Infection control

How long does the DBC require that biological monitoring records be kept?

1 year

The dentist/employer MUST provide the HBV vaccine series to all employees within ____ days of employment.

10

High level disinfection submersion usually takes approximately:

10 min.

An employer must provide the employee with a copy of the evaluating healthcare professional's opinion after an exposure incident within:

15 days

Dental unit water lines must be flushed for a minimum of _____ at the beginning of the work day.

2 minutes

Dental unit water lines must be flushed for a minimum of _____ between patients.

20 seconds

Microbial counts in dental treatment water can reach as high as _____ within 5 days of installing new dental equipment.

200,000 CFU/mL

Sharps containers should be filled only to

3/4 full

Medical records for all employees with occupational exposure must be kept for the duration of their employment plus:

30 years

The EPA's guidelines for healthy water is at or below _____ CFU/mL.

500

Chemical liquid sterilization usually requires at least _____ of contact time for sterilization to occur.

6-10 hours (but could be as much as 12 hours)

Gloves are on and off.

?

Put the following steps in the proper order as they relate to instrument processing.

?

The most common mode of disease transmission of HIV is contact and is NOT common in dentistry.

?

gloves are always considered

?

The first step to good quality water is the use of:

A self-contained water system

Which of the following is an example of an OSHA-required sharp with engineered injury protection?

A self-sheathing needle attached to a dental anesthetic syringe

HBV can live up to ____ outside the host, whereas HIV can only live

A week ; a few minutes

Sterilization destroys:

All microbial forms, including bacterial spores

A written hazard communication program must include a list of:

All potentially hazardous chemicals used in the dental office

An exposure control plan must be updated:

Annually and when new or modified tasks are introduced

All dental healthcare personnel should have a tuberculin skin test:

As a baseline, preferably upon hire

Employers must make hepatitis B vaccinations available to employees at potential risk of occupational exposure:

At a reasonable time and place At no cost to the employee Even if employee initially declines

1. Employees must be trained on the hazard communication standard:

At the time of initial assignment Whenever a new potentially hazardous chemical is introduced in the office

A mask should:

Be changed between each patient or if visibly soiled Should create a seal around the mouth and nose Not be touched except on the loops or ties during removal

OSHA requires that exam gloves

Be provided to all ADHP at no cost Be removed and replaced when torn or compromised Must NOT be washed and reused

Examination gloves that are contaminated with blood or other potentially infectious materials (OPIM) that could be released during handling should be discarded in the:

Biohazardous waste container

The only method to confirm that the sterilization process has happened and all spores are destroyed are by using:

Biological monitoring systems

Contaminated waste contains items that have come in contact with:

Body fluids

During a boil-water advisory, it is acceptable to use:

Bottled water for patient rinsing

If extracted amalgam-filled teeth are sterilized in a steam autoclave, the process may:

Cause hazardous vapors

Heat sensitive tape that changes color rapidly when a given parameter is reached is which type of monitoring system?

Chemical

Besides alcohol, which of the following is a common antimicrobial agent found in hand hygiene products?

Chlorohexidine

Barriers should be placed with _____ hands and removed with _____ hands.

Clean and bare ; gloved

What is the proper management for work surfaces that become contaminated with blood?

Clean and then disinfect

According to the CDC, to reduce the contamination of cleaning solutions, reusable mops used on housekeeping surfaces should be:

Cleaned and dried before reuse

The first step in managing an exposure incident to a communicable disease is to:

Cleanse or flush the exposure site

CFU in reference to biofilm in the waterlines stands for:

Colony forming units

What is the best environmental infection control practice for clinical contact surfaces with irregular surfaces (e.g., switches, connections, etc.)?

Covering surface with fluid impervious barriers

Which agency has a regulation that dental unit water lines must be flushed at the beginning of the work day and between patients?

DBC

Which organization requires the use of anti-retraction systems in the dental equipment?

DBC

Who REQUIRES weekly biologic testing of sterilization equipment?

DBC

Who REQUIRES the use of PPE?

DBC OSHA

The purpose of wearing PPE is to protect the _____ from contracting communicable diseases.

DHCP

What does the CDC recommend if a patient presents in a dental practice with symptoms of M. tuberculosis?

Defer elective dental treatment until the physician confirms the patient is no longer contagious

Autoclaves operate through four cycles. Which cycle allows the steam under pressure to be released from within the chamber?

Depressurization cycle

Extracted teeth containing amalgam should be:

Disinfected using a high-level disinfectant and disposed as a hazardous waste

What should be done if the SDS is not available in the office for a given material?

Do not use the material until the MSDS is reviewed

What is the recommended procedure when a sterilizer fails two consecutive spore tests?

Do not use the sterilizer until the reason for the failure has been determined and corrected

The mechanism of disease transmission for influenza is:

Droplet

After an exposure incident, the employer must provide the evaluating physician with a description of the:

Employee's relevant job duties

1. One requirement of an exposure control plan is that the employer should seek the input of:

Employees who have direct patient contact

According to OSHA, the proper laundering or disposal of outer personal protective clothing (lab coats or gowns) is the responsibility of the:

Employer

Reusable liquid hand soap containers should be

Emptied and washed before refilling

Manufactured items that help prevent injury from sharps are called:

Engineering controls

The type of solution that should be used for sanitizing instruments is a/an:

Enzymatic

Mechanical monitoring of the sterilization process should occur with:

Every load

Self-contained water systems are ALL WE NEED in order to ensure quality water reaching the patient's mouth through the hoses.

FALSE

Who regulates the manufacturing of medical equipment and supplies?

FDA

1. Anti-retraction valves are 100% effective in preventing contaminants from going up waterline hoses during treatment.

False

Almost all waste generated in a dental office is regulated waste.

False

The primary active agent in the solution for chemical vapor sterilization is:

Formaldehyde

The reason OSHA updated Hazcom1994 to Hazcom2012 was to ensure uniformity and ease of use:

Globally

When using the air water syringe during dental treatment, which of the following personal protective equipment is recommended by the CDC?

Gloves Mask Eyewear Gown

Which of the following PPE items are required by OSHA to be worn during routine dental treatment procedures?

Gown or lab coat Mask gloves goggles

A person with a latent tuberculosis infection will:

Have a positive skin test and no symptoms of active tuberculosis

Hazards of disinfectants should be found on the Safety Data Sheet as required by the:

Hazard Communication Standard

Used radiographic fixer solution is considered:

Hazardous waste

Waste containing toxic chemicals is also known as:

Hazardous waste Regulated waste

Within the steam autoclave, what is the order of the cycles it must go through in order to sterilize instruments?

Heat-up Sterilize Depressurize Dry

Which disease is a viral infection that can be prevented through immunization?

Hepatitis B

Which disease is caused by a bloodborne pathogen?

Hepatitis C

Process indicators that change color are useful for:

Identifying instrument packs that have been exposed to a certain temperature

According to the CDC, how long should sterilization monitoring records be kept?

In compliance with state and local regulations

According to the OSHA BBP Standard, each dental office must have an exposure control plan that is:

In writing and reviewed at least once a year

Water systems that effectively reduce biofilm in the dental unit water lines include:

In-line filters Sterile water delivery systems Use of specific chemicals to treat the water

Overloading an autoclave may result in an

Inability of steam to penetrate the materials

Touching a contaminated object is an example of:

Indirect transmission

Semi-critical instruments

Instruments that come in contact with oral mucosa

Critical instruments

Instruments that cut soft tissue or penetrate bone

If clinical contact surfaces are contaminated with blood, we need to use _____ level disinfection.

Intermediate

Non-critical care items

Items that are used for patient treatment but do not go in the oral cavity

When conducting an infection control training program, the trainer must provide training in the:

Language of and at the literacy level of the employee

Two microorganisms that may pose a risk of infection thru dental unit water lines include:

Legionella Pseudomonas aeruginosa

The difference between airborne transmission and droplet infection is the:

Length of time the disease can suspend in the air

According to OSHA, safety measures that should be taken when using bonding materials with potential chemical hazards must be found in a:

Material Safety Data Sheet

Safety Data Sheets were previously called:

Material Safety Data Sheets

Where can information on the chemical and physical properties of mercury be found?

Material Safety Data Sheets

How is "engineering controls" best described?

Materials and devices that prevent employee exposure to hazardous or infectious substances

The reason high speed handpieces must be heat sterilized is that they:

May have retracted pathogenic organisms into the inside of the handpiece

OSHA approved training must include:

Methods that will prevent or reduce exposure Tasks that may involve potential exposure The employer's exposure control plan The modes of disease transmission

Ways in which disease can be transferred from one person to another are called:

Modes of transmission

Routine handwashing removes:

Most of the transient microbes and some of the resident microbes

Which of the following statements are true regarding protective eyewear?

Must contain front and side protection during exposure prone procedures Reusable protective eyewear needs to be cleaned and disinfected between patients

Which of the following verifies that the sterilization process destroyed all microbes?

Negative spore test results

OSHA requirements regarding the disposal of contaminated needles include:

Not bending or shearing the needle Use of sharps containers as close to the area of use as possible Use of a medical device or the one-handed scoop method of recapping the needle

Alcohol-based hand rubs have been shown to be effective in hand antisepsis when the hands are

Not visibly soiled

If using chemical tablets to treat the waterlines, a shock system should be done:

Once a month

An example of a "work practice control" is using a:

One-handed recapping technique for needles

Which of the following are considered clinical contact surfaces?

Operatory computer keyboard Aspirator hose Operatory light switch

OPIM stands for

Other potentially infectious material

Which of the following modes of disease transmission best describe a human bite?

Parenteral

When transporting and processing contaminated patient care items, the ADHP can be exposed to microorganisms through _____.

Percutaneous injury or contact with mucous membranes of the eye, nose, or mouth

Which factors can affect the success of the sterilization process?

Proper packaging Proper timing Proper temperature Proper loading

The primary reason a face mask must be used during a dental procedure is to:

Protect the DHCP from exposure to spatter

Regarding PPE, employers are required to:

Provide alternatives in the case of latex allergies Clean, launder, and dispose of PPE at no cost to the employee Provide appropriate sizes Ensure use of PPE

According to the OSHA bloodborne Pathogens Standard, a contaminated sharps container should be:

Puncture resistant and closable

If an inaccurate or positive result occurs when performing a biological test, the DHCP should:

Re-sterilize suspected loads Remove sterilizer from service if a second spore test is positive

How should a used anesthetic needle be handled before placing it in a sharps container?

Recap it and remove from the syringe

The main purpose of SURGICAL hand antisepsis is to:

Reduce the chance for contamination of the patient if the gloves become punctured or torn

Which of the following is an example of a clinical contact surface?

Regular garbage

A blood-soaked gauze is an example of:

Regulated or biohazardous waste

A used dental anesthetic needle is an example of:

Regulated waste

When removing PPE, the correct order should be:

Remove gloves Wash hands Remove eyewear Remove mask Remove protective clothing

The correct steps to take when a glove rips or tears during a procedure are:

Remove the glove, wash and dry hands, place new glove

The purpose(s) for flushing the dental unit water lines between patients include:

Removes contaminants that may have been retracted during patient treatment Clears away free-floating organisms in the water

Exam gloves should be:

Replaced immediately if damaged or torn Discarded after each patient

Sharps containers in dental practice settings must be:

Replaced when items reach the marked fill-line on the container Placed in each area where sharps are generated

Having a patient close their lips around a saliva ejector may cause:

Retraction of the fluids in the waterlines into the patient's mouth

A program evaluation method for post-exposure management should include:

Review of the plan with the dental team

Which patient care item is classified as a semi-critical instrument?

Rubber dam forceps

Impressions must be high level disinfected because they are a:

Semi-critical item

An unused dental needle should be disposed of in a:

Sharps container

Which statements are true regarding PPE?

Should have long sleeves and high neckline to minimize skin/clothing exposure Should be changed if visibly soiled or moist Should be made of fluid resistant material Should not be worn out of the patient treatment area

The appropriate delivery method for irrigation during oral surgery includes:

Sterile water in a sterile bulb syringe or sterile tubing

The two organisms that are the hardest to kill, and are therefore used to determine the strength of the disinfecting solutions in your office are:

TB and Spores

There are two exposure determination lists required by OSHA. They include:

Tasks and procedures performed by employees with potential occupational exposure Job classifications of employees with some or all occupational exposure

The word ASEPSIS means

The absence of contamination (free from pathogenic organisms)

Who supplies the original MSDS?

The chemical manufacturer

An OSHA approved BBP training program must include a general explanation of:

The epidemiology and modes of disease transmission

An exposure control plan must include:

The evaluation of safety devices

Who is responsible for appropriate disposal of regulated waste?

The generating facility

The Dental Board of California requires that all sterilized instruments must be labeled with:

The sterilizer they were processed in The date of sterilization

Heat sterilization of extracted teeth may result in:

The vaporization of mercury, presenting a health hazard

Which statements are true regarding resident flora?

They are harder to remove than transient microorganisms They are less likely to cause healthcare related infections than transient microbes

Which statement(s) is/are correct about ultrasonic cleaner solutions?

They are highly contaminated Should be discarded at least once a day Should be changed when visibly cloudy May contain enzymatic activity

Which statement is incorrect about liquid chemical sterilant?

They may be disposed of by dumping down the sink

Areas of the hand that are frequently missed when performing a routine handwashing include:

Thumb and in-between fingers

Why are instruments bagged before sterilization?

To allow them to be grouped into special set-ups by procedure To protect them from becoming contaminated after sterilization

Why are instruments bagged before sterilization?

To protect them from becoming contaminated after sterilization To allow them to be grouped into special set-ups by procedure

After washing hands at a faucet that is not automatic, the dental healthcare personnel should:

Use a dry paper towel to turn off the faucet

You are placing instruments into the instrument package, and the explorer tears a hole in the package. You should:

Use a new package

To reduce the risk of disease transmission in the dental office, it is recommended to:

Use disposable items whenever possible

What is the infection control protocol when working with an HIV-positive patient?

Use standard precautions

Which of the following are considered a part of the chain of infection?

Virulence of the organism Amount of organisms A susceptible host A portal of entry

An ADHP who receives an accidental exposure on the skin from a contaminated source should first:

Wash the exposed skin with soap and water

Routine handwashing for dental healthcare personnel includes the use

Water and plain soap

How can you protect yourself from coming in contact with contamination during the removal of utility gloves?

Wear a pair of clean exam gloves under the utility gloves

The CDA, ADA, and OSAP recommend at least _____ biologic monitoring of all sterilizing equipment.

Weekly

Hands need to be cleaned/washed:

When they are visibly dirty After touching contaminated objects with bare hands Before and after patient treatment (before glove placement and immediately after glove removal) When there is a tear in your exam gloves

Employees must receive training regarding hazardous chemicals upon hire and:

Whenever a new hazard is introduced

During the sterilization process, how often should chemical monitoring be performed?

With every package of instruments

What is the best protocol for retrieval of a cotton roll from a drawer at chairside during patient treatment

With sterile cotton pliers or tongs

The one handed scoop technique while recapping a reusable anesthetic needle is an example of:

Work practice controls

. Which office training program includes safety measures when using a hazardous chemical?

Written Hazard Communication

The most difficult microorganism to kill is:

a spore

According to the OSHA BBP Standard, employers must provide employees with education and training on the standard at least:

annually

OSHA's mandated written exposure control plan must be updated at least:

annually

The exposure control program must be reviewed at least:

anually

The ultrasonic cleaner should be cleaned and disinfected:

at least once a day

Which of the following would be regulated under OSHA's Hazard Communication Standard?

bonding agents

The next step after a positive TB skin test is a _____ x-ray which will determine if they have active or latent TB.

chest

Instruments that are used to penetrate soft tissue or bone are _____ instruments.

critical

Which category of instruments possess the greatest risk for infection?

critical

Instruments that are used to penetrate soft tissue and/or bone are considered:

critical instruments

The most common mode of disease transmission in the dental office is:

droplet transmission

The accessibility of the exposure control plan for employees is the responsibility of the:

employer

Who is responsible for ensuring a Safety Data Sheet is available in the workplace for each hazardous material?

employer

The pictogram created by OSHA that represents potential harm to the _____ is not required on any of the Hazcom2012 approved labels.

environment

ALL reusable critical care items MUST be heat sterilized.

false

All PPE should be worn at all times when performing any dental treatment.

false

All reusable items that come in contact with the patient's blood, saliva, or mucous membrane, must be heat sterilized.

false

Chin-length face shields are sufficient without the use of a mask if performing a routine dental procedure.

false

I can identify all patients who are carrying a bloodborne disease by reading their medical histories.

false

If hands are not completely dry before donning gloves, it may be challenging to get them on, but it will not contribute to bacterial growth.

false

Instruments must be left in the ultrasonic for at least 10 minutes.

false

Most organisms recovered from dental waterlines have a high potential for causing illness in healthy, immunocompetent persons.

false

OSHA's BBPS specifically states that personal protective equipment provided by the employer include disposable gowns that are closed at the wrists and cover the neck.

false

Persons with latent TB can transmit the disease.

false

Pre-soak holding solutions contain glutaraldehyde to disinfect the instruments.

false

Safety glasses used during patient treatment are sufficient for use during handling of hazardous chemicals.

false

Scrubs are considered part of your PPE.

false

The motor of a slow speed handpiece must be heat sterilized because it is a semi-critical item.

false

The hazard communication standard is a set of policies in place to help employees keep safe from the hazards of pathogens in the workplace.

false Hazardous chemicals - not pathogens (that is the Bloodborne Pathogen Standard)

. Labels on all potentially hazardous chemicals must meet OSHA's new Hazcom2012 standards by May 1, 2016?

false it is june 1,2016

A method of sterilizing unwrapped patient care items for immediate use is called:

flash sterilization

Which PPE item should be removed before temporarily leaving a patient to retrieve additional supplies?

gloves

The least desirable method of sanitizing dental instruments is:

hand scrubbing

One of the most important sources in preventing the spread of disease is proper hygiene of one's:

hands

A vaccine is available for protection against:

hep. B

Which disease poses the greatest risk of infection to dental workers?

hepatitis B

A needlestick involving a used anesthetic syringe can lead to what type of microbial contact?

indirect

Reuse of a nonsterile explorer on the next patient can lead to what type of disease transmission?

indirect

Which vaccine-preventable disease poses the greatest risk of transmission in a dental office setting?

influenza

Eyewash stations must be inspected:

monthly

At least one of the _____ pictograms created by OSHA must be included in the label of all potentially hazardous chemicals.

nine

What type of infection occurs in individuals whose immune system (resistance) is decreased or compromised?

opportunistic

The term for a disease causing microorganism is:

pathogen

The purpose of a surgical scrub and use of sterile gloves is to protect:

patient

When donning PPE, the correct order is:

protective clothing eyewear ? mask wash hands don gloves

The next step after instruments have been processed in the ultrasonic is to:

rinse and dry

Ultrasonic cleaners are used to:

sanitize

Handpieces are considered:

semi- critical items

Items that have a lower risk of disease transmission because they contact only the mucous membrane and do not penetrate soft tissues are called:

semi-critical

The majority of the spray produced by dental handpieces consists of:

spatter

Another term for biological monitoring is _____ testing.

spore

Which set of precautions is intended to prevent exposure to all body fluids?

standard

The process of killing all microorganisms, including bacterial spores, is called:

sterilization

A person has been exposed to herpes simplex but has never had an outbreak. This person experiences stress during a major life change, such as going away to college. The stress is compounded by the fact that the person is staying up late cramming for exams and socializing and not getting enough sleep. While the person is in this stressful state, a herpetic lesion develops on the person's upper lip. This is an example of which link in the chain of infection?

susceptible host

Who is responsible for ensuring the labeling of secondary containers of hazardous chemicals?

the employee

Protective measures to keep employees safe from hazardous chemicals include:

toring chemicals safety Mercury Spill kits Eyewash stations Appropriate PPE

How long must employers maintain Hazard Communication training records?

training records are not required

According to OSHA's Bloodborne Pathogens Standard, PPE must be removed prior to leaving the work area.

true

An internal chemical indicator should be placed in every sterilization package to monitor the sterilization parameters such as time, temperature, and for autoclaves, pressure.

true

An occupational exposure to a transmittable disease is a medical emergency.

true

Because the DHCP is frequently exposed to blood and blood-contaminated saliva during dental procedures, they are at greater risk of infection by a bloodborne pathogen than the patients of the practice.

true

Conducting an annual review of personnel immunization records would be an appropriate method of ensuring dental healthcare personnel immunizations are complete and current.

true

Eating, drinking, smoking, applying cosmetics or lip balm, nor handling contact lenses in dental treatment areas would be a violation of OSHA's Bloodborne Pathogen Standard.

true

Employers must conduct hazard communication training in a language and at a level understandable by each employee.

true

Failure of the sterilization process should be reported by the monitoring service immediately by phone to the dental office as a positive result.

true

If an ADHP wears their own prescription glasses during treatment, sideshields must be attached to the glasses.

true

Latent TB is NOT contagious.

true

One person needs to be designated as the point person to ensure compliance with the hazard communication standard.

true

Personal protective equipment will be considered "appropriate" only if it does not permit blood or other potentially infectious materials to pass through to or reach the employee's work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes.

true

Regulations are enforceable requirements.

true

The Center for Disease Control (CDC) has no regulatory powers.

true

The DBC regulation for the treatment of critical instruments and semi-critical instruments is the same.

true

The exposure control plan must show/reflect changes in technology and consideration and implementation of new devices.

true

The post management program requires rapid access to clinical care, post exposure treatment, and testing the source patient or DHCP.

true

Waterborne microorganisms have been linked to numerous infections and instances of disease transmission in hospital settings and in the community.

true

A disease caused by a bacteria is:

tuberculosis

The most contaminated area in the entire office is the:

ultrasonic cleaner

Personal protective equipment (PPE) including _____ must always be used when processing instruments.

utility gloves

What additional item must be worn, besides the normal PPE, when processing instruments?

utility gloves

What type of gloves must be worn to clean the treatment room, sterilize instruments, or for surface disinfecting?

utility gloves

The best protection against HBV infection is:

vaccination

The two signal words required on the label of all potentially hazardous chemicals are:

warning danger

The formation of holes in exam gloves during excessive use of liquids (such as washing the exam gloves) is called:

wicking

The proper way to set up an operatory is:

without gloves on

Candida Albicans is a

yeast