Test 1 modules (342, 363, 474)

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T/F Ideally, FDA-cleared film barrier pouches should be used when exposing dental films; after exposure, the film should be removed from the pouch and placed in a clean container.

True

T/F Impressions, prostheses, and other devices must be rinsed under running tap water to remove blood and OPIM, disinfected with an EPA-registered intermediate-level disinfectant with tuberculocidal claim, and thoroughly rinsed under running tap water before handling.

True

T/F In the receiving, cleaning, and decontamination section of the central instrument processing area, reusable instruments are first cleaned with a hands-free process using an ultrasonic system with a strainer-type basket.

True

T/F Pathogens may be transferred from the source to a host by contact transmission, i.e., direct or indirect contact transmission; or respiratory transmission, i.e., inhalation of droplets or droplet nuclei (airborne transmission).

True

11. (474) All of the following statements are correct with respect to detergents and enzymatic cleaners, EXCEPT for one. Which one is the exception? A. Detergents with an acidic pH generally provide the best material compatibility profile and good soil removal. B. Enzymes, usually proteases, sometimes are added to neutralize pH solutions to assist in removing organic material. C. Some cleaning solutions also contain lipases (enzymes that inactivate fat) and amylases (enzymes that inactivate starches) . D. After cleaning, the instruments must be washed to remove detergent and enzyme residues.

A. Detergents with an acidic pH generally provide the best material compatibility profile and good soil removal.

14. (363) All the following statements are correct with respect to housekeeping surfaces EXCEPT which one? A. Extraordinary cleaning and decontamination of floors in healthcare settings is warranted. B. Cleaning the walls, blinds, and window curtains is recommended when they are visibly soiled. C. Housekeeping surfaces need to be cleaned only with soap and water, alternatively, a detergent/disinfectant may be used. D. The methods, thoroughness, and frequency of cleaning housekeeping surfaces and the products used are determined by healthc are facility policy.

A. Extraordinary cleaning and decontamination of floors in healthcare settings is warranted.

4. (474) All of the following statements related to critical or semi-critical, or non-critical patient-care items are correct, EXCEPT for one. Which one is the exception? A. Heat-tolerant semi-critical items such as handpieces must minimally undergo high-level disinfection with an FDA-registered chemical sterilant used as a high level disinfectant. B. Heat tolerant critical and semi-critical items must be sterilized by steam, unsaturated chemical vapor, or dry heat. C. Heat-sensitive critical items can be sterilized by ethylene oxide or by immersing them in liquid chemical germicides registered by the FDA as chemical sterilants. D. Non-critical items, when visibly soiled, must be disinfected with an EPA-registered hospital level intermediate-level disinfectant.

A. Heat-tolerant semi-critical items such as handpieces must minimally undergo high-level disinfection with an FDA-registered chemical sterilant used as a high level disinfectant.

Highlights of the OSHA Healthcare ETS and CDC guidance to mitigate the transmission of SARS-CoV-2 in the dental setting include all the following, EXCEPT for one. Which one is the exception? A. Mandatory use of a NIOSH-approved N95 or equivalent or higher-level respirator when providing patient care. B. Where feasible, enforce 6-foot physical distancing. C. Ensure existing HVAC systems are used in accordance with manufacturer's instructions and design specifications for the sys tems and that air filters are rated Minimum Efficiency Reporting Value (MERV) 13 or higher, if the system allows it. D. Whenever possible, provide dental care in individual treatment rooms.

A. Mandatory use of a NIOSH-approved N95 or equivalent or higher-level respirator when providing patient care.

7. (363) Measures to prevent the spread of waterborne pathogens include all of the following EXCEPT which one? A. Pipe runs from the water main as long as practical. B. Hand hygiene and glove use. C. Barrier precautions. D. Eliminating or minimizing contamination at point-of-use fixtures.

A. Pipe runs from the water main as long as practical.

Which of the following are considered Category I procedures, i.e., procedures with minimal risk of bloodborne pathogen transmission? A. Routine preventive dental procedures - not requiring the administration of local anesthesia B. Operative, endodontic, and prosthetic procedures and periodontal scaling and root planning C. Minor surgical procedures D. Periodontal curettage, gingivectomy, and mucogingival and osseous surgery

A. Routine preventive dental procedures - not requiring the administration of local anesthesia

All of the following statements, in reference to the mandated Infection Control/Exposure Control Protocol, are correct, EXCEPT for one. Which one is the exception? A. The concept of Universal Precautions implies only symptomatic patients were considered as infectious. B. Standard Precautions (periodically expanded with new evidence-based elements) and Transmission-Based Precautions provide the fabric for an effective Infection Control/Exposure Control Protocol. C. The office Infection Control/Exposure Control Protocol is predicated on the concept that blood and all other body fluids ( secretions and excretions with the exception sweat) are potentially infectious. D. The office Infection Control/Exposure Control Protocol is a hierarchy of preventive strategies designed to protect OHCPs a nd patients alike.

A. The concept of Universal Precautions implies only symptomatic patients were considered as infectious.

12. (363) All the following statements are correct in relation to intermediate-level disinfectants EXCEPT which one? Intermediate-level disinfectants __________. A. are regulated exclusively by the FDA B. inactivate Mycobacterium tuberculosis, which is substantially more resistant to chemical germicides than ordinary vegetati ve bacteria, fungi, and viruses (with or without lipid envelops) C. except for sodium hypochlorite, have no demonstrable sporicidal activity D. are labeled as "tuberculocidal hospital disinfectants"

A. are regulated exclusively by the FDA

15. (363) All the following strategies for spills of blood and OPIM are acceptable according to OSHA regulations EXCEPT which one? Removing visible organic matter with absorbent material such as disposable paper towels; discard it into a leak-proof properly labeled container; and then, disinfect the area with __________. A. household bleach, 1:10 v/v dilution B. an EPA-List D low-level disinfectant (i.e., hospital disinfectant with HIV and HBV claims) C. an EPA-List E intermediate-level disinfectant (i.e., hospital disinfectant with tuberculocidal, HIV, and HBV claims) D. EPA-List B intermediate-level disinfectant (i.e., hospital disinfectant with tuberculocidal claim)

A. household bleach, 1:10 v/v dilution

All of the following statements with respect to education and training are correct, EXCEPT for one. Which one is the exception? A. An education and training program is to be completed by all OHCPs prior to initial assignment to tasks and procedures in which exposure to blood and OPIM may occur and at least annually thereafter. B. An education and training program is to be scheduled during nonworking hours and the cost is to be borne by the OHCP. C. An education and training program is to be conducted by person(s) knowledgeable about the subject and the speaker is to provide an opportunity for interactive questions and answers. D. An individual training record is to be maintained on all OHCP for the most recent 3-year period.

B. An education and training program is to be scheduled during nonworking hours and the cost is to be borne by the OHCP.

6. (363) Which of the following modes are likely to serve as a vehicle for the transmission for Legionella spp. from a contaminated water source? A. Ingestion of water. B. Aspiration of water or inhalation of aerosols. C. Direct contact with water. D. Indirect-contact transmission (e.g., from an improperly reprocessed device).

B. Aspiration of water or inhalation of aerosols.

T/F 13. (363) If barriers are not used, regardless of the surface condition, i.e., visibly soiled or not, first clean the surface then disinfect with an EPA-Listed product that qualifies under EPA's emerging viral pathogens program for use against SARS-CoV-2.

True

All of the following statements are correct in relation to environmental infection control, EXCEPT for one. Which one is the exception? A. To prevent contamination of clinical contact surfaces cover them with materials impervious to moisture. B. Before removing gloves and performing hand hygiene, place clean barriers on clinical contact surfaces after each patient. C. Housekeeping surfaces such as floors and sinks are cleaned regularly with a detergent and water or an EPA-registered hospital disinfectant/detergent designed for general housekeeping purpose. D. At the end of each day, general cleaning and disinfection of clinical contact surfaces are performed regardless of barrier protection.

B. Before removing gloves and performing hand hygiene, place clean barriers on clinical contact surfaces after each patient.

All of the following statements are correct in relation to extracted teeth, EXCEPT for one. Which one is the exception? A. Extracted teeth are considered to be potentially infectious. B. Extracted teeth containing dental amalgams are to be placed in the medical waste container for final disposal by incineration . C. Extracted teeth can be disinfected and returned to the patient upon request. D. Extracted teeth must be heat-sterilized or disinfected in 10% formalin before clinical exercises or study.

B. Extracted teeth containing dental amalgams are to be placed in the medical waste container for final disposal by incineration .

All of the following statements are true regarding gloves, EXCEPT for one. Which one is the exception? A. To reduce the risk of latex-related allergies, only powder-free, low-allergen latex gloves, or non-latex (nitrile, vinyl) gloves should be used. B. Gloves should not be changed when torn or punctured until treatment of the patient is completed. C. Gloves may not be washed because it can lead to the formation of glove micro-punctures (wicking) and subsequent hand contamination. D. Double gloving is acceptable for extensive oral surgical procedures.

B. Gloves should not be changed when torn or punctured until treatment of the patient is completed.

Pathogenic organisms of concern in the oral healthcare setting include all of the following, EXCEPT for one. Which one is the exception? A. HBV B. HPV C. HIV D. HCV

B. HPV

To prevent backflow in low-volume suction lines all of the following should be accomplished, EXCEPT for one. Which one is the exception? A. Instruct the patient not to create a seal around the saliva ejector. B. Have the assistant hold the suction tubing above the patient's mouth. C. Have the assistant hold the suction tubing below the patient's mouth. D. Avoid the simultaneous use of other evacuation devices (high-volume).

B. Have the assistant hold the suction tubing above the patient's mouth.

12. (474) All of the following statements are correct with respect to preparing and packaging instruments, EXCEPT for one. Which one is the exception? A. The individual instruments should be placed in individual self-sealed or heat-sealed plastic and paper pouches or arranged in rigid or perforated trays/cassettes and wrapped. B. Hinged instruments placed in various packs must be in a closed, locked position. C. Each instrument unit must have an internal indicator placed on the inside and, if the internal indicator cannot be seen, a n external indicator must be applied to the outside. D. The packing material e.g., paper or plastic pouches and unwoven and woven wraps must maintain the sterility of instruments during transport and storage.

B. Hinged instruments placed in various packs must be in a closed, locked position.

19. (474) All of the following statements relative to the sterilization monitoring record (SMR) are correct, EXCEPT for one. Which one is the exception? A. Documentation, in the form of a log, is an absolute requirement of quality assurance. B. Mail-in biological monitoring reports are maintained by the testing agency and there is no requirement for separate recordkeeping in the dental office. C. The SMR provides a mechanism for determining if a recall is indicated and, in combination with the date and sterilizer num ber on each pack, the extent of the recall. D. The sterilization monitoring record and the sterilizer maintenance record shall be maintained for a specified period of ti me (state dental board requirements may vary).

B. Mail-in biological monitoring reports are maintained by the testing agency and there is no requirement for separate recordkeeping in the dental office.

All of the following statements are correct in relation to laboratory asepsis, EXCEPT for one. Which one is the exception? A. Environmental surfaces must be barrier-protected or cleaned and disinfected in the same manner as clinical contact surfaces in treatment areas. B. Metal impression trays and face bow forks may be disinfected with an EPA-registered hospital level disinfectant with tuberculocidal claim. C. Articulators, case pans, lathes, pressure pots, and water baths are to be cleaned and disinfected between patients accordi ng to manufacturers' recommendations. D. Burs, polishing points, rag wheels, and laboratory knives used on contaminated or potentially contaminated prostheses or o ther material are to be heat-sterilized, disinfected, or discarded between cases according to manufacturers' recommendations.

B. Metal impression trays and face bow forks may be disinfected with an EPA-registered hospital level disinfectant with tuberculocidal claim.

All of the following statements are correct in relation to hepatitis B vaccination, EXCEPT for one. Which one is the exception? of the following statements are correct in relation to hepatitis B vaccination, EXCEPT for one. Which one is the exception? A. Primary immunization with hepatitis B vaccine consists of a series of three intramuscular injections. B. Post-vaccination confirmation of seroconversion is mandated 1-2 months after the third dose. C. OHCP who fail to develop an adequate antibody response to the primary vaccination series, a second 3 -dose vaccine series is recommended. D. If no antibody response occurs to the hepatitis B vaccination series, testing for HBsAg is strongly recommended.

B. Post-vaccination confirmation of seroconversion is mandated 1-2 months after the third dose.

All of the following precautions are correct with respect to the treatment phase of patient care, EXCEPT for one. Which one is the exception? A. All procedures are performed in such a manner as to minimize splashing, spraying, spattering, and the generation of drople ts (aerosols). B. Prior to dental procedures, patients must rinse with chlorhexidine gluconate-, essential oil-, or povidone iodine-containing mouthwash. C. Use rubber dental dam, high volume evacuator (HVE) and other protective barriers, engineering and work practice controls w herever possible. D. Use one handed "scoop" technique or a recapping safety device to recap anesthetic needles.

B. Prior to dental procedures, patients must rinse with chlorhexidine gluconate-, essential oil-, or povidone iodine-containing mouthwash.

6. (474) All of the following statements with respect to unsaturated chemical-vapor sterilizers are correct, EXCEPT for one. Which one is the exception? A. Unsaturated chemical-vapor sterilization involves heating a chemical solution, primarily alcohol with 0.23% formaldehyde, in a closed pressurized chamber. B. The advantage of using unsaturated chemical-vapor sterilization is that the instruments do not have to be dry before sterilization. C. When using an unsaturated chemical-vapor sterilizer federal, state and local authorities must be consulted for hazardous waste disposal requirements. D. Unsaturated chemical-vapor sterilization causes less corrosion of carbon steel instruments than steam sterilization because less water is present during the cycle.

B. The advantage of using unsaturated chemical-vapor sterilization is that the instruments do not have to be dry before sterilization.

4. (363) All the following statements related to laser plumes or surgical smoke, and aerosolized allergens are correct EXCEPT which one? A. Lasers and electrosurgical units release laser plumes or surgical smoke containing gases, tissue debris, and aerosolized i nfectious agents. B. The presence of pathogens in laser plumes or surgical smoke will predictably cause disease. C. Exposure to aerosolized allergens can cause urticaria, asthma, allergic rhinitis, conjunctivitis, angioedema, and rarely a naphylaxis. D. The FDA banned all powdered surgeon's gloves because of unreasonable and substantial risk of allergic reactions.

B. The presence of pathogens in laser plumes or surgical smoke will predictably cause disease.

14. (474) All of the following statements are correct with respect to sterilizing unwrapped instruments and their use, EXCEPT for one. Which one is the exception? A. Unwrapped instruments must be thoroughly cleaned and dried prior to sterilization. B. When sterilizing unwrapped instruments mechanical indicators must be checked, but there is no requirement to place a chemical indicator with the items. C. Critical items sterilized unwrapped must be transferred from the sterilizer to the point of use by an aseptic method for i mmediate use. D. Unwrapped sterile instruments can become contaminated with dust, airborne organisms, and other contaminants and should nev er be stored.

B. When sterilizing unwrapped instruments mechanical indicators must be checked, but there is no requirement to place a chemical indicator with the items.

All of the following statements are correct in relation to infection control-related issues in association with oral surgical procedures, EXCEPT for one. Which one is the exception? A. For oral surgical procedures, clinicians must perform surgical hand asepsis. B. When using laser or electrosurgical units, the thermal destruction of tissue creates laser plumes or surgical smoke, which do es not contain aerosolized infectious material. C. For oral surgical procedures, clinicians must don surgeon's gloves. D. When performing oral surgical procedures, only sterile saline or sterile water can be used as a coolant.

B. When using laser or electrosurgical units, the thermal destruction of tissue creates laser plumes or surgical smoke, which do es not contain aerosolized infectious material.

The technique of wetting the hands under warm running water, applying an antimicrobial soap (e.g., chlorhexidine, iodine and iodophors, chloroxylenol, or triclosan), rubbing the hands together vigorously for 15 seconds to work-up a lather, using the fingernails to clean the fingernails on the opposing hand, rinsing the soap off with the hands held under warm running water,and drying the hands with a disposable paper towel is ____________. A. routine handwashing B. antiseptic handwashing C. antiseptic hand rub D. surgical asepsis

B. antiseptic handwashing

9. (363) All the following statements relative to boil-water advisory are correct EXCEPT which one? While the boil-water advisory is in effect __________. A. use bottled water for patient rinsing B. if hands are visibly soiled, use an alcohol-based handrub C. do not deliver water to the patient through point-of-use fixtures from the public water system D. do not use water from the public water system for handwashing

B. if hands are visibly soiled, use an alcohol-based handrub

10. (363) All the following are specifically designed point-of-use devices to ensure water quality when performing oral surgical procedures for the delivery of sterile irrigating fluid EXCEPT which one? A. Bulb syringe. B. Single-use disposable products. C. Air-water syringe. D. Sterilizable tubing.

C. Air-water syringe.

While the OSHA has withdrawn the non-recordkeeping portions of the Healthcare ETS, it considers compliance with the terms of the Healthcare ETS as satisfying an employer's related obligations under the general duty clause, respiratory protection, and PPE standards. A. The first part of the statement is true, but the second part of the statement is false. B. The first part of the statement is false, but the second part of the statement is true. C. Both parts of the statement are true. D. Both parts of the statement are false.

C. Both parts of the statement are true.

5. (474) All of the following statements with respect to steam sterilizers are correct EXCEPT which one? A. Steam sterilization (autoclaving) is the most widely used method for wrapped and unwrapped critical and semi-critical items that are not heat and moisture sensitive. B. To kill microorganisms, steam sterilization requires exposure of each item to direct steam contact at a specified temperat ure and pressure for a defined period of time. C. Gravity displacement steam sterilizers should be tested daily for adequate air removal. D. The majority of tabletop sterilizers used in oral healthcare settings are gravity displacement sterilizers.

C. Gravity displacement steam sterilizers should be tested daily for adequate air removal.

To minimize the exposure of patients to OHCPs who have been exposed to or have been diagnosed with an infectious disease, work restrictions may be appropriate for all of the following scenarios EXCEPT for one. Which one is the exception? A. The OHCP with acute orofacial herpes B. The OHCP with acute influenza with fever C. The OHCP with acute genital herpes D. The OHCP with acute varicella infection

C. The OHCP with acute genital herpes

3. (474) All of the following statements related to critical or semi-critical, or non-critical patient-care items are correct EXCEPT for one. Which one is the exception? A. Heat-tolerant critical patient-care items confer a high degree of risk for infection if contaminated with pathogens and must be sterilized by a U.S. Food and Drug Administration (FDA)-cleared heat sterilizer. B. Heat-tolerant semi-critical patient-care items, including all dental handpieces, must be heat sterilized. C. Heat-sensitive critical items must minimally undergo intermediate-level disinfection using an FDA-registered chemical sterilant. D. Unless visibly soiled, for non-critical items disposable barrier protection is the preferred infection control method during their use.

C. Heat-sensitive critical items must minimally undergo intermediate-level disinfection using an FDA-registered chemical sterilant.

9. (474) All of the following statements are correct with respect to processing contaminated reusable patient-care items, EXCEPT for one. Which one is the exception? A. There should be a central processing area (CPA) of adequate size with four successive stations for (1) receiving and clean ing; (2) preparation and packaging; (3) sterilization or disinfection; and (4) storage of sterilized units. B. Within the CPA, each station should be physically separated to control traffic flow and to contain contaminants during the process. C. If physical separation between stations is not practical, barriers must be installed to isolate the stations. D. Reusable contaminated patient-care items must be transported from the point of use to the CPA in sealed, leak proof containers displaying a biohazard symbol.

C. If physical separation between stations is not practical, barriers must be installed to isolate the stations.

1. (474) All of the following statements are correct with respect to sterilization and levels of disinfection EXCEPT for one. Which one is the exception? A. Sterilization is a validated process that destroys all forms of microbial life. B. High-level disinfection kills all pathogens but not all bacterial spores. C. Intermediate-level disinfection kills mycobacteria, all nonlipid or small viruses (e.g., polio), all fungi, all vegetative bacteria, and all lipid or medium-size viruses (e.g., HBV, HIV), but not bacterial spores. D. Low-level disinfection kills lipid or medium-sized viruses (e.g., HBV, HIV), some fungi, and vegetative bacteria.

C. Intermediate-level disinfection kills mycobacteria, all nonlipid or small viruses (e.g., polio), all fungi, all vegetative bacteria, and all lipid or medium-size viruses (e.g., HBV, HIV), but not bacterial spores.

The information from which inferences can be drawn about the quality of infection control/exposure control practices includes all of the following EXCEPT: A. Infection control/exposure control strategies should be appropriate for the oral healthcare setting. B. As these strategies deviate from optimal design and implementation, the quality (value, outcome) of infection control/expo sure control program decreases at an accelerated rate. C. It is recommended that the hygienist be appointed as the Office Infection-Control Coordinator (OICC) with responsibility for the development and management of the office infection control/exposure control program. D. The creation and maintenance of a safe work environment mandates the commitment and accountability of all OHCP.

C. It is recommended that the hygienist be appointed as the Office Infection-Control Coordinator (OICC) with responsibility for the development and management of the office infection control/exposure control program.

17. (363) All the following statements are correct with reference to contaminated laundry EXCEPT which one? A. OSHA defines contaminated laundry as ""laundry which has been soiled with blood or OPIM."" B. Healthcare-associated infections linked to contaminated fabrics are so few that the overall risk of disease transmission during the laundry process is negligible. C. OSHA regulations prohibit home laundering of PPE, and experts agree that this regulation extends to uniforms and scrubs not contaminated with blood and OPIM. D. In response to the recent SARS-CoV-2 virus pandemic, the ADA recommends office attire, such as scrubs, be changed between street clothes upon entry and exit and not be taken home.

C. OSHA regulations prohibit home laundering of PPE, and experts agree that this regulation extends to uniforms and scrubs not contaminated with blood and OPIM.

All of the following statements are correct relative to regulated waste, EXCEPT for one. Which one is the exception? A. Disposable sharps (e.g., needles, anesthetic cartridge, orthodontic wire, scalpel blade, suture needle, endodontic file & broken instruments are placed in a rigid, puncture-resistant, leak-proof container with secure lid for storage & transportation. B. Other regulated waste (e.g., item drips when vertical, release fluid when compressed, has dried on fluid that could flake off in transit) is placed in a small biohazard bag and disposed into a central Regulated Waste Receptacle after each appointment. C. Regulated waste is disposed of according to the requirements established by national, as opposed to local and state, environm ental agencies. D. Biohazard labels (fluorescent orange or orange red, with lettering or symbols in a contrasting color) are affixed as close as feasible to containers of regulated waste.

C. Regulated waste is disposed of according to the requirements established by national, as opposed to local and state, environmental agencies.

16. (474) All of the following statements are correct with respect to storing sterilized items, EXCEPT for one. Which one is the exception? A. After the sterilization cycle is completed and the instrument units are dry and cool, inspect all packages for proper colo r change by visible chemical indicators. B. Instruments units should be stored in a clean, dry, closed cabinet. C. Storage practices for wrapped sterilized instruments are time-related, i.e., recognize that wrapped instruments maintain their sterility for a specified time. D. When the packaging is compromised (i.e., torn, wet, or open), the instruments should be re -cleaned, re-packaged in a new wrap, and re-sterilized.

C. Storage practices for wrapped sterilized instruments are time-related, i.e., recognize that wrapped instruments maintain their sterility for a specified time.

18. (363) All the following statements are correct with reference to disposable (i.e., single use) surgical gowns, drapes, and fabrics EXCEPT which one? A. Disposable (i.e., single use) surgical gowns, drapes, and fabrics must be resistant to liquids and microbial penetration. B. Disposable (i.e., single use) surgical gowns, drapes, and fabrics must be registered with the FDA to demonstrate their saf ety and effectiveness. C. The CDC offers specific recommendations regarding the use of disposable fabrics and textiles versus durable goods. D. Repellency and pore size of the fabric contribute to gown performance, but performance capability can also be influenced b y the item's design and construction.

C. The CDC offers specific recommendations regarding the use of disposable fabrics and textiles versus durable goods.

All of the following statements with respect to hepatitis B vaccination are true, EXCEPT for one. Which one is the exception? A. Hepatitis B vaccination is to be made available to all OHCP, without a history of prior immunization, at the time of initi al assignment to tasks in which exposure to blood or OPIM may occur. B. If the hepatitis B vaccination series is declined, the OHCP must sign a copy of the Mandatory Hepatitis B Vaccination Decl ination Form. C. The U.S. Public Health Service recommends routine booster doses of the hepatitis B vaccine. D. Other vaccines highly recommended for all OHCP include influenza, measles, mumps, rubella, varicella, and pertussis.

C. The U.S. Public Health Service recommends routine booster doses of the hepatitis B vaccine.

All of the following are true regarding monitoring the correct functioning of a sterilizer, EXCEPT for one. Which one is the exception? A. A chemical indicator should be placed in a visible area of each package before sterilization processing. B. A biological indicator spore test should be processed through a sterilizer cycle at least once a week. C. The cassette tray or pack containing the biological indicator should be placed on the top of the load. D. Mechanical monitoring, i.e., confirming the manufacturer's recommended settings cycle time, temperature, and pressure should be completed with each load.

C. The cassette tray or pack containing the biological indicator should be placed on the top of the load.

15. (474) All of the following statements are correct with respect to sterilizing and high-level disinfecting with germicides, EXCEPT for one. Which one is the exception? A. Patient-care items must be rinsed with sterile water after immersion to remove toxic or irritating residues. B. Patient-care items must be handled using sterile gloves, dried with sterile towels, and delivered to the point of use in an aseptic manner for immediate use. C. The efficacy of the sterilization or high-level disinfection process using germicides is readily verifiable. D. Federal law requires that label instructions on FDA and EPA-registered products be followed (e.g., use-dilution, shelf life, storage, material compatibility, safe use, and disposal).

C. The efficacy of the sterilization or high-level disinfection process using germicides is readily verifiable.

10. (474) All of the following statements are correct with respect to cleaning reusable instruments and other devices, EXCPT for one. Which one is the exception? A. If visible debris (both organic and inorganic contaminants) is not removed, it will interfere with microbial inactivation and compromise the sterilization and disinfection processes. B. Factors to consider in selecting a cleaning method include (1) efficacy of the method, process, and equipment used; (2) co mpatibility with items to be cleaned; and (3) occupational health and exposure risks. C. The use of automated equipment (e.g., ultrasonic cleaner or washer/disinfector) is discouraged because manual cleaning of instruments is more efficient. D. If the manual method is used, the instruments must be placed in a leak proof, puncture-resistant container and soaked with a detergent, a disinfectant/detergent, or an enzymatic cleaner to prevent drying of contaminants.

C. The use of automated equipment (e.g., ultrasonic cleaner or washer/disinfector) is discouraged because manual cleaning of instruments is more efficient.

16. (363) All the following statements are correct with reference to carpeting and cloth furnishings in clinical setting EXCEPT which one? A. Carpeting and cloth furnishings harbor a diverse microbial population and allergens and should be vacuumed regularly; alth ough, the bacterial and allergen burden is reduced only temporarily. B. Despite evidence of microbial growth and persistence, there is little evidence that carpets and cloth furnishings influenc e the rate of HAIs. C. There are specific recommendations against the use of carpeting and cloth furnishings in general patient-care areas. D. Avoiding carpeting and cloth furnishings in areas where spills are likely to occur is prudent because fully contaminating carpets and cloth furnishings is difficult.

C. There are specific recommendations against the use of carpeting and cloth furnishings in general patient-care areas.

20. (363) All the following items related to waste management and hazard communication compliance are correct EXCEPT which one? A. Regulated medical waste is a subset of hazardous solid waste. B. The federal OSHA and its counterpart state agencies are responsible for developing and enforcing rules related to regulate d medical waste. C. Universal waste includes chemical agents used or generated in the workplace, which pose a hazard to human health or to the environment when handled improperly. D. The federal OSHA and its counterpart state agencies are responsible for developing and enforcing rules for hazardous chemi cals as they relate to workers' health and safety.

C. Universal waste includes chemical agents used or generated in the workplace, which pose a hazard to human health or to the environment when handled improperly.

3. (363) All the following statements are correct with respect to droplets EXCEPT which one? Droplets __________. A. are particles of moisture greater than 5μ B. can contain infectious pathogens C. can be transported over a long distance, i.e., beyond 3 feet of the source D. are instrumental in spreading the influenza virus

C. can be transported over a long distance, i.e., beyond 3 feet of the source

2. (363) Which of the following statements is NOT a requisite for the transmission of pathogenic organisms from an environmental source to people? A. There must be a source of infectious agents, i.e., contaminated air, water or fomites. B. There must be a susceptible host exposed to an adequate number of sufficiently virulent microorganisms. C. There must be a mechanism to transfer or mode of transmission of pathogens from the source to the host. D. A subset of immunocompromised patients, those with an absolute lymphocyte count of ≤ 500 cells/mL has the greatest risk of HAIs.

D. A subset of immunocompromised patients, those with an absolute lymphocyte count of ≤ 500 cells/mL has the greatest risk of HAIs.

20. (474) All of the following statements are correct with respect to procedures to follow in the event of a positive spore test, EXCEPT for one. Which one is the exception? A. In case of a positive spore test, the sterilizer should be removed from service and all records of physical and chemical m onitoring since the last negative BI test should be reviewed. B. If the physical and chemical indicators demonstrate that the sterilizer is functioning correctly consider the possibility of operator error, using the same cycle that produced the failure, repeat the spore test immediately after correctly loading the s C. If packaging, loading, and operating procedures have been confirmed as performed correctly and the repeat BI test is negat ive, the sterilizer must remain out of service until it has been inspected, repaired, and re-challenged with a confirmatory BI tes D. All items sterilized from suspect loads dating back to the last negative BI test should be re-cleaned, wrapped, and re-sterilized.

D. All items sterilized from suspect loads dating back to the last negative BI test should be re-cleaned, wrapped, and re-sterilized.

8. (474) All of the following statements are correct with respect to the use of chemical sterilants and disinfectants, EXCEPT for one. Which one is the exception? A. Heat-sensitive critical items must be cleaned and sterilized by immersing them for 3-12 hours in liquid germicides registered by the FDA as chemical sterilants. B. Heat-sensitive semi-critical items must minimally undergo high-level disinfection, i.e., they must be immersed in an FDA-registered chemical sterilant, but for a shorter contact time (≤12 min.). C. Non-critical patient-care items, when visibly soiled, must be cleaned and disinfected (10-minute contact time for most products) using an EPA-registered intermediate-level disinfectant with tuberculocidal claim. D. All of the above are correct.

D. All of the above are correct.

Highlights of the OSHA Healthcare ETS and CDC guidance to mitigate the transmission of SARS-CoV-2 in the dental setting include all the following, EXCEPT for one. Which one is the exception? A. Implementation of a workforce screening plan B. Postpone all non-urgent dental treatment for patients with suspected or confirmed active SARS-CoV-2 infection C. Patients with suspected or confirmed active SARS-CoV-2 infection should only be provided dental care if medically necessary following transmission-based precautions to mitigate airborne transmission. D. All patients presenting for care with a fever should be considered to be infected with SARS-CoV-2.

D. All patients presenting for care with a fever should be considered to be infected with SARS-CoV-2.

18. (474) All of the following statements are correct with respect to biological monitoring of the sterilization process, EXCEPT for one. Which one is the exception? A. In oral healthcare facilities, BIs should be processed with a load in all sterilizers at least weekly. B. A BI must be processed in every load containing an implant and the implant should be quarantined until the result of the s pore test is known. C. When biological testing is done in-office, the test BI must be incubated (along with a positive control from the same lot but not processed through the sterilizer) within two hours (or refrigerated). D. Bacillus atrophaeus spores are used to steam sterilizers.

D. Bacillus atrophaeus spores are used to steam sterilizers.

5. (363) Typically, which of the following areas in healthcare settings is not equipped with special ventilation? A. Operating rooms. B. Protective environment rooms. C. Airborne infection isolation rooms. D. Community-based oral healthcare facilities.

D. Community-based oral healthcare facilities.

2. (474) All of the following statements pertain to Spaulding's approach to sterilization and disinfection, EXCEPT for one. Which one is the exception? A. During the course of their intended use, critical items penetrate soft and hard sterile tissues or the vascular system. B. During the course of their intended use, semi-critical items contact, but do not penetrate nonintact skin or mucous membranes. C. During the course of their intended use, non-critical items come in contact with intact skin, but not mucous membranes. D. During the delivery of care, the most important factor determining the risk of infection from contaminated instruments is the duration of exposure.

D. During the delivery of care, the most important factor determining the risk of infection from contaminated instruments is the duration of exposure.

Elements of an effective Respiratory Hygiene/Cough Etiquette program include all of the following, EXCEPT for one. Which one is the exception? A. Posted signs, in language(s) appropriate to the population served, with instructions to patients and accompanying family m embers and friends. B. Source control measures C. Education of OHCPs, patients, and visitors D. Enforcement predicated on the presence of fever.

D. Enforcement predicated on the presence of fever.

19. (363) Which of the following statements related to solid waste generated in oral healthcare settings is incorrect? A. Solid waste generated in oral healthcare settings is a subset of municipal solid waste. B. Standard methods of collecting, storing, transporting, and disposing of municipal solid wastes are regulated by state or l ocal jurisdictions. C. Municipal solid waste regulations often include mandatory requirements for recycling certain materials (e.g., newspapers, cardboards, plastics, glass containers, etc.). D. Most solid waste generated in oral healthcare settings is hazardous solid waste.

D. Most solid waste generated in oral healthcare settings is hazardous solid waste.

All of the following statements are true regarding facemasks, EXCEPT for one. Which one is the exception? A. Surgical masks, which cover both the nose and the mouth, must be worn by all OHCPs during the clinical process likely to generate splash, spatter, and aerosols. B. Masks should be changed whenever visibly soiled. C. When lengthy procedures are performed and the facemask becomes wet, the facemask should be changed as soon as possible. D. NIOSH-certified particulate-filter respirators are never indicated for use in dentistry

D. NIOSH-certified particulate-filter respirators are never indicated for use in dentistry

13. (474) All of the following statements are correct with respect to sterilizing wrapped instruments loading instruments, EXCEPT for one. Which one is the exception? A. Perforated trays/cassettes should be placed so that they are parallel to the shelf. B. Non-perforated containers should be placed on their edge. C. Peel-packs should be placed on edge and small items should be loosely placed in wire baskets. D. Once the sterilization cycle is complete, remove the packs to cool and dry outside the chamber.

D. Once the sterilization cycle is complete, remove the packs to cool and dry outside the chamber.

T/F 8. (363) The presence of biofilms of waterborne bacteria (e.g., Legionella spp. and Pseudomonas aeruginosa) in dental unit waterlines has been confirmed.

True

All of the following statements are correct with respect to preparing the DTR for the patient, EXCEPT for one. Which one is the exception? A. Place protective plastic covers on clinical contact surfaces such as headrests, dental unit control switches, air and wate r line hoses, light handles, chairside light curing unit, and other hard-to-clean areas and equipment. B. Have appropriate instrument packs and supplies ready to begin treatment. This includes all necessary PPE (gloves, masks, e ye protection, etc.) for the provider, assistant and the patient. C. Check all sterilized instrument packs and packages to ensure they are intact and the external chemical indicator has chang ed to the appropriate color. D. Open packs in advance of the patient's arrival.

D. Open packs in advance of the patient's arrival.

All of the following statements are true regarding protective clothing, EXCEPT for one. Which one is the exception? A. Protective clothing is to be changed daily, when it becomes visibly soiled, and as soon as possible if penetrated by blood or OPIM. B. Protective clothing is removed before leaving the work area. C. Dirty protective clothing is to be placed in designated areas before leaving the work area. D. Protective clothing must be disposable

D. Protective clothing must be disposable

To minimize latex allergy-related health problems among OHCPs and patients all of the following actions apply, EXCEPT for one. Which one is the exception? A. Reduce exposure to latex-containing materials by substituting non-latex products when appropriate and using appropriate work practice controls. B. Train and educate of OHCPs to recognize signs and symptoms of latex-related adverse effects. C. Refer OHCP with signs and symptoms suggestive of latex allergy to a physician to confirm diagnosis. D. Refer patients with latex allergy.

D. Refer patients with latex allergy.

All of the following precautions are correct with respect to the DTR-turn-around between patients, EXCEPT for one. Which one is the exception? A. Wear heavy-duty utility gloves and other PPE while handling contaminated instruments and cleaning contaminated surfaces. B. Place instruments in cassette tray (or properly labeled and approved container) for transport to the central sterilization room (CSR). C. Clean and disinfect clinical contact surfaces that were not barrier protected with an EPA-registered hospital disinfectant with a tuberculocidal claim (i.e., intermediate-level disinfectant). D. Remove gloves, perform hand hygiene and then it is safe to transport instrument trays, packs, and cassettes to the receiving side of CSR or another designated holding space.

D. Remove gloves, perform hand hygiene and then it is safe to transport instrument trays, packs, and cassettes to the receiving side of CSR or another designated holding space.

All of the following procedures are to be performed when securing the DTR at the end of the day, EXCEPT for one. Which one isthe exception? A. Wear appropriate gloves, face protection, and eye protection while cleaning contaminated surfaces. B. Clean and disinfect all contact surfaces, dental unit surfaces, and countertops with an EPA-registered disinfectant. C. Flush and clean each water line and suction hoses, follow manufacturer's instructions if waterline treatment products are used. Follow manufacturer's instructions for cleaning and maintenance of dental unit water bottles. D. Store regulated medical waste under the sink

D. Store regulated medical waste under the sink

17. (474) All of the following statements are correct with respect to the various quality assurance indicators of the sterilization process, EXCEPT for one. Which one is the exception? A. Monitoring physical indicators involves observing the gauges or displays on the sterilizer and recording the time, tempera ture, and pressure associated with each sterilization cycle for each load. B. Chemical indicators use sensitive chemicals to assess critical variables (i.e., time, temperature, steam saturation) durin g a sterilization cycle and validate that sterilization has been achieved. C. Biological indicators (BIs), or spore tests, assess directly the killing of known highly resistant, nonpathogenic bacteria l spores. D. The results of physical, chemical and biological monitoring must be documented in a sterilization monitoring record.

D. The results of physical, chemical and biological monitoring must be documented in a sterilization monitoring record.

All of the following statements are correct in relation to post-exposure evaluation and follow-up, EXCEPT for one. Which one is the exception? A. Immediately after an exposure incident wash injuries with soap and water and apply an antiseptic agent (if available). B. Following a needlestick or sharp object injury a post-exposure evaluation must be made within 2 hours of exposure. C. Report the exposure incident to the Office Infection-Control Officer or other designated person immediately following exposure. D. The source person must be identified within 24 hour of an exposure incident.

D. The source person must be identified within 24 hour of an exposure incident.

7. (474) Which of the following statements are correct with respect to dry heat sterilization, EXCEPT for one. Which one is the exception? A. Dry heat may be used to sterilize patient-care items that might be damaged by moist heat (e.g., burs and certain orthodontic instruments). B. Dry heat has the advantages of low operating cost and being noncorrosive. C. Dry heat is a prolonged process and the high temperatures required are not suitable for the sterilization of many instrume nts and devices. D. The static-air type has the advantage a shorter sterilization cycle time compared to the forced-air type.

D. The static-air type has the advantage a shorter sterilization cycle time compared to the forced-air type.

363 1. In healthcare settings, pathogenic organisms are least likely to be detected __________. A. in air B. in water C. on fomites D. primarily under dry conditions

D. primarily under dry conditions

In a community-based oral healthcare setting, the implementation and enforcement of an appropriate TB infection-control protocol includes all of the following actions, EXCEPT for one. Which one is the exception? A. identification of patients with suspected or confirmed TB disease B. isolation of patients with suspected or confirmed TB disease from other patients and OHCPs C. referral of patients suspected or confirmed TB disease for medical evaluation and /or urgent dental care to a facility wit h appropriate environmental controls and respiratory-protection controls D. scheduling the provision of routine dental for the last appointment of the day

D. scheduling the provision of routine dental for the last appointment of the day

Principal prerequisites for cross-infection include all of the following, EXCEPT for one. Which one is the exception? A. source or reservoir of infectious agents B. susceptible host with a portal of entry receptive of the agent C. mode of transmission for the agent D. the presence of an infected patient at the time of transmission

D. the presence of an infected patient at the time of transmission

The objectives of the education and training program are to educate OHCPs regarding all of the following, EXCEPT for one. Which one is the exception? A. the risk of healthcare-associated infections B. preventive strategies C. exposure management and follow-up D. administrative controls E. cost control measures.

E. cost control measures.

T/F After percutaneous, mucous membrane, or non-intact skin exposure to blood or OPIM the consulting physician will initiate post-exposure prophylaxis (if applicable) and follow-up according to the latest CDC recommendations.

True

T/F Generally, blood and/or saliva-tinted items (e.g., disposable clinic gowns, gloves, and patient bibs) are not considered regulated waste and are placed in the regular trash receptacle.

True

T/F Noncritical items, i.e., items that contact only skin during their intended use may be disinfected with an EPA-registered intermediate level disinfectant without a tuberculocidal claim.

False

T/F Heat-tolerant semi-critical and critical items must be heat sterilized in an FDA cleared device.

True

T/F Personal protective equipment (PPE) is designed to protect the skin and mucous membranes (eyes, nose, and mouth) and respiratory epithelium of OHCP from exposure to a source or reservoir of pathogenic organisms by contact transmission, i.e., direct or indirect contact transmission; and respiratory transmission, i.e., inhalation of droplets or droplet nuclei (airborne transmission).

True

T/F Protective eyewear with solid side shields or a face shield must be worn by OHCP and patients during the clinical process likely to generate splash, splatter, and aerosols.

True

T/F To prevent or minimize HAIs among OHCP and patients, oral healthcare facilities, like all healthcare facilities, are mandated to develop a written infection control/exposure control protocol predicated on a hierarchy of preventive strategies

True

T/F 11. (363) An essential first step to ensure the success of the disinfection process on fomites is the physical action of scrubbing with a detergent and rising with water, which removes large amounts of microorganisms from surfaces.

True

T/F All handpieces, unless disposable, are heat sterilized between patients according to manufacturers' recommendations.

True

T/F Charts should be notated and radiographs viewed before gloving or after the gloves are removed and the hands are washed, unless cover gloves are worn.

True


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