FINAL EXAM: EXTRA QUESTIONS
When using the sequential wrapping method
Apply one wrapper followed by the second one
A coronary artery bypass surgery may be performed on patients with
Arteriosclerosis
A technician working in decontamination notices that the maintenance person working on the washer sterilizer did not remove the barrier attire when the person left the area to get additional tools. The technician should
Ask the maintenance person to remove the barrier attire when leaving the area
300 series stainless steel is also called
Austenitic
Outside shipping cartoons should NOT be brought into the SPD because they are often
Biologically contaminated
You are taking a used IV pump from a nursing unit to be reprocessed. The nurse tells you not to take it because there is an emergency admission and the patient will need it. What is ethically correct thing to do?
Call the department to have a clean pump brought to the unit right away
What would you do if a loaner set came into receiving the evening and the surgery will be performed at 7:30 am the next morning and the carrier did not bring the instructions for use?
Call the loaning facility and ask them to fax or email the instruction for use
Loose fitting clothing, jewelry should not be worn in SPD because it
Can get caught in moving equipment
What are some critical medical devices
Catheters, surgical instruments, needles
The EO biological test pack is placed
Center of the load (geometric)
Material Safety Data Sheet (MSDS) provide health and safety hazard and risk of information
Chemical
A staff member brings several contaminated trays to SPD on a cart and request that replacement trays be put on the same cart. The technician should
Clean and dry the transport cart and send it to distribution for the trays
An acceptable method of decontaminating an item that has been used on a patient is to
Clean with detergent solution and then use an appropriate disinfection agent
Supplies contaminated with blood and body fluids that require sterilization should be
Clean, dried and passed on the processing area for assembly, packaging and sterilization
Which of the following BEST describes the manual cleaning process of surgical instruments?
Cleaning and brushing the instrument beneath the water level
This organism is part of the normal flora of intestines but when a person started taking antibiotic the drugs alter the flora causing the organism to produce toxins in the colon, colitis and severe diarrhea. What is it?
Clostridium difficile
Which of the following is MOST efficient and cost-effective method in inventory control in the SPD ordering and data generation?
Computerized inventory control systems
What is the primary reason that the items are allowed to cool on a sterilizer cart before being placed in the storage?
Condensation and contamination may result if items are moved to cooler areas when they are still warm
The effectiveness of any chemical disinfection process depends on
Contact time, Concentration of the solution and Temperature of solution
High risk instrument set for prion processing
Craniotomy Set
Instruments used on patients with CJD
Decontaminated
You are wearing a scrub coat or lab coat. Where can you not go to?
Decontamination
What are the major physical areas of a typical SPD?
Decontamination, Assembly and Sterile Processing, Sterile Storage and Distribution
Which of the following generally describes the current sequence for the traffic workflow in areas in which medical devices are processed?
Decontamination, assembly, packaging, sterilization, sterile storage
Manual cleaning endoscopes should be
Deep and large enough to completely submerge the endoscope
What distribution system are requisitions filled and delivered as they are received?
Demand distribution
Every healthcare facility has an organizational structure or chart that outlines
Departmental authority relationships
A positive biological indicator test shows that the sterilization process
Did not result in the death of all the test organism
What is the first step in cleaning laparoscopic instruments?
Disassemble parts
Which of the following sterilization methods would be appropriate for petrolatum gauze
Dry heat
What would approve the disinfectants used on floors and walls in the sterile processing and distribution department?
EPA
All agencies are involved with the regulation and control of EO when it is used as a sterilant are
EPA, FDA, OSHA
Lot control numbers are used to
Enable recall following sterilization failure
PAR inventory level is also known as
Fixed inventory level
How do you kill microorganism (LTGP)
Free radicals
EtO penetration of bacterial cells (critical)
Humidity
You receive a cell phone text message from your friend while you are assembling instrument sets which of the following is the BEST action to take
Ignore the text until you are on break
"Inventory performance" is evaluated by
Inventory turnover, Percent of back orders, Availability of critical items
There are 2 pressure gauges on a steam sterilizer. These gauges measure the
Jacket and the chamber
In this system, the healthcare facility's stock keep minimal on hand and supplies are delivered when needed, usually just prior to use
Just in time
Instrument set to remove a gall bladder
Laparoscopic cholecystectomy
When lifting heavy objects which of the following muscles should bear most of the weight?
Leg
Which of the following would be an action to take if you note that a co-worker has hair hanging out of his or her surgical cap while assembling sets
Let him or her to know the hair is visible
The tech is asked to remove an arthroscopy set from the aerator 4 hours prior to completion of aeration time. The supervisor is not available. What should the tech do?
Let the set complete aeration cycle and borrow a set from another hospital
Detergent for orthopedic instruments
Lipolytic enzymatic
Cotton gauze cannot be used in which sterilizer
Low temperature gas plasma (LTGP)
If the operating room request instruments for an emergency ruptured aortic aneurysm the tech should send
Major vascular instruments
Steps in reprocessing flexible endoscope
Manual pre-clean, leak test, manual clean, HLD
400 series stainless steel is also called
Martensistic
What PPE will be the last one to be removed
Mask
Clamps used for hemostasis are also designed to
Minimize damage to tissue
Nerves are divided into two parts. One carry messages from the brain to organs and muscles and the other carry info to the brain
Motor and sensory nerve
The pH of the detergent solution that has been demonstrated to be the safest for cleaning surgical instrument is
Neutral
What regulates EtO?
OSHA, EPA, FDA
A newly sterilized surgical instrument set is to be placed at sterile storage's shelves, where do you store the set?
On the back of stored items
Surgical grade instruments, if properly cared for, usually last longer than floor grade instruments because they have a
Passivation layer
Perforated wire mesh tray placed flat in the sterilizer cart to
Permit air removal and steam penetration
This gland coordinates all the activities of the endocrine system and also known as "master gland"
Pituitary gland
When transporting sterile packaged items by hand
Place in a plastic bag or tote bin
A broken glass suction bottle is returned to decontamination should the technician do?
Place it in an appropriate rigid container
When a steam sterilizer is loaded with linen packs only, the packs should be
Placed on their edges
A bowie-dick test should be performed in what type of sterilizer
Pre-vacuum steam (dynamic air removal)
There are 3 sinks. What is the use of the middle sink?
Preliminary rinsing
What is necessary to attain the highest temperature needed in a steam sterilizer?
Pressure
Warm-up jacket are recommended to be worn in the preparation and packaging area for the purpose of
Preventing bacterial shedding from bare arms
In ambulatory surgery centers where there are no separate decontamination and preparation/packaging/sterilization areas. How do you keep from cross-contamination?
Procedural barriers
Factor for assigning an expiration date to a product
Product degradation
After you clean and disinfect laryngoscope using high level disinfectant. What do you have to do with the "paddles"?
Protect them from damage
The function of gastrointestinal system is to
Provide the body with nutrients
Sterilizer cannot print what will you do with the load?
Quarantine(enforced isolation) the load and report to your supervisor
Bacteriostatic solution used on surfaces and floors
Quarternary Ammonium Compounds
What kind of energy is used on Hydrogen Peroxide to create a Gas Plasma in LTGP sterilizer?
Radio frequency (RF)
You are in a hurry to leave for a doctor's appointment and you forget to punch your timecard. What action should be taken?
Report this to your supervisor the next day
Plastic sterilization bags are generally used to package
Respiratory therapy items
When preparing the instruments for processing the instruments should be positioned
Retractors on the bottom of the basket and the handheld instruments on the top
While delivering sterile supplies to multiple units, the SPD technician is asked by a unit secretary to an opened and used tray of instruments back to the SPD's decontamination area. What is the BEST procedure to use?
Return the used tray after completing all deliveries, using the appropriate collection cart
What kind of endoscope would a surgeon use for nasal surgery?
Rhinoscope
A tray of instruments has been brought to the decontamination area in a saline solution. What action should the tech take?
Rinse them with water and them clean them in the usual manner.
Applying PPE order
Show covers, Gown, Mask, Goggles/Face Shield, Gloves
When 2 similar basins with different sizes and nesting directly to each other. What is the best reason why basin should have a non-linting absorbent material in between them?
So that steam can penetrate adequately if metal basins are nested directly in other metal basin
If it is not possible to wash contaminated instruments immediately after use, they should be kept moist by
Spraying with an enzymatic foam, covering them with a towel moistened with water and placing them in a plastic bag
To kill the remaining microorganisms on metal surgical instruments within the SPD, the MOST cost-efficient sterilization method is generally considered to be
Steam under pressure
When heat is added to steam without increasing the moisture content, the steam is called.
Superheated steam
Containerized packaging systems are MOST commonly used to protect which of the following during steam sterilization
Surgical instrument sets
A co-worker is observed taking dressing supplies for use at home. What would be the FIRST action to take?
Tell him or her that this is not the right thing to do
Why is the routine biological testing of a flash sterilizer performed in an empty chamber?
The empty chamber presents a greater challenge to the biological indicator
Before releasing an item to fill a sterile supply order, what needs to be checked?
The expiration date, package damage, verification of chemical indicator
Controlled temperature and humidity, limited traffic
The general environmental conditions of SPD sterile storage
Which of the following is the MOST important factor in preventing bacteria from contaminating sterile packages
The handling of packages
What is the main DISADVANTAGE of using rigid sterilization container system?
They must be disassembled, processed, reassembled and checked before each use.
Effective sterilization begins with
Thorough cleaning
The first step to inspect the insulation of a laparoscopic instrument is to
Try to slide the insulation back
What is a factor affecting the dry time in a steam sterilizer
Type of packaging, weight of the sets, configuration of the load
A nosocomial infection can be prevented by
Using proper hand washing techniques, maintaining barriers to contamination and follow established isolation procedures
If a technician skin is exposed to liquid EO, what should the technician do FIRST?
Wash the exposed area with a large amount of soap and water
An instrument dropped after a HLD glutaraldehyde
Wash, rinse and disinfect
When working in the decontamination area, transmission of pathogenic organisms from used surgical instruments can BEST be minimized by
Wearing appropriate PPE
The sterility maintenance covers should be placed on sterile items
When the sterilized items cool to room temperature
Inspection and verification of adequate cleaning is difficult with instruments
With lumens
When a steam sterilizer load contains a mixture of fabric and metal items, the items should be placed?
With the metal items below the fabric items
Dirty to Clean is an SPD term to describe
Work Flow
When to remove the dust cover?
at the point of use
Which of the following scissors is designed to have the sharpest cutting edge?
black handled
When cleaning the IV pump, it is important to use a germicide on the pump surface in order to
reduce the bioburden present in the equipment
After manually cleaning contaminated surgical instruments with an disinfectant solution, the NEXT step in the decontamination process is
rinsing
Lot control numbers should be placed on each packaged sterilized, and on the
sterilization load record
Drains in pre-vacuum and gravity displacement sterilizers are placed at the bottom front of the sterilizers because
the air tends to concentrate at the bottom of the chamber
The following steps in the hand washing is
-Rotational rubbing palm, finger -Wetting hands, with water and soap -Turned off faucet using disposable towel
Exposure time for Ortho-phthalaldehyde (CIDEX OPA)
12 minutes
Temperature to incubate spores (LTGP)
131 F- 140 F
CJD case cycle for processing
18 minutes, 273 degrees, pre vac cycle
Which of the following solution is generally considered MOST appropriate for high level disinfections of semi-critical devices
2% activated glutaraldehyde
Change sharp container when (OSHA)
2/3 full
Which of the following would be the appropriate sterilization cycle for an autoclave load containing basin set, a minor surgery set and 12 towel packs?
270 F (132 C) for 4 mins 30 psi and 30min drying time
How much weight should be the limit of a basin set
7lbs
All of the following items of PPE should be worn when manually decontaminating flexible fiber optics endoscopes EXCEPT
A lead apron
Simultaneous wrapping means to wrap an instrument set
A single non-woven wrapper, double-ply, bonded at the edges
A patient contracts an infection from an improperly sterilized surgical instrument. This is an example of?
A vector transmission
Acrylic nails are not permitted to be worn in preparation and packaging because they can
Allow fungus to grow beneath them
How do you neutralize glutaraldehyde?
Ammonia, sodium bisulfate and glycine
An instrument tray for a laparotomy procedure must include
An abdominal retractor
Generally the first step in loosening blood soils from the channels of an instruments is to soak it in
An enzymatic detergent
