Infection Control

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Heat-tolerant semi-critical and critical items must be heat sterilized in an FDA cleared device. A. True B. False

A. True

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. A. True B. False

A. True

A positive skin patch testing is diagnostic of __________. A. a delayed (Type IV) hypersensitivity reaction B. an immediate (Type I) hypersensitivity reaction C. irritation contact dermatitis D. the presence of allergen-specific IgE antibodies

A. a delayed (Type IV) hypersensitivity reaction

Which of the following precautions apply to the care of all patients in all healthcare settings, regardless of the suspected or confirmed presence of an infectious agent and constitutes the primary strategy for the prevention of healthcare-associated infections? A. Universal Precautions B. Standard Precautions C. Transmission-based Precautions D. All of the above.

B. Standard Precautions

Which of the following statement in relation to the normal skin flora and the acquisition and transmission of healthcare-associated pathogens is incorrect? A. One of the largest human-associated microbial habitats is the skin. B. Transient organisms tend to colonize the superficial layers of skin and since they are amenable to removal by washing hands with plain soap and water, they are less likely to cause healthcare-associated infections than resident pathogens. C. Organisms are transferred in much larger numbers from wet hands than from hands that are thoroughly dried. D. Resident organisms are attached to deeper layers of skin and they are more resistant to removal than transient pathogens.

B. Transient organisms tend to colonize the superficial layers of skin and since they are amenable to removal by washing hands with plain soap and water, they are less likely to cause healthcare-associated infections than resident pathogens.

All of the following statements related to medical waste are correct except which one? A. Needles, scalpel blades, suture needles, endodontic files, orthodontic wires, local anesthetic cartridges, and glass slides, even if unused, must be considered RMW. B. Unfixed oral tissues removed during surgery, biopsies, and extracted teeth are not considered RMW. C. Generally, gauze, cotton balls or rolls, swabs, and used dressings containing small amounts of blood or OPIM are not considered RMW. D. Generally, disposable non-absorbent materials such as gowns, gloves, drapes, bracket table covers, rubber dams, patient bibs, and face masks are not considered RMW.

B. Unfixed oral tissues removed during surgery, biopsies, and extracted teeth are not considered RMW.

Which of the following ASTM level surgical face mask has a high level of barrier effectiveness in the presence of splash, spatter, spray and aerosols? A. Level 1 B. Level 2 C. Level 3 D. Particulate respirator

C. Level 3

All of the following are considered preventive measures to minimize occupational exposure to RMW except which one? A. Engineering controls B. Work practice controls C. Maintaining a Sharps injury Log D. The use of personal protective equipment

C. Maintaining a Sharps injury Log

The most effective medication available to treat allergic contact dermatitis is __________. A. Epinephrine, IM B. oral H1-receptor antagonist C. a topical high-potency corticosteroid D. an inhaled beta2-adrenergic agonist

C. a topical high-potency corticosteroid

Each of the following statements regarding alcohol-based hand rubs is true except which one? Alcohol-based hand rubs ____________. A. reduce bacterial counts on the hands of HCWs more effectively than plain and antiseptic soap and water B. kill microorganisms more rapidly than iodophors and other antiseptic containing soaps C. are only effective if they are applied for ≥60 seconds D. have been demonstrated to cause less skin irritation and dryness than repeated handwashing (i.e., washing hands with plain soap and water) or antiseptic handwash (i.e., washing hands with antimicrobial soap and water)

C. are only effective if they are applied for ≥60 seconds

All of the following statements are correct with respect to particulate respirators except which one? A. When Airborne Precautions are necessary (i.e., Transmission-based Precautions), NIOSH-certified, fit-checked particulate-filter respirator, a class II medical device, must be worn. B. NIOSH-certified N95, N99, or N100 particulate-filter respirators, which have the ability to filter particles in the range of 0.1 to 1.0 micron, have a filtration efficiency of 95, 99, and 99.8% respectively. C. Currently, the CDC recommends the use of a N95 or higher level respirator by OHCP exposed to patients with suspected or confirmed tuberculosis. D. All of the above are correct.

D. All of the above are correct.

An exposure that might place HCP at risk for HAIs is defined as an event that results in the transfer of pathogenic organisms from a source to a host by _______________. A. direct contact transmission B. indirect contact transmission C. respiratory transmission, i.e., inhalation of droplets or droplet nuclei (airborne transmission) D. All of the above are correct.

D. All of the above are correct.

In oral healthcare settings, administrative policies and work restrictions are primarily predicated on the mode of transmission of which of the following pathogens and the period of infectivity of exposed or infected OHCP. A. Measles, mumps, and rubella viruses B. Herpes simplex and varicella zoster viruses C. Influenza, streptococcus, and meningococcus D. All of the above are correct.

D. All of the above are correct.

Infection control-related administrative policies and work restrictions should __________. A. be written B. include a statement of authority that defines who can exclude OHCP (e.g., personal physicians) C. be clearly communicated through education and training D. All of the above are correct.

D. All of the above are correct.

NIOSH recommends ______________________. A. the placement of a sharps container of sufficient size, i.e., one that accommodates both the volume generated and the largest sharp used, at each workstation B. that the sharps container be readily accessible, i.e., without obstacles between the user and the container C. that horizontally, sharps containers must be located within easy arm's reach and the vertical height must be below eye level, i.e., the user must have a clear, unobstructed view of the container's opening D. All of the above are correct.

D. All of the above are correct.

OHCP with which of the following acute or chronic medical conditions are susceptible to opportunistic infections or the reactivation of latent vaccine-preventable infections? A. Immune deficiency syndromes. B. Immunosuppressive therapy such as radiotherapy, chemotherapy, anti-graft rejection medications, steroids, monoclonal antibodies. C. Chronic diseases such as diabetes mellitus, cancer, emphysema, heart failure, malnutrition, and old age. D. All of the above are correct.

D. All of the above are correct.

OSHA mandates that ______________________. A. sharps disposal containers be puncture resistant, the sides and the bottom be leak-proof, and they be closable (i.e., they have a lip, flap, door, or other means of closing the container) B. sharps disposal containers be labeled with the universal biohazard symbol and the word "BIOHAZARD," and/or color-coded red C. the labels on sharps disposal containers must be fluorescent orange or orange-red, with the symbol and lettering in a contrasting color D. All of the above are correct.

D. All of the above are correct.

The content of an occupational exposure report should include the date and time of exposure and _______________. A. details of the procedures being performed B. details of the exposure C. type of exposure D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to PPE? A. The CDC issues recommendations for when, what, and how PPE should be used to prevent exposure to infectious pathogens. B. OSHA regulations require that employers provide their employees with appropriate PPE. C. Key elements to consider when selecting PPE include the type of anticipated exposure, the durability and appropriateness of the PPE for the task, and the fit. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to biological monitoring of the sterilization process? 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 spore 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. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to dry heat sterilization? 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 instruments and devices. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to gloves? A. Patient examination gloves and surgeon's gloves may not be washed for subsequent reuse because microorganisms cannot be removed reliably and continued glove integrity cannot be ensured. B. Washing gloves can lead to wicking (penetration of liquids through undetectable holes in the gloves) and subsequent hand contamination. C. To prevent transmission of infectious pathogens, it may be necessary to change gloves when during the course of treatment radiographs, dental charts, computer keyboards, or other equipment are touched. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to personal protective equipment (PPE)? A. The wearing of PPE is mandated by Standard and Transmission-Based Precautions. B. PPE are medical devices designed to protect healthcare personnel from acquiring healthcare-associated infections (HAIs). C. In healthcare settings PPE include the use of surgical gowns, surgical masks, respirators, goggles, face shields, and gloves. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to precautions when treating a patient who has a confirmed type I hypersensitivity to latex? A. Patients allergic to latex must be treated in a latex-free environment. B. Patients should be scheduled for first appointment of the day. C. Use latex-free procedure tray and have available a latex-free emergency kit. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to procedures to follow in the event of a positive spore test? A. In case of a positive spore test, the sterilizer should be removed from service and all records of physical and chemical monitoring 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 sterilizer. C. If packaging, loading, and operating procedures have been confirmed as performing correctly and the repeat BI test is positive, the sterilizer should remain out of service until it has been inspected, repaired, and re-challenged with BI tests in three consecutive empty-chamber sterilization cycles. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to surgical masks? A. Surgical masks must be worn by all OHCP during clinical activities likely to generate splash, spatter, spray, and aerosols. B. Surgical masks, which are Class II medical devices, are labeled according to their performance level on testing standards developed by the American Society for Testing and Materials (ASTM). C. Fluid resistance, bacterial filtration efficiency (BFE), particulate filtration efficiency (PFE), breathability (P-Δ), and flammability of the mask material determine surgical mask performance. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to the HPV? A. The HPV may be acquired occupationally by OHCP through a cut, abrasion, or small tear in the outer layer of skin or mucous membranes. B. High-risk strains of HPV may cause cervical cancer and contribute to cancer of the mouth and upper respiratory tract. C. The recommended HPV for OHCP is Gardasil. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to the hepatitis A virus? A. The HAV is transmitted primarily by the fecal-oral route, either person-to-person contact or consumption of contaminated food or water. B. HAV vaccination is recommended for all adults with chronic liver disease, illicit drug users, and those at risk of healthcare-associated exposure. C. There are two inactivated hepatitis A whole-virus vaccines and a combination hepatitis A and B vaccine. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to the use of chemical sterilants and disinfectants? 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.

Which of the following statements is correct with respect to the use of surgical gowns? A. Surgical gowns should be changed between patients. B. When penetrated by blood or OPIM, even intra-procedure, surgical gowns should be changed as soon as possible. C. Surgical gowns should be changed before leaving patient-care areas. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to the various quality assurance indicators of the sterilization process? A. Monitoring physical indicators involves observing the gauges or displays on the sterilizer and recording the time, temperature, 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) during a sterilization cycle and are applied either to the outside or placed on the inside of each instrument unit to be sterilized. C. Biological indicators (BIs), or spore tests, assess directly the killing of known highly resistant, nonpathogenic bacterial spores. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements related to critical or semi-critical, or non-critical patient-care items is correct? A. Heat tolerant critical and semi-critical items must be sterilized by steam, unsaturated chemical vapor, or dry heat. B. 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. C. Non-critical items, when visibly soiled, must be disinfected with an EPA-registered hospital level intermediate-level disinfectant. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements related to exposure to Mycobacterium tuberculosis (MBT) are correct? A. HCP should obtain a baseline tuberculin skin test (TST), preferably a two-step TST, at the beginning of employment. B. HCP with a negative TST, in case of unprotected occupational exposure, are susceptible to infection. C. HCP with a previously negative TST or BAMT who subsequently have a positive TST result (a reaction ≥5 mm) or a positive BAMT result should be evaluated for treatment of LTBI. D. All of the above are correct.

D. All of the above are correct.

Alcohol-based hand rubs have good or excellent antimicrobial activity against which of the following microorganisms? A. Viruses and fungi B. Mycobacteria C. Gram-positive and gram-negative bacteria D. All of the above.

D. All of the above.

Backflow in low-volume suction lines occur and microorganisms present in the lines may be retracted into the patient's mouth when: A. A seal is created around the saliva ejector. B. A section of the suction tubing holding the tip is positioned above the patient's mouth. C. During simultaneous use of other evacuation devices (high-volume). D. All of the above.

D. All of the above.

Compliance with hand hygiene guidelines is substantially improved when a multidimensional strategy includes ____________. A. introduction of alcohol-based hand rub B. educational and behavioral initiatives C. institutional verification of compliance and feedback D. All of the above.

D. All of the above.

Factors contributing to irritant contact dermatitis include __________. A. repeated donning and removing of gloves B. repeated hand washing and drying C. incomplete hand drying D. All of the above.

D. All of the above.

Principal prerequisites for cross-infection include a ____________. 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. All of the above.

D. All of the above.

To prevent the transmission of respiratory tract infections, the implementation of Respiratory Hygiene/Cough Etiquette applies to which of the following persons with cough, congestion, rhinorrhea, or increased production of respiratory secretions entering an oral healthcare facility? A. Patients B. Visitors C. OHCPs D. All of the above.

D. All of the above.

Which of the following controls apply to airborne precautions? A. Administrative controls B. Environmental controls C. Respiratory-protection controls D. All of the above.

D. All of the above.

Which of the following infections can be potentially transmitted from patients to HCWs if appropriate glove use and hand hygiene are not performed? A. Herpes simplex virus infections B. Colonization or infection Staphylococcus aureus C. Hepatitis B and C virus infection D. All of the above.

D. All of the above.

Which of the following is either a new or the reinforcement of an existing infection control standard? A. Respiratory hygiene/cough etiquette. B. Safe injection practices. C. Infection control practices for special lumbar puncture procedures. D. All of the above.

D. All of the above.

Which of the following pathogens is transmitted primarily by direct contact with vesicular fluids/exudates? A. HSV type 1 B. HSV type 2 C. VZV D. All of the above.

D. All of the above.

Which of the following statements is correct with respect to infection in a susceptible host with a portal of entry receptive of the agent? A. While the numbers, pathogenicity, virulence, and antigenicity of organisms are important determinants of infection. B. The establishment of infection and its severity relate to the state of host defense mechanisms. C. Some susceptible hosts become colonized but remain asymptomatic, others progress from colonization to symptomatic disease, either immediately or following a period of asymptomatic latency. D. All of the above.

D. All of the above.

Which of the following statements is correct with respect to source control measures? A. Turning the head away from others and covering the mouth and nose during coughing and sneezing. B. Using tissues to contain respiratory secretions and their prompt disposal into a no-touch receptacle. C. Performing hand hygiene after contact with respiratory secretions with soap and water or an alcohol-based hand rub. D. All of the above.

D. All of the above.

Which of the following statements is correct with respect to the duration of transmission-based precautions? A. For most infectious diseases, transmission-based precautions remain in effect for a time period that reflects know patterns of persistence or shedding of pathogens related to the natural history of the infectious process and its treatment. B. For some diseases, transmission-based precautions remain in effect until culture or antigen-detection tests confirm eradication of the pathogen. C. In immunocompromised patients the shedding of a pathogen can persist for prolonged periods of time; therefore the duration of contact, droplet, or airborne precautions may extend for many weeks or even months. D. All of the above.

D. All of the above.

Which of the following statements is correct with respect to the influenza viruses? A. Influenza type A and B are the two influenza viruses that cause human disease. B. The viruses are spread from person to person primarily via droplets. C. Standard Precautions, augmented by Transmission-based Precautions, i.e., droplet precautions, prevent or reduce the transmission of influenza viruses. D. All of the above.

D. All of the above.

Which of the following statements, in reference to the mandated Infection Control/Exposure Control Protocol, are correct? A. Standard Precautions (periodically expanded with new evidence-based elements) and Transmission-Based Precautions provide the fabric for an effective Infection Control/Exposure Control Protocol. B. 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. C. The office Infection Control/Exposure Control Protocol is a hierarchy of preventive strategies designed to protect OHCPs and patients alike. D. All of the above.

D. All of the above.

All of the following statements are true in relation to potential adverse reaction to vaccines except which one? A. In addition to the desired antigen, vaccines may also contain other components such as residual animal or human proteins, antibiotics (neomycin), preservatives (thimerosal) and stabilizers (aluminum phosphate), which may cause allergic reactions or toxicity. B. The most common allergic component of vaccines is egg proteins found in vaccines prepared in chicken eggs or chicken embryonic cultures. C. Subcutaneous administration of some vaccines, such as those containing aluminum phosphates can lead to local tissue necrosis. D. Most adult vaccines are given by SC or IM injection, intravascular administration tends to reduce adverse effects and increase the immune response.

D. Most adult vaccines are given by SC or IM injection, intravascular administration tends to reduce adverse effects and increase the immune response.

Which of the following areas requiring special ventilation must be maintained by community-based oral healthcare facilities? A. Operating rooms B. Protective environment rooms C. Airborne infection isolation rooms D. None of the above.

D. None of the above.

All of the following statements are correct with respect to goggles except which one? A. Goggles must be worn by OHCP and patients to prevent the transmission of pathogens through the conjunctival mucosa either directly (e.g., splash, spatter, spray, or aerosols) or by touching the eyes with contaminated hands or other objects. B. Goggles, which are Class I medical devices, must fit snugly from the corners of the eyes across the brow. C. Indirectly-vented goggles with anti-fog coating provide the most reliable eye protection. D. Personal eyeglasses and contact lenses are considered adequate eye protection.

D. Personal eyeglasses and contact lenses are considered adequate eye protection.

Immune to the varicella-zoster virus can be confirmed by all of the following methods except which one? A. Physician-diagnosed varicella (chickenpox) or herpes zoster. B. Laboratory evidence of VZV immunity. C. Age-appropriate vaccination against VZV. D. Evidence based on maternal recollection.

D. Evidence based on maternal recollection.

Which of the following federal agencies is the nation's health protection agency that makes evidence-based recommendations related to the prevention and control of disease, injury, and disability? A. CDC B. NIOSH C. OSHA D. FDA

A. CDC

Which of the following bloodborne pathogens is considered the major occupation hazard to HCP? A. HBV B. HCV C. HIV D. All of the above.

A. HBV

Immunization strategies for OHCWs are predicated on: A. Vaccines mandated or strongly recommended at the time of employment. B. Vaccine recommended if another risk factor is presents. C. The availability of immunoglobulins , which are administered to susceptible persons only in the event of inadvertent exposure to blood or OPIM. D. All of the above are correct.

D. All of the above are correct.

All of the following statements are correct in relation to post-exposure evaluation and follow-up EXCEPT which one? 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.

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. A. True B. False

A. True

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. A. True B. False

A. True

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. A. True B. False

A. True

An unvaccinated or incompletely vaccinated HCP exposed to a HBsAg-positive source person should receive _______________. A. one dose of HBIG and the HepB vaccine series B. HepB vaccine series C. no treatment D. two doses of HBIG one month apart

A. one dose of HBIG and the HepB vaccine series

Intercellular lipids, which form the only continuous domain of the skin essential for a complete barrier function, e.g., to minimize microbial invasion from the environment, are a basic component of the ____________. A. stratum corneum B. viable epidermis C. dermis D. hypodermis

A. stratum corneum

All of the following statements are correct with respect to active immunization except which one? A. Active immunization promotes the production of antibodies against infectious agents or their toxins. B. Active immunization initiates cellular responses mediated by macrophages and lymphocytes. C. Active immunization provides immediate protection for the host. D. Sensitized lymphocytes acting alone or antibodies interacting with lymphoid K-cells may recognize surface charges in virus-infected cells and target them for destruction.

C. Active immunization provides immediate protection for the host.

Which of the following precautions are intended to prevent the prevent transmission of pathogens spread by direct or indirect contact with an infected patient, or a contaminated object, or an environmental surface? A. Contact precautions B. Droplet precautions C. Airborne precautions D. All of the above.

A. Contact precautions

All of the following statements are correct with respect to detergents and enzymatic cleaners except which one? 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 neutral 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.

All of the following statements are correct with respect to surgical gowns except which one? A. Disposable and reusable surgical gowns are Class I medical devices. B. Repellency and pore size of the fabric affect blood and OPIM penetration of the barrier and contribute to gown performance. C. Regardless of the material used to manufacture surgical gowns, they must be resistant to liquid and microbial penetration. D. Several gown sizes should be available in oral healthcare settings to ensure appropriate coverage for all staff members.

A. Disposable and reusable surgical gowns are Class I medical devices.

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

Infection control problems that emerge in the course of outbreak investigations often lead to new or the reinforcement of existing standards. These recommendations are considered standards of care and are added to _______________. A. Standard Precautions B. Transmission-based Precautions C. Universal Precautions D. None of the above.

A. Standard Precautions

A Transmission-Based Precautions category is assigned based on a pathogen's predominant mode(s) of transmission. A. True B. False

A. True

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. A. True B. False

A. True

All handpieces, unless disposable, are heat sterilized between patients according to manufacturers' recommendations. A. True B. False

A. True

Between 2000 and 2004, four large outbreaks of hepatitis B and hepatitis C viral infections among patients in ambulatory care facilities were attributed to either the reinsertion of used needles into multi-dose vials or solution containers; or the use of a single needle/syringe to administer intravenous medications to multiple patients. A. True B. False

A. True

HCP who have a respiratory infection should avoid direct patient contact, especially with high risk patients; and must observe contact and droplet precautions, i.e., must wear a gown, gloves (perform appropriate hand hygiene), and a surgical mask for all patient interactions. A. True B. False

A. True

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. A. True B. False

A. True

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. A. True B. False

A. True

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. A. True B. False

A. True

To safely remove PPE begins with the gloves and progresses sequentially to goggles or face shield, gown, mask or respirator, and concludes with hand hygiene immediately after removing all PPE OR the gown and gloves and progresses sequentially to goggles or face shield, mask or respirator, and concludes with hand hygiene immediately after removing all PPE. A. True B. False

A. True

The term nosocomial infection refers to an infection acquired during the delivery of healthcare in _______________. A. hospitals B. long-term care facilities C. ambulatory settings, e.g., oral healthcare settings D. home care settings

A. hospitals

Antimicrobial-impregnated wipes, i.e., towelettes ____________. A. might be considered as an alternative to washing hands with plain soap and water B. are as effective as alcohol-based hand rubs C. are as effective as washing hands with antimicrobial soap and water D. B and C

A. might be considered as an alternative to washing hands with plain soap and water

According to the CDC, which antiseptic agent is least likely to produce irritant contact dermatitis or allergic contact dermatitis? A. Chlorhexidine B. Ethanol C. Triclosan D. Iodophors

B. Ethanol

All of the following statements regarding surgical hand antisepsis are true except which one? A. Antimicrobial counts on hands are reduced as effectively with a 5-minute scrub as with a 10-minute scrub. B. A brush or sponge must be used when applying the antiseptic agent to adequately reduce bacterial counts on hands. C. The FDA, CDC, and the WHO recommend surgical hand antisepsis using an antimicrobial soap and water or two-stage surgical hand antisepsis. D. Handwashing with plain soap and water followed by the application of an alcohol-based hand rub is an acceptable method of surgical hand antisepsis.

B. A brush or sponge must be used when applying the antiseptic agent to adequately reduce bacterial counts on hands.

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.

All of the following statements are correct in relation to environmental infection control EXCEPT which one? 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.

A medical device for which general regulatory controls alone cannot assure safety and effectiveness is categorized by the FDA as a ____________________. A. Class I medical device B. Class II medical device C. Class III medical device D. All of the above are correct.

B. Class II medical device

All of the following statements are correct in relation to extracted teeth EXCEPT which one? 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.

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. A. True B. False

B. False

All of the following statements are correct with respect to preparing and packaging instruments except which one? 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, an 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.

All of the following statements are correct with respect to the source or reservoir of infectious agents responsible for HCIs except which one? A. Pathogens associated with HAIs are derived primarily from human sources, but contaminated objects and environmental sources are also implicated. B. Human sources include patients and HCP, but not house hold members and visitors. C. A source individual may have acute infection, or may be transiently or chronically colonized by pathogenic organisms. D. The source individual may be asymptomatic or may be in the incubation phase of infection.

B. Human sources include patients and HCP, but not house hold members and visitors.

All of the following statements are correct in relation to the MMR vaccine except which one? A. It is strongly recommended that all OHCP be immune to measles, mumps, and rubella. B. Immunity to rubella in women of childbearing age should not be a concern in healthcare setting because congenital rubella in the US is no longer considered a public health threat. C. The trivalent MMR vaccine is the vaccine of choice for routine adult vaccination. D. The MMR vaccine contains live attenuated measles, mumps, and rubella viruses.

B. Immunity to rubella in women of childbearing age should not be a concern in healthcare setting because congenital rubella in the US is no longer considered a public health threat.

All of the following statements relative to the sterilization monitoring record (SMR) are correct except which one? 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 number 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 time (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 which one? 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 according to manufacturers' recommendations. D. Burs, polishing points, rag wheels, and laboratory knives used on contaminated or potentially contaminated prostheses or other 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.

Which of the following federal agencies is responsible for safe and healthy working conditions? A. EPA B. OSHA C. FDA D. NIOSH

B. OSHA

All of the following statements in relation to hepatitis B vaccination are correct except which one? A. Primary immunization with hepatitis B vaccine consists of three IM injections at 0, 1, and 6 months. B. Post-vaccination confirmation of seroconversion is mandated 1-2 months after the third dose. C. OHCP who do not develop an adequate antibody response to the primary vaccination series shall be offered a second 3-dose vaccine series. D. If no antibody response occurs to the second 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 statements are correct with respect to respiratory-protection controls except which one? A. Oral HCP providing dental care on a patient with suspected or confirmed airborne infectious disease must use a respirator with N95 or higher filtration capacity to prevent inhalation of infectious particles that are less than 5 μm in size. B. Respiratory-protection controls reduce the number of areas in which exposure to airborne pathogens might occur, thus, minimizing the number of persons exposed. C. N95 disposable respirators are non-powered, air-purifying, particulate-filter respirators. D. The N-series respirators are available with filtration efficiencies of 95% (N95), 99% (N99), and 99.7% (N100).

B. Respiratory-protection controls reduce the number of areas in which exposure to airborne pathogens might occur, thus, minimizing the number of persons exposed.

All of the following statements related to protective clothing are correct except which one? A. Surgical gowns must be worn by OHCP whenever splash, spatter, spray, and aerosols of blood or OPIM are anticipated during the clinical process. B. Scrubs, or clinical and laboratory coats or jackets worn for comfort and/or purposes of identity are considered appropriate PPE. C. Surgical gowns should have long sleeves to protect the wrists and forearms. D. Surgical gowns should cover the torso from neck to knees and wrap around the back to prevent contamination of street the clothes.

B. Scrubs, or clinical and laboratory coats or jackets worn for comfort and/or purposes of identity are considered appropriate PPE.

All of the following statements in relation to live attenuated vaccines are correct except which one? A. Live attenuated vaccines, because of their potential for infecting the fetus, should not be administered to pregnant women unless there is a high immediate risk of infection. B. The administration of live attenuated vaccine is highly recommended for patients undergoing cancer chemotherapy, post-organ transplantation, and those on corticosteroids. C. The administration of live attenuated vaccines is contraindicated to persons with known or suspected congenital or acquired immunodeficiency. D. Live attenuated vaccines tend to have higher rates of adverse effects (particularly fever).

B. The administration of live attenuated vaccine is highly recommended for patients undergoing cancer chemotherapy, post-organ transplantation, and those on corticosteroids.

All of the following statements with respect to unsaturated chemical-vapor sterilizers are correct except which one? 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.

All of the following statements are correct with respect to droplet nuclei (airborne transmission) except which one? A. Droplet nuclei are airborne particles ranging from 1-5 µm that may contain potentially infectious pathogens. B. The risk of inhalation of droplet nuclei is generally limited to within 3 feet of the source. C. Droplet nuclei are residuals of droplets that, while suspended in air dried out and in a cool environment may remain suspended in air indefinitely. D. Transmission of droplet nuclei may result from contact of a susceptible host with contaminated intermediate objects or environmental surfaces.

B. The risk of inhalation of droplet nuclei is generally limited to within 3 feet of the source.

All of the following statements are correct with respect to patient examination and surgeon's gloves except which one? A. Patient examination gloves and surgeon's gloves are made primarily of latex, nitrile, or vinyl. B. There are significant differences in the barrier properties of unused intact gloves. C. Vinyl gloves have higher failure rates than latex or nitrile gloves. D. To reduce the risk of latex-related allergies, low-allergen latex gloves or nitrile gloves should be used.

B. There are significant differences in the barrier properties of unused intact gloves.

All of the following statements with respect to waste segregation and office waste are correct except which one? A. The various waste categories generated in oral healthcare facilities (office waste, hazardous waste, universal waste, and medical waste) must be separated at their points of origin. B. There are very specific requirements for the containment of office waste. C. Most waste generated in oral healthcare settings is office waste. D. The waste receptacle, lined with a plastic liner bag, should be of sufficient size and strength to accommodate the type and quantity of office waste generated.

B. There are very specific requirements for the containment of office waste.

All of the following statements are correct with respect to sterilizing unwrapped instruments and their use except which one? A. Unwrapped the 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 immediate use. D. Unwrapped sterile instruments can become contaminated with dust, airborne organisms, and other contaminants and should never 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 which one? 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 does 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 does not contain aerosolized infectious material.

Which of the following is a high-potency formulation vaccine recommended for OHCP older than 60 years of age for the prevention of herpes zoster? A. Varivax B. Zostavax C. VZIG D. None of the above are correct.

B. Zostavax

Handwashing is an inappropriate hand hygiene procedure ____________. A. when the hands are visibly dirty or contaminated with proteinaceous material or are visibly soiled with blood or other body fluids B. to remove or destroy transient microorganisms and reduce the resident hand flora C. before eating D. after using the bathroom

B. to remove or destroy transient microorganisms and reduce the resident hand flora

All of the following statements are correct in relation to the influenza vaccine except which one? A. It is strongly recommended that all OHCP, including those in training, be vaccinated annually against influenza. B. The virologic basis for the annual influenza vaccine is the emergence of new influenza virus variant from frequent antigenic change. C. The live attenuated intranasal influenza vaccine is the vaccine of choice for OHCP. D. Antiviral agents with activity against influenza viruses are available but they are not substitutes for the influenza vaccine.

C. The live attenuated intranasal influenza vaccine is the vaccine of choice for OHCP.

All of the following statements are correct with respect to face masks except which one? A. Face shields with high crowns and chin protection that wrap around the face to the point of the ears are recommended for infection control purposes. B. Face masks should fit snugly and the foam brow-band contoured to the wearer. C. Face shields can be worn without surgical masks. D. Eye protective devices should be cleaned with soap and water, disinfected with a hospital level disinfectant, rinsed with water, and air dried before reuse.

C. Face shields can be worn without surgical masks

If hands are not visibly soiled or visibly contaminated with blood or other proteinaceous material, which of the following regimens is the most effective for reducing the number of pathogenic organisms on the hands of HCWs? A. Handwashing, i.e., washing hands with plain soap and water. B. Antiseptic handwash, i.e., washing hands with an antimicrobial soap and water. C. Hand antisepsis, i.e., applying an appropriate amount of alcohol-based hand rub to the hands and rubbing hands together until they feel dry. D. Using an antimicrobial impregnated wipe, i.e., towelettes.

C. Hand antisepsis, i.e., applying an appropriate amount of alcohol-based hand rub to the hands and rubbing hands together until they feel dry.

All of the following statements regarding hand hygiene in healthcare settings are true except which one? A. The overall adherence of HCWs to fundamental principles of infection control and aseptic technique (e.g., failure to wear gloves and perform hand hygiene) is low. B. Poor adherence to hand hygiene practices is a primary contributor to healthcare-associated infection. C. Hand hygiene is not necessary if gloves are worn. D. The prevalence of healthcare-associated infections is decreased as adherence to recommended hand hygiene practices is improved.

C. Hand hygiene is not necessary if gloves are worn

All of the following statements related to critical or semi-critical, or non-critical patient-care items are correct except which one? 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 high-level disinfection using an FDA-registered chemical sterilant/high-level disinfectant. 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 high-level disinfection using an FDA-registered chemical sterilant/high-level disinfectant.

All of the following statements are correct with respect to sterilization and levels of disinfection except which one? 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 kill spores. D. Low-level disinfection kills some nonlipid or small viruses (e.g., polio), some fungi, all vegetative bacteria, and all lipid or medium-size viruses (e.g., HBV, HIV).

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 kill spores.

Which of the following federal agencies is responsible for setting and enforcing regulations to assure safe and healthy working conditions? A. CDC B. NIOSH C. OSHA D. FDA

C. OSHA

All of the following statements are correct with respect to an education and training program to preventing transmission of infectious agents in healthcare settings except which one? A. Creation and maintenance of a safe work-environment is predicated on the commitment and accountability of all HCP. B. Compliance with Standard and Transmission-based Precautions is significantly improved if HCP understand the rationale for written policies and practices. C. Participation in an education and training program is mandated on a onetime basis, i.e., prior to initial assignment of HCP to tasks in which exposure to blood and OPIM may occur. D. The program shall reflect current best practice recommendations made by federal, state, and local agencies and professional organizations.

C. Participation in an education and training program is mandated on a onetime basis, i.e., prior to initial assignment of HCP to tasks in which exposure to blood and OPIM may occur.

All of the following statements are correct with respect to passive immunization except which one? A. Immunoglobulins may be obtained from human or animal donors who have recovered from an infectious disease or who have been previously immunized. B. Passive immunity against specific microorganisms may be conferred with the administration of immunoglobulins. C. Passive immunization usually affects an immune response in about 7-10 days. D. Passive immunization is useful when active immunization is unavailable or contraindicated, or when an individual cannot form antibodies

C. Passive immunization usually affects an immune response in about 7-10 days.

All of the following statements are correct relative to regulated waste except which one? A. Disposable sharps (e.g., needles, local anesthetic cartridges, orthodontic wires, scalpel blades, suture needles, endodontic files, and broken instruments are placed in a rigid, puncture-resistant, leak-proof container with a secure lid for storage and transportation. B. Other regulated waste (e.g., items that drip when held vertically, release fluid when compressed, have dried on fluid that could flake off in transit) is placed in small biohazard bag and are disposed of into a centralized 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, environmental 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.

All of the following statements are correct with respect to storing sterilized items except which one? A. After the sterilization cycle is completed and the instrument units are dry and cool, inspect all packages for proper color 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.

All of the following statements are correct with respect to gloves except which one? A. Patient examination gloves, classified as Class I medical devices, should be worn during dental cleaning, restorative, and other non-surgical dental procedures. B. Sterile surgeon's gloves are intended for use during surgical procedures to protect the provider and the wound from contamination. C. Surgeon's gloves are subject to design control requirements and are classified as Class II medical devices. D. Surgeon's gloves must be sterile when offered for sale to end-users.

C. Surgeon's gloves are subject to design control requirements and are classified as Class II medical devices.

All of the following statements are correct with respect to Streptococcus pneumoniae except which one? A. Streptococcus pneumoniae organisms commonly colonize the respiratory tract and are spread via airborne droplets. B. All adults with compromised immune system and the elderly are high risk of infection. C. The conjugated vaccine (Prevnar 13) is indicated for those between 2-64 years of age with increased susceptibility. D. The polysaccharide vaccine (Pneumovax 23) is indicated for those ≥65 years old.

C. The conjugated vaccine (Prevnar 13) is indicated for those between 2-64 years of age with increased susceptibility.

All of the following statements are correct with respect to sterilizing and high-level disinfecting with germicides except which one? 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.

All of the following statements are correct with respect to cleaning reusable instruments and other devices except which one? 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) compatibility 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.

All of the following statements are correct with respect to the office Infection-control Coordinator (ICC) except which one? The ICC shall _______________. A. be knowledgeable to develop and maintain the office infection control/exposure control protocol B. provide both access to and an explanation of its contents upon request C. have overall responsibility for compliance with infection control guidelines D. monitor the effectiveness of the program over time to ensure that the criteria are relevant, the procedures are efficient, and the practices are successful

C. have overall responsibility for compliance with infection control guidelines

All of the following statements in relation to OHCP who failed to seroconvert following two HBV vaccination series are correct except which one? Such OHCP __________. A. are at risk of HBV infection after percutaneous or permucosal exposure. B. should be administered hepatitis B immune globulin within a week of exposure (ideally within 24 hours). C. in addition to HBIG, should receive a complete series of the hepatitis B vaccine, if not previously vaccinated. D. should receive a second dose of HBIG 30 days after the first dose if the HB vaccibe is declined.

C. in addition to HBIG, should receive a complete series of the hepatitis B vaccine, if not previously vaccinated.

All of the following statements are correct in relation to the hepatitis B vaccine except which one? A. Universal immunization is mandated for all OHCP. B. Persons who decline the hepatitis B vaccination series must sign a copy of the Mandatory Hepatitis B Vaccination Declination Form. C. Vaccination should be completed during training. D. All of the above are correct.

D. All of the above are correct.

Task-specific gloves should be worn by all OHCP to prevent contamination of the hands when _______________. A. anticipating direct contact with blood, mucous membranes, nonintact skin, and OPIM. B. having direct contact with patients who are colonized or infected with pathogens transmitted by the contact route. C. handling visibly or potentially contaminated patient care items and environmental surfaces. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements are correct in relation to documentation of vaccination and immune status of OHCP? A. An immunization record should be established for each OHCP at the time of initial employment. B. At each subsequent immunization encounter, the record should be updated. C. If there is any doubt as to the immune status of a OHCP, it is best to assume that the person is not immune. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements best describes Spaulding's classification of patient-care items? 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. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct in reference to vaccine-preventable diseases in the United States? A. Immunization programs in the U.S. have markedly reduced the incidence of vaccine-preventable diseases in children. B. Today, a substantial percentage of morbidity and mortality from vaccine-preventable childhood diseases occurs in older adolescents and adults. C. Adults who escaped natural infection or immunization during childhood may be at increased risk of vaccine-preventable disease because of advanced age, the presence of certain chronic diseases, or occupation. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to Neisseria meningitidis? A. Neisseria meningitidis is transmitted from the respiratory tract into the bloodstream and causes inflammation of the meninges surrounding the brain and spinal cord. B. OHCP who are immunocompromised should receive two doses of conjugated (if <55 years old) or one dose of unconjugated (if ≥55 years old) vaccine. C. All OHCP adults should receive a single dose of conjugated (if <55 years old) or unconjugated (if ≥55 years old) vaccine. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to cleaning (utility or general purpose) gloves? A. The FDA does not regulate cleaning (utility or general purpose) gloves used for routine janitorial functions in healthcare facilities. B. It is illegal for manufacturers to label or to suggest that such gloves as suitable for medical use. C. Gloves used for cleaning patients, or cleaning or handling surfaces or items contaminated with patient waste or fluids and patient-care devices contaminated with blood or OPIM should meet the requirements for patient examination gloves. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to processing contaminated reusable patient-care items? A. There should be a central processing area (CPA) of adequate size with four successive stations for (1) receiving and cleaning; (2) preparation and packaging; (3) sterilization or disinfection; and (4) storage of sterilized units. B. Within CPA, each station should be physically separated to control traffic flow and to contain contaminants during the process. C. 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. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to putting on and for the safe removal of PPE? A. The CDC recommends a hierarchical sequence of steps for putting on PPE and for the safe removal of PPE that will prevent skin, mucosal, clothing, or environmental contamination. B. Designated containers for used disposable or reusable PPE should be placed in a location convenient to the site of removal to facilitate containment of contaminants. C. Putting on PPE begins with the gown and progresses sequentially to the mask or respirator, goggles or face shield, and, finally, the gloves. D. All of the above are correct.

D. All of the above are correct.

Hand hygiene products and procedures can decrease the barrier function of skin by ____________. A. extracting skin lipids B. chemically inducing irritation C. physically stripping the stratum corneum D. All of the above.

D. All of the above.

Hand hygiene refers to ____________. A. handwashing, i.e., washing hands with plain soap and water B. hand antisepsis, i.e., antiseptic hand wash or antiseptic hand rub C. surgical hand antisepsis D. All of the above.

D. All of the above.

In a community-based oral healthcare setting, implementation and enforcement of TB infection-control protocol provides for prompt ____________. 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 with appropriate environmental controls and respiratory-protection controls D. All of the above.

D. All of the above.

Pathogens may be transferred from the source to a host by _______________. A. contact transmission, i.e., direct or indirect contact transmission B. respiratory transmission, i.e., inhalation of droplets C. respiratory transmission, i.e., inhalation of droplet nuclei D. All of the above.

D. All of the above.

The "chain of infection", i.e., the transmission of infectious agents in healthcare settings requires a _______________. 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. All of the above.

D. All of the above.

The term "healthcare personnel" applies to all paid and unpaid persons who _______________. A. have professional training in a healthcare-related field and provide patient care in a healthcare setting B. have technical training in a healthcare-related field and provide patient care in a healthcare setting C. provide services that support the delivery of healthcare D. All of the above.

D. All of the above.

The transmission of which of the following pathogens is prevented or reduced by Standard Precautions? A. HBV B. HCV C. HIV D. All of the above.

D. All of the above.

To minimize latex allergy-related health problems among OHCPs and patients: 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. All of the above.

D. All of the above.

Which of the following is true regarding monitoring the correct functioning of a sterilizer? 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. Mechanical monitoring, i.e., confirming the manufacturer's recommended settings cycle time, temperature, and pressure should be completed with each load. D. All of the above.

D. All of the above.

Which of the following pathogens is transmitted primarily by droplet inhalation? A. Measles virus B. Mumps virus C. Rubella (German measles) virus D. All of the above.

D. All of the above.

Which of the following reflect/represent the primary objective(s) of administrative controls? A. Identification of the patient with a suspected or confirmed airborne infectious disease. B. Isolation of the patient with a suspected or confirmed airborne infectious disease. C. Either the referral of the patient with a suspected or confirmed airborne infectious disease to a facility with an airborne infection isolation room (AIIR); or the return of the patient home, as deemed medically/dentally appropriate. D. All of the above.

D. All of the above.

Which of the following statements are correct with respect to safe injection practices? A. The leftover contents of single-dose cartridges, ampules, vials, or prefilled syringes should be discarded; and never combined with medications for use on another patient. B. Medications from single-dose cartridges, ampules, vials, or prefilled syringes should not be administered to multiple patients, even if the needle is changed. C. Always use a sterile, single-use, disposable needle and/or syringe for each patient. D. All of the above.

D. All of the above.

Which of the following statements is correct in relation to homeostatic control and the rate of keratinocyte proliferation? A. Under basal conditions, differentiated keratinocytes require 2 weeks to exit the nucleated compartment and an additional 2 weeks to move through the stratum corneum. B. When stimulated by injury or infection, keratinocytes have the capacity for increased rates of proliferation and maturation, and 50 to 60% of barrier recovery typically occurs within 6 hours. C. When stimulated by injury or infection, keratinocytes have the capacity for increased rates of proliferation and maturation, and complete normalization of barrier function occurs in 5 to 6 days. D. All of the above.

D. All of the above.

Which of the following statements is correct with respect to Mycobacterium tuberculosis (MBT)? A. MBT is transmitted via inhalation of droplets and droplet nuclei. B. Patients and HCP share the same air space and, predictably, the transmission of MBT in healthcare settings has been discounted. C. Standard Precautions, augmented by Transmission-based Precautions, i.e., airborne precautions, prevent or reduce the transmission of the MBT in healthcare settings. D. All of the above.

D. All of the above.

Which of the following statements is correct with respect to airborne infection isolation rooms (AIIRs)? AIIRs _______________. A. are engineered to provide negative pressure in the room so that air flows under the door gap into the room B. have an air changes per hour rate of 6-12 ACH C. direct exhaust of air from the room to the outside of the building or recirculate air in the room through a high efficiency particulate air (HEPA) filter D. All of the above.

D. All of the above.

Which of the following statements is correct with respect to fundamental elements needed to prevent the transmission of pathogens in healthcare settings? A. Infection control/exposure control strategies should be appropriate for the setting and extend to all aspects of the clinical process. B. As the protocol deviates from optimal design and implementation, the quality (value, outcome) of the program decreases at an accelerated rate. C. Information from which inference can be drawn about the quality of infection control/exposure control practices may be classified under three headings: structure, process, and outcome. D. All of the above.

D. All of the above.

Which of the following statements is correct with respect to respiratory hygiene/cough etiquette? A. Respiratory hygiene/cough etiquette evolved from observations during the 2003 widespread outbreak of coronavirus (CoV)-associated severe acute respiratory syndrome (SARS). B. The transmission of SARS-CoV resulted from a failure to implement simple source control measures when patients, visitors, and HCP with undiagnosed respiratory tract infections entered healthcare facilities. C. The transmission of SARS-CoV highlighted the need for prompt implementation of source control measures at the first point of encounter within healthcare settings. D. All of the above.

D. All of the above.

Which of the following statements is correct with respect to transmission-based precautions? A. There are three categories of transmission-based precautions; contact precautions, droplet precautions, and airborne precautions. B. Transmission-based precautions are implemented empirically until the suspected pathogen is either identified or the infectious status of the patient is ruled out. C. Transmission-based precautions, whether used alone or in combination, are always used in addition to Standard Precautions. D. All of the above.

D. All of the above.

The decision to immunize OHCP against a specific pathogen is based on all of the following except which one? A. An assessment of the risk of infection. B. The consequences of natural unmodified illness. C. Availability of a safe and effective vaccine. D. Cost

D. Cost

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 temperature and pressure for a defined period of time. C. The majority of tabletop sterilizers used in oral healthcare settings are gravity displacement sterilizers. D. Gravity displacement steam sterilizers should be tested daily for adequate air removal.

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

All of the following statements are correct with respect to sterilizing wrapped instruments loading instruments except which one? 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 onside the chamber.

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

Pathogenic organisms of concern in the oral healthcare setting include ____________. A. HBV, HCV, HIV B. measles, mumps, and rubella viruses; herpes simplex virus and varicella zoster virus C. influenza and respiratory syncytial viruses; group A streptococci and Mycobacterium tuberculosis D. emerging pathogens such as MRSA and others E. All of the above.

E. All of the above.

All of the following statements are correct relative to tetanus, diphtheria, and pertussis except which one? A. Tetanus, diphtheria, and pertussis are bacterial infections. B. The Td vaccine contains tetanus and diphtheria toxoids. C. OHCP with uncertain history of primary vaccination should receive and initial dose of Tdap followed by two doses of Td. D. Td is recommended as part of wound management.

D. Td is recommended as part of wound management.

When latex proteins interact with antibodies on mast cells and basophiles, a massive release of histamine and other substances result in __________. A. acute urticaria B. angioedema C. allergic rhinoconjunctivitis D. generalized anaphylactic shock

D. generalized anaphylactic shock

To minimize the exposure of patients to OHCPs who have been exposed to or have been diagnosed with an infectious disease, which of the following factors are considered in imposing restrictions on clinical practice? A. Mode of transmission B. Period of infectivity C. Level of circulating viral burden D. Level of risk for the transmission of a pathogen in association with a procedure E. All of the above.

E. All of the above.

HCP with close or lengthy contact with a patient with meningococcal disease are considered at increased risk of infection and should receive PEP, i.e., antibacterial prophylaxis. A. True B. False

A. True

OHCP with a positive Mantoux tuberculin skin test (TST) are not infectious and, therefore, there are no associated work restrictions. A. True B. False

A. True

In healthcare settings pathogenic organisms can be detected ____________.

air, water, fomites

Which of the following medication is most critical when treating anaphylaxis? A. Epinephrine, IM B. Oral H1-receptor antagonist C. An inhaled beta2-adrenergic agonist D. Oxygen, 2-4 L/min by nasal cannula

A. Epinephrine, IM

All of 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 healthcare facility policy.

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

All of the following statements are related to Clostridium tetani, Corynebacterium diphtheriae, or Bordetella pertussis are correct EXCEPT which one? A. Following exposure to C. tetani, no PEP is indicated; exposed HCP should be monitored closely and human tetanus immune globulin (TIG) should be administered at the first sign(s) of illness. B. HCP in close contact with patients with diphtheria should be administered PEP, i.e., a dose of diphtheria toxoid booster Td) and antibacterial agents. C. HCP exposed to B. pertussis should receive PEP, i.e., antibacterial prophylaxis within 21 days of exposure when (1) at high risk of developing severe pertussis or (2) when close contact with patients at high risk is anticipated. D. If there is an increased risk of pertussis in a healthcare setting, evidenced by documented or suspected healthcare-associated transmission of pertussis, revaccination of HCP with Tdap should be considered.

A. Following exposure to C. tetani, no PEP is indicated; exposed HCP should be monitored closely and human tetanus immune globulin (TIG) should be administered at the first sign(s) of illness.

Naturally occurring proteins found in latex are believed to be responsible for inducing what type of adverse reaction? A. IgE-mediated immediate hypersensitivity (i.e., Gell and Coombs Type 1) reactions B. Latex glove-related irritant contact dermatitis C. Cell-mediated delayed hypersensitivity (i.e., Gell and Coombs Type IV) reactions D. Latex glove-related allergic contact dermatitis

A. IgE-mediated immediate hypersensitivity (i.e., Gell and Coombs Type 1) reactions

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.

All of the following statements relative to the disposal of RMW are correct except which one? A. The disposal of RMW is regulated by specific OSHA mandates. B. Most states require that RMW be treated before disposal and most states allow on-site treatment. C. The most common on-site treatment methods include (1) steam sterilization (autoclaving), (2) microwave sterilization, (3) chemical disinfection, and (4) sewer discharge for liquid RMW. D. Some states require permits for any type of on-site treatment; other states leave it up to the generator to select a treatment method based on current best practices.

A. The disposal of RMW is regulated by specific OSHA mandates.

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). A. True B. False

A. True

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). A. True B. False

A. True

The presence of biofilms of waterborne bacteria (e.g., Legionella spp. and Pseudomonas aeruginosa) in dental unit waterlines has been confirmed. A. True B. False

A. True

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. A. True B. False

A. True

While the presence of an infectious agent in laser plumes or surgical smoke may not be sufficient to cause disease from airborne exposure, especially if the normal mode of transmission is not airborne, laser plumes and surgical smoke are considered potential risks in healthcare settings. A. True B. False

A. True

All of 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 vegetative bacteria, fungi, and viruses (with or without lipid envelops) C. with the exception of sodium hypochlorite, have no demonstrable sporicidal activity D. are labeled as "tuberculocidal hospital disinfectants

A. are regulated exclusively by the FDA

ll of the following strategies for spills of blood and OPIM are acceptable according to OSHA regulations EXCEPT which one? In patient-care areas, OHCWs can manage small spills first by removing visible organic matter with an absorbent material (e.g., disposable paper towels discarded into leak-proof, properly labeled containers) and then decontaminating the area with _______________. A. household bleach, 1:10 v/v dilution B. low-level disinfectant List D (i.e., a hospital disinfectant with HIV, HBV claim) C. intermediate-level disinfectant List B (i.e., a hospital disinfectant with a tuberculocidal claim) D. intermediate-level disinfectant List E (i.e., a hospital disinfectant with a tuberculocidal, and an HIV, HBV claim)

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

Type I immediate hypersensitivity reactions are mediated by __________. A. IgA antibodies B. IgG antibodies C. IgE antibodies. D. IgM antibodies

C. IgE antibodies.

All of the following statements related to a source person are correct EXCEPT which one? A. The source person may be a patient, another HCP, a visitor to the healthcare facility, or a house-hold member. B. A person with asymptomatic acute or chronic infections, in general, is non-infectious and does not qualify as a source person. C. The source person may have acute infection, or may be transiently or chronically colonized by pathogenic organisms. D. The source person with an acute or chronic infection may be asymptomatic.

B. A person with asymptomatic acute or chronic infections, in general, is non-infectious and does not qualify as a source person.

All of following statements related to exposure to the influenza viruses are correct EXCEPT which one? A. It is strongly recommended that HCP be vaccinated annually. B. An antiviral drug for PEP is recommended following healthcare-associated exposure to the influenza viruses. C. PEP with either oseltamivir or zanamivir, 1 dose daily for 10 days, is effective if initiated before the onset of illness. D. Watchful waiting and early treatment (when signs and symptoms of infection appear) with an antiviral agent is preferred to PEP. E. Antiviral agents, i.e., oseltamivir and zanamivir appear to be effective against both influenza A and B viruses.

B. An antiviral drug for PEP is recommended following healthcare-associated exposure to the influenza viruses.

All of the following statements with respect to education and training are correct EXCEPT which one? 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.

Epidemiological evidence suggest that solid or liquid waste from hospitals, other healthcare facilities, or clinical/research laboratories is more infective than residential waste. A. True B. False

B. False

It is common for contacts of patients with S. pneumoniae infection to develop pneumococcal infection; PEP with an effective antibacterial agent is recommended. A. True B. False

B. False

All of the following statements are true regarding gloves EXCEPT which one? 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.

All of the following items are considered "regulated medical waste" EXCEPT which one? A. Solid waste soaked or saturated with blood or OPIM, e.g., gauze saturated with blood during surgery. B. Gloves, masks, lightly soiled gauze or cotton roles, and environmental barriers. C. Extracted teeth, and surgically removed hard and soft tissues. D. Contaminated sharp items, e.g., needles, scalpel blades, and wires.

B. Gloves, masks, lightly soiled gauze or cotton roles, and environmental barriers.

The most common form of adverse reaction to latex glove use is __________. A. IgE-mediated immediate hypersensitivity (i.e., Gell and Coombs Type 1) reactions B. Latex glove-related irritant contact dermatitis C. Cell-mediated delayed hypersensitivity (i.e., Gell and Coombs Type IV) reactions D. Latex glove-related allergic contact dermatitis

B. Latex glove-related irritant contact dermatitis

All of the following statements are correct in relation to hepatitis B vaccination EXCEPT which one? 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 which one? A. All procedures are performed in such a manner as to minimize splashing, spraying, spattering, and the generation of droplets (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 wherever 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.

All of the following statements about storing RMW prior to disposal are correct except which one? A. The storage of RMW must be in accordance with applicable regulations of the United States, States and Territories, and political subdivisions of States and Territories. B. RMW must be stored in a designated, conveniently located storage area such as under the sink in the treatment room. C. In preparation for storage, sharps containers must be closed, if there is a chance of leakage, the container must be placed in a secondary container. D. Red biohazard bags must be "twist tied," if a bag seems especially heavy, it must be place inside another red biohazard bag prior to moving it to storage.

B. RMW must be stored in a designated, conveniently located storage area such as under the sink in the treatment room.

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

All of 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

All of the following statements with respect to the responsibilities of an Office medical Waste manager are correct except which one? The Office Medical Waste Manager ______________________. A. should be familiar with pertinent federal, state and local requirements for RMW management B. is solely responsible for the creation and maintenance of a safe and healthy work environment C. should develop, implement, and maintain a written RMW management protocol that meets federal, state, and local requirements D. act as advisor on RMW management matters to all office personnel

B. is solely responsible for the creation and maintenance of a safe and healthy work environment

All of 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

To reduce latex exposure, when performing routine restorative dentistry, which of the following is not recommended? A. Whenever possible, use non-latex gloves and other non-latex products. B. If latex gloves are preferred, use reduced protein, powder-free gloves. C. Always use oil-based hand creams or lotions to reduce latex-related problems. D. After removing latex gloves, perform adequate hand hygiene.

C. Always use oil-based hand creams or lotions to reduce latex-related problems.

All of the following statements related to solid RMW are correct except which one? A. OSHA requires that solid RMW be placed in containers that are closable, constructed to contain all contents, and prevent leakage of fluids during handling, storage, transport, or shipping. B. Biohazard bags used to collect RMW within a facility must be certified by the manufacturer to meet the American Society for Testing Materials (ASTM) ASTM D1709 Impact Resistance Of Polyethylene Film By The Free-Falling Dart Method. C. Autoclavable biohazard bags are available and some feature an indicator that changes to read "AUTOCLAVED" during steam sterilization; but RMW that has been decontaminated still needs to be labeled or color-coding. D. It is recommended to place a larger general office waste container beside the regulated waste container.

C. Autoclavable biohazard bags are available and some feature an indicator that changes to read "AUTOCLAVED" during steam sterilization; but RMW that has been decontaminated still needs to be labeled or color-coding.

All of the following statements relative to off-site shipping of RMW for treatment and disposal are correct except which one? A. In nearly all states, transporters of RMW must have a transport permit to pick up and transport the waste to a treatment and disposal facility. B. The United States Department of Transportation (USDOT) mandates that the biohazard bags used to line approved shipping containers for transport of RMW from the generator's facility to a treatment and disposal facility be certified by the manufacturer to meet USDOT standards. C. If the biohazard bags used to collect and transport RMW within a facility meet impact resistance of 165 grams by the ASTM D1709 method, it meets USDOT requirements for shipping RMW from the generator's facility to a treatment and disposal facility. D. OSHA requires that RMW containers be closed prior to removal from the workstation to prevent spillage or protrusion of contents during handling, storage, transport, or shipping.

C. If the biohazard bags used to collect and transport RMW within a facility meet impact resistance of 165 grams by the ASTM D1709 method, it meets USDOT requirements for shipping RMW from the generator's facility to a treatment and disposal facility.

All of the following statements related to exposure to the HCV are correct EXCEPT which one? A. Immune globulin (IG) and antiviral agents are not recommended for PEP after exposure to HCV-positive blood or OPIM B. No guidelines exist for the treatment of acute HCV infection. C. Limited data indicate that antiviral therapy is not beneficial even when initiated early in the course of an acute HCV infection. D. Recommendations for postexposure evaluation and follow-up are intended to achieve early diagnosis of HCV infection.

C. Limited data indicate that antiviral therapy is not beneficial even when initiated early in the course of an acute HCV infection.

All of 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, however experts agree that this regulation extends to uniforms and scrubs that are not contaminated with blood and OPIM. D. Employers must launder workers personal protective garments or uniforms and other laundry contaminated with blood and OPIM.

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

All of the following strategies are appropriate in the treatment of acute asthma except which one? A. Intranasal corticosteroid B. Inhaled beta2-adrenergic agonist C. Place patient in supine position and elevate legs D. Provide immediate oxygen, 2-4 L/min by nasal cannula

C. Place patient in supine position and elevate legs

All of 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 safety 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 by 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 V vaccination are true EXCEPT which one? A. Hepatitis B vaccination is to be made available to all OHCP, without a history of prior immunization, at the time of initial 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 Declination 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 segments related to wound care are correct EXCEPT which one? A. Percutaneous wounds and nonintact skin that have been in contact with blood or OPIM should be washed with soap and water. B. Mucous membranes that have been in contact with blood or OPIM should be flushed with water. C. Using antiseptics (e.g., chlorhexidine) for wound care or expressing fluid by squeezing the wound have been shown to reduce the risk for infection. D. Injecting antiseptics or disinfectants into a wound and the application of caustic agents (e.g., bleach) is not recommended.

C. Using antiseptics (e.g., chlorhexidine) for wound care or expressing fluid by squeezing the wound have been shown to reduce the risk for infection.

All of the following statements related to exposure to the varicella-zoster virus (VZV) are correct EXCEPT which one? A. If VZV exposure occurs in a healthcare setting, all case-patient contacts should be evaluated immediately for presumptive evidence of immunity. B. All susceptible HCP exposed to the VZV should receive PEP with two subcutaneous doses (4-8 weeks apart) of the varicella-zoster vaccine (Varivax). C. Women exposed to the VZV at any stage of pregnancy should receive the varicella-zoster vaccine (Varivax) no later than 96 hours of an exposure. D. Susceptible HCP exposed to the VZV for whom the vaccine is contraindicated should be administered varicella-zoster immunoglobulin (VZIG).

C. Women exposed to the VZV at any stage of pregnancy should receive the varicella-zoster vaccine (Varivax) no later than 96 hours of an exposure.

All of the following statements about allergic contact dermatitis are correct except which one? Allergic contact dermatitis __________. A. is caused primarily by the accelerators, promoters, and antioxidants that are added to natural rubber latex during harvesting, processing, or manufacturing B. is characterized by a papular, pruritic (itchy) rash, which usually begins 24 to 48 hours after contact with offending products C. associated oozing vesicles and blisters are limited to areas of skin touched by latex D. may be the first sign that more serious reactions could occur with continued exposure

C. associated oozing vesicles and blisters are limited to areas of skin touched by latex

All of 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

An exposure that might place HCP at risk for HAIs with bloodborne pathogens (i.e., infection with hepatitis B, hepatitis C, or human immunodeficiency viruses) is defined as ______________________________. A. a percutaneous injury, e.g., needlestick or cut with a sharp object contaminated with blood or OPIM. B. direct contact of ocular, nasal, or oral mucous membranes with blood or OPIM. C. direct contact of nonintact skin, e.g., dermatitis, or chapped or abraded skin with blood and OPIM. D. All of the above are correct.

D. All of the above are correct.

As many as one-third of all sharps injuries occur during the disposal process as a result of ______________________. A. inadequate sharps disposal container design B. inappropriate sharps disposal container placement C. inappropriate sharps disposal handling practices, including overfilling of sharps disposal containers by HCP D. All of the above are correct.

D. All of the above are correct.

Based on the OSHA definition, RMW generated in oral healthcare settings may include ______________________. A. contaminated sharps B. contaminated items that would release blood or OPIM in a liquid or semiliquid state if compressed and items caked with dried blood or OPIM and are capable of releasing these materials during handling C. liquid or semi-liquid blood and OPIM; and pathological, and microbiological waste D. All of the above are correct.

D. All of the above are correct.

Under the "Medical Waste Tracking Act of 1988," the EPA conducted a model waste management program and concluded that ______________________. A. due to the biological instability of most microorganisms commonly regarded as human pathogens, the actual adverse environmental or public health consequences or risks were negligible B. the disease-causing potential of medical waste is greatest at the point of generation C. medical waste primarily represents an occupational health hazard D. All of the above are correct.

D. All of the above are correct.

Waste generated in healthcare facilities may be categorized as ______________________. A. office waste B. hazardous and universal waste C. medical waste D. All of the above are correct.

D. All of the above are correct.

Which of the following statements about the sharps disposal container is correct? A. Sharps containers must be kept upright throughout use to keep the sharps and any liquid from spilling out. B. The fill status of the container must be obvious under prevailing lighting conditions at the workstation. C. The container's opening must be identifiable and easily accessible by the user and must facilitate one-handed disposal of sharps. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements are correct with reference to healthcare personnel (HCP)? A. The term HCP refers to all paid and unpaid persons working in healthcare settings who have the potential for exposure to blood and OPIM. B. HCP include emergency medical service personnel, dental personnel, laboratory personnel, nurses, nursing assistants, physicians, technicians, therapists, pharmacists, and students and trainees. C. HCP include persons not directly involved in patient care but potentially exposed to blood and OPIM (e.g., clerical, dietary, housekeeping, security, maintenance, and volunteer personnel). D. All of the above are correct.

D. All of the above are correct.

Which of the following statements in reference exposure to methicillin-resistant Staphylococcus aureus (MRSA) is correct? A. MRSA is primarily transmitted by direct contact with an infected skin lesion; less frequently by contact with contaminated articles and environmental surfaces. B. PEP is not recommended for HCP. C. Exposed HCP should be monitored for skin lesions; incision and drainage and adjunctive antibacterial coverage are the first step in treating purulent skin infections. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements in reference to exposure to the hepatitis A virus (HAV) is correct? A. The HAV is transmitted primarily by the fecal-oral route, either person-to-person, i.e., close personal contact with an infected household member or sex partner; or consumption of contaminated food or water. B. The HAV is transmitted primarily by the fecal-oral route, either person-to-person, i.e., close personal contact with an infected household member or sex partner; or consumption of contaminated food or water. C. Anti-HA-positive HCP who have not been vaccinated previously should be administered PEP, i.e., a single dose of hepatitis A vaccine (Vaqta or Havrix) or immune globulin (IG) within 2 weeks after exposure. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with reference to postexposure prophylaxis (PEP)? A. Key to successful postexposure management is the timely initiation of PEP. B. PEP is any preventive medical treatment, e.g., administration of vaccines, immune globulins, or antibacterial agents. C. PEP started in a timely manner after exposure to a pathogenic virus or bacteria is intended to prevent infection and the development of disease. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements is correct with respect to OHCP infected with the HAV? A. The hepatitis A virus (HAV) is primarily transmitted by the fecal-oral route, either by person-to-person contact or consumption of contaminated food or water. B. In oral healthcare settings, administrative policies and work restrictions are primarily predicated on its mode of transmission and the period of infectivity. C. Infected OHCP should be restricted from patient contact, contact with patient's environment, and food-handling until 7 days after onset of jaundice. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements related to recordkeeping, reporting, and tracking of RMW is correct? A. Some states require that generators maintain records of the quantity of RMW generated and its disposition; some require the submission of an annual report. B. The OMWM should maintain an Infectious Waste Log that includes: date, type of waste, amount (weight, volume, or number of containers), and disposition. C. If infectious waste is transported off-site, the receiving facility must provide the generator written documentation of proper treatment and disposal. D. All of the above are correct.

D. All of the above are correct.

The objectives of the education and training program are to educate OHCPs regarding ____________. A. the risk of healthcare-associated infections B. preventive strategies C. exposure management and follow-up D. administrative controls E. All of the above.

E. All of the above.

Which of the following statements related to spills of infectious material is correct? A. Infectious waste spills must be cleaned up immediately using appropriate PPE such as gloves, coveralls, mask, and goggles. B. Small spills are managed by removing visible organic matter with absorbent material (e.g., disposable paper towels) discarded into a leak-proof, properly labeled containers biohazard container. C. OSHA regulations require the use of an EPA-registered disinfectant to disinfect housekeeping surfaces after a spill. D. All of the above are correct.

D. All of the above are correct.

Which of the following statements related to the safe handling of contaminated needles is correct? A. Contaminated disposable needles must never be sheared or broken. B. If bending or removing of a needle from the syringe is necessary, it must be accomplished with the use of a mechanical device or a one-handed technique. C. Recapping must be accomplished by the one-handed "scoop technique," i.e., using the needle itself to pick up the cap and then pushing the cap against a hard surface to ensure a tight fit over the needle. D. All of the above are correct.

D. All of the above are correct.

Within hours of exposure to a bloodborne pathogen, exposed HCP should presents for evaluation by an expert consultant with _______________. A. the incident report B. all available information about the source person C. HCP's OSHA-mandated medical record maintained by the employer D. All of the above are correct.

D. All of the above are correct.

For infection to occur, which of the following element of the "chain of infection" must be satisfied? There must be _______________. A. an adequate number and sufficient virulence of pathogenic organisms B. a susceptible host C. a mode of transmission and a portal of entry D. All of the above.

D. All of the above.

Historical clues to a possible latex sensitivity include __________. A. allergies to foods known to have allergens that cross-react with latex B. signs and symptoms of an allergic response after exposure to latex C. previous hand dermatitis of any kind, atopy, and multiple surgical exposures D. All of the above.

D. All of the above.

If barriers are not used on clinical contact surfaces, surfaces without soil (i.e., without visible blood and OPIM) should be cleaned and then they may be disinfected using an EPA-registered _______________. A. low-level disinfectant List D (i.e., a hospital disinfectant with HIV, HBV claim) B. intermediate-level disinfectant List B (i.e., a hospital disinfectant with a tuberculocidal claim) C. intermediate-level disinfectant List E (i.e., a hospital disinfectant with a tuberculocidal, and an HIV, HBV claim) D. All of the above.

D. All of the above.

The diagnostic algorithm for latex allergy includes __________. A. obtaining a through medical history B. skin-patch testing for diagnosing type IV delayed hypersensitivity and serum IgE measurements to confirm type I immediate hypersensitivity C. glove provocation testing when patient's clinical history is incongruent with IgE results D. All of the above.

D. All of the above.

Which of the following procedures are to be performed when securing the DTR at the end of the day? 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. All of the above.

D. All of the above.

Which of the following statements are true regarding facemasks? 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. All of the above.

D. All of the above.

Which of the following statements are true regarding protective clothing? 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. All of the above.

D. All of the above.

All of the following administrative policies and work restrictions of OHCP exposed to or infected with a bloodborne pathogen are correct except which one? A. Clinical privileges should be graduated according to the level of risk for transmission in association with a procedure. B. Clinical privileges should be graduated according to the level of circulating viral burden of the infected OHCP. C. Strategies should encourage routine voluntary, confidential testing and emphasize that OHCP who perform Category III procedures should know their immune or infection status. D. OHCP who develop to HBV, HCV, and HIV infections are ethically bound to report it to the CDC.

D. OHCP who develop to HBV, HCV, and HIV infections are ethically bound to report it to the CDC.

All of the following statements are correct with respect to preparing the DTR for the patient except which one? A. Place protective plastic covers on clinical contact surfaces such as headrests, dental unit control switches, air and water 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, eye 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 changed 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 precautions are correct with respect to the DTR-turn-around between patients except which one? 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 statements are correct with reference to carpeting and cloth furnishings in clinical setting EXCEPT which one? A. Vacuuming and cleaning can temporarily reduce the numbers of bacteria, but these populations tend to rebound and return to pre-cleaning levels. B. Avoiding the use of carpeting is prudent in areas where spills are likely to occur because carpeting contaminated with blood or OPIM cannot be fully decontaminated. C. Allergens have been detected in or on cloth furniture and it is suggested that cloth chairs be vacuumed regularly to keep dust and allergens levels to a minimum. D. There is solid evidence that carpets and cloth furnishings in general patient-care areas increase the risk of healthcare associated infections.

D. There is solid evidence that carpets and cloth furnishings in general patient-care areas increase the risk of healthcare associated infections.

All of the following statements related to exposure to measles, mumps, or rubella are correct EXCEPT which one? A. If measles, mumps, or rubella exposure occurs in a healthcare setting, all case-patient contacts should be evaluated immediately for presumptive evidence of measles, mumps, or rubella immunity. B. Exposed HCP without evidence of immunity to the measles virus should be offered the MMR vaccine and an intramuscular dose of immune globulin (IG). C. Exposed HCP without evidence of immunity should be offered the MMR vaccine; however, antibodies develop slowly to the mumps component of the vaccine to provide effective prophylaxis after exposure. D. There is strong evidence that postexposure vaccination is effective in preventing rubella infection.

D. There is strong evidence that postexposure vaccination is effective in preventing rubella infection.

All of the following statements related to exposure to the HIV are correct except which one? The latest U.S. Public Health Service (PHS) guidelines emphasize the importance of _______________. A. prompt reporting of expert management of occupational exposures B. adherence to the recommended HIV PEP regimen C. follow-up of exposed HCP to including careful monitoring for adverse events related to PEP and for virologic, immunologic, and serologic signs of infection D. modified patient-care responsibilities of exposed HCP based solely on evidence of HIV exposure

D. modified patient-care responsibilities of exposed HCP based solely on evidence of HIV exposure

The information from which inferences can be drawn about the quality of infection control/exposure control practices includes ____________. 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/exposure control program decreases at an accelerated rate. C. It is recommended that an Office Infection-Control Coordinator (OICC) be appointed 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. E. All of the above.

E. All of the above.

All of the following statements related to liquid RMW generated by suctioning during surgical procedures are correct except which one? A. Liquid RMW generated by suctioning during surgical procedures may be decanted directly into clinical sinks unless prohibited by state or local regulations. B. In the absence of a surgical sink, liquid RMW generated by suctioning during surgical procedures may be decanted into the hand washing sink. C. If discharge into a sanitary sewer is prohibited, liquid RMW must be placed into a rigid container, labeled or color coded red and double bagged using biohazard bags. D. The State-by-State Regulated Medical Waste Resource Locator is good resource for the OMWM to determine available options for the disposal of liquid RMW.

In the absence of a surgical sink, liquid RMW generated by suctioning during surgical procedures may be decanted into the hand washing sink.


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