wrapper, double-ply, bonded at the edges

A patient contracts an infection from an improperly sterilized surgical instrument. This is an example of?

A vector transmission

Acrylic nails are not permitted to be worn in preparation and packaging because they can

Allow fungus to grow beneath them

How do you neutralize glutaraldehyde?

Ammonia, sodium bisulfate and glycine

An instrument tray for a laparotomy procedure must include

An abdominal retractor

Generally the first step in loosening blood soils from the channels of an instruments is to soak it in

An enzymatic detergent