infection control module 10 (course 342)

1. 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

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

A. True

6. 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

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

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

42. 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

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

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

11. 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

15. 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

21. 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

23. 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

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

A. True

29. 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

33. 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

34. 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

37. 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

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

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

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

D. Store regulated medical waste under the sink

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

C. Both parts of the statement are true.

3. The information from which inferences can be drawn about the quality of infection control/exposure control practices includes all of the following, EXCEPT for one. Which one is the exception? 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 the hygienist be appointed as the Office Infection-Control Coordinator (OICC) with responsibility for the development and management of the office infection control/exposure control program. D. The creation and maintenance of a safe work environment mandates the commitment and accountability of all OHCP.

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

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

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

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

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

24. 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

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

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

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

B. HPV

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

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

32. All of the following statements are correct in relation to laboratory asepsis, EXCEPT for one. Which one is the exception? A. Environmental surfaces must be barrier-protected or cleaned and disinfected in the same manner as clinical contact surfaces in treatment areas. B. Metal impression trays and face bow forks may be disinfected with an EPA-registered hospital level disinfectant with tuberculocidal claim. C. Articulators, case pans, lathes, pressure pots, and water baths are to be cleaned and disinfected between patients 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.

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

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

18. All of the following precautions are correct with respect to the treatment phase of patient care, EXCEPT for one. Which one is the exception? A. All procedures are performed in such a manner as to minimize splashing, spraying, spattering, and the generation of 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.

30. All of the following statements are correct in relation to infection control-related issues in association with oral surgical procedures, EXCEPT for one. Which one is the exception? A. For oral surgical procedures, clinicians must perform surgical hand asepsis. B. When using laser or electrosurgical units, the thermal destruction of tissue creates laser plumes or surgical smoke, which 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.

16. 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

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

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

C. The OHCP with acute genital herpes

10. All of the following statements with respect to hepatitis B vaccination are true, EXCEPT for one. Which one is the exception? A. Hepatitis B vaccination is to be made available to all OHCP, without a history of prior immunization, at the time of 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.

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

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

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

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

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

D. Enforcement predicated on the presence of fever.

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

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

17. All of the following statements are correct with respect to preparing the DTR for the patient, EXCEPT for one. Which one is the exception? A. Place protective plastic covers on clinical contact surfaces such as headrests, dental unit control switches, air and 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.

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

D. Protective clothing must be disposable

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

D. Refer patients with latex allergy.

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

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

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

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

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

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

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

E. cost control measures.