Sterilization and Disinfection

based on what you have learned about surgical implants, Match the implant with the type of surgery in which it is used. 1. Teflon and Dacron patches 2. Stapedectomy prostheses 3. Synthetic mesh 4. Ventriculoatrial shunts 5. scleral buckles/bands A. ENT B. General C. Neuro D. Ophthalmic E. Cardiovascular

1. Teflon and Dacron patches - E. Cardiovascular 2. Stapedectomy prostheses - A. ENT 3. Synthetic mesh - B. General 4. Ventriculoatrial shunts - C. Neuro 5. scleral buckles/bands - D. Ophthalmic

match the automated cleaning or decontamination device with its description 1. ultrasonic cleaner 2. washer decontaminator/disinfector 3. washer/ sterilizer A. process instruments through several cycles. instruments are not considered prepared for subsequent use B. allows hands-free processing. renders instruments safe for handling C. removes fine debris though cavitation

1. ultrasonic cleaner - C. removes fine debris though cavitation 2. washer decontaminator/ disinfector - B. allows hands-free processing. renders instruments safe for handling 3. washer/ sterilizer - A. process instruments through several cycles. instruments are not considered prepared for subsequent use

which of the following statements about ethylene oxide (EO) sterilization is true? A. EO exposure is potentially carcinogenic and mutagenic to personnel and patients B. it cannot be used for heat-sensitive items C. it is effective against prions D. items processed by EO sterilization may used immediately

A. EO exposure is potentially carcinogenic and mutagenic to personnel and patients

match each class of surgical wound with the appropriate example class I, II, III, IV A. Gastrectomy B. compound fracture C. perforated viscera D. Hernia surgery

A. Gastrectomy Class II B. compound fracture Class III C. perforated viscera class IV D. Hernia surgery Class I

items that enter sterile tissue or the vascular system are categorized as ______ and should be sterile when used A. critical B. semicritical C. noncritical D. non of the above

A. critical

according to the AORN guideline for sterilization, which of the following work areas requires all of the following attire: scrubs, head covers, gloves, gowns, eye protection and masks or face shields A. decontamination B. preparation and packaging C. sterilization processing D. sterile storage

A. decontamination

disassembly, cool water rinse, enzymatic wash and use of appropriate detergent are principles used in: A. decontamination B. steam sterilzation C. high-level disinfection D. gas plasma sterilzation

A. decontamination

all instruments opened in the operating or procedure room should be decontaminated except for those that were not used A. True B. False

B. False

in which wound category should a total abdominal hysterectomy be classified? A. clean B. clean contaminated C. contaminated D. dirty

B. clean contaminated

based on what you have learned about the assembly process, is the following statement true or false? during the assembly process, instruments should be placed in a specifically designed container that restricts the penetration of the sterilizing agent and prevent the trapping of air. A. true B. false

B. false during assembly, instruments should be arranged in sets and placed in a tray with a mesh or perforated bottom or specially designed container that permits the penetration of the sterilizing agent and prevents the trapping of air

in order to achieve environmental and microbial control between decontamination and sterilization areas functional workflow patterns should establish __________ and vented airflow to the outside that will minimize potential contamination of processed items A. elevated room temperature B. physical separation C. traffic patterns D. the amount of bioburden

B. physical separation

an integrator is a multiparameter indicator designed to measure which of the following parameters? A. pressure, steam and temperature B. temperature, time and presence of steam C. pressure and sterility

B. temperature, time and presence of steam

ineffective cleaning and the amount of bioburden negatively affect the process of sterilzation. the process of sterilization is also negatively affected by_______ A. an instrument tray weighing 20 pounds B. the number, type, and resistance of microorganisms C. soaking of instruments in cleaning solution prior to decontamination D. all of the above

B. the number, type, and resistance of microorganisms

immediate-use steam sterilization can be used: A. for implants B.in urgent situations C. under no circumstances D. for all items

B.in urgent situations

low temperature gas plasma hydrogen peroxide sterilization has which of the following A. accommodates lumened instruments B. exhaust monitoring is required C. items can be stored for future use D. no toxic residue E. the sterilant is bactericidal, virucidal and fungicidal F. useful for items that are heat sensitive

C. items can be stored for future use D. no toxic residue E. the sterilant is bactericidal, virucidal and fungicidal F. useful for items that are heat sensitive

after completion of the steam sterilization cycle, wrapped, sterilized items should be: A. placed on metal table until cooled B. used immediately C. left untouched to cool for 30 to 60 mins D. left untouched to cool for 15 to 30 mins

C. left untouched to cool for 30 to 60 mins. until they have cooled to room temp

the use of peracetic acid on surgical items requires the following considerations. A. items can be stored for future use B. items must be aerated C. items can withstand high tempertaures D. items must be isolated for 7 days E. items must be immersible

E. items must be immersible

based on what you have learned about the basic principles of decontamination, is the following statement true or false? Cooked-on dirt is considered as sterile dirt and hence ignored during the decontamination process

False. cooked on dirt is not considered sterile dirt

because the process of chemical disinfection destroys blood, tissue, and mucous, there is no need to decontaminate used surgical instruments before chemical disinfection. True or false

False. items should be thoroughly cleaned and decontaminated before disinfection. debris, blood, mucous, and tissue will interfere with the action of the disinfectant.

Based on what you have learned about the sterile and aseptic practices, is the following statement true or false? sterile technique is defined as "comprises methods which are designed to exclude all microbes."

False. sterile technique is the use of specific actions and activities to prevent contamination and maintain sterility of identified areas during operative or other invasive procedures.

based on what you have learned about classification of wounds, identify the category in which acute appendicitis or cholecystitis is classified. A. class I - clean wounds B. class II - clean contaminated wounds C. class III - contaminated wounds D. class IV - dirty or infected wounds

class III - contaminated wounds acute inflammation of any organ with out frank pus present such as acute appendicitis or cholecystitis is classified as a class III - contaminated wound

list the properties of low-temperature gas plasma hydrogen perozide sterilization.

items can be stored for future use no toxic residue the sterilant is bactericidal, veridical, and fungicidal useful for items that are heat sensitive

explain the difference between sterile technique and aseptic practices

sterile- the absence of all living microorganism aseptic- absence of all pathogenic microorganisms

complete sterilization in ethylene oxide is dependent upon four primary variables: proper time, gas concentration, temperature and: A proper packaging B. aeration C. chamber humidity D. pressure

C. chamber humidity 45-75%

which of the following is NOT a goal of sterile technique and aseptic practices? choose the best answer A. minimize the length of recovery from surgery B. optimize primary wound healing C. create a surgical conscience D. prevent a surgical site infection

C. create a surgical conscience

appropriate methods for function testing of devices should be obtained from the _____ A. biomedical department B. recommended practices C. device manufacturer D. person in charge

C. device manufacturer

based on what you have learned about ethylene oxide sterilization, complete the following sentence. complete sterilization in ethylene oxide is dependent upon four primary variables: proper time, humidity, temperature and: A. proper packaging B. aeration C. gas concentration D. pressure

C. gas concentration

per the spaulding classification system, critical items include instruments or objects that are: A. in contact with mucous membranes B. in contact with patient's unbroken skin C. introduced into the human body D. which are out of the sterile field

C. introduced into the human body critical items include instruments or objects that are introduced into the human body, either into or in contact with the blood stream or normally sterile areas of the body

Based on what you have learned about chemical indicators, match the indicator type with its description: 1. Class 1 2. Class 2 3. Class 3 4. Class 4 5. Class 5 6. Class 6 A. integrating>>reacts to all critical parameters over a specific range of sterilization cycles; performance has been correlated to the performance of the stated test organism under labeled conditions of use B. Emulating>>reacts of all of the critical parameters of a specific cycle C. Reacts to two or more of the critical parameters of sterilization D. Bowie-dick>>detects air leaks, ineffective air remove, and presence of non condensable gases; used in dynamic air removal sterilizers E. Demonstrates that the package has been exposed to the sterilization process to distinguish between processed and unprocessed packages F. Process indicator that reacts to a single parameter of the sterilization process

1. Class 1 - E. Demonstrates that the package has been exposed to the sterilization process to distinguish between processed and unprocessed packages 2. Class 2 - D. Bowie-dick>>detects air leaks, ineffective air remove, and presence of non condensable gases; used in dynamic air removal sterilizers 3. Class 3 - F. Process indicator that reacts to a single parameter of the sterilization process 4. Class 4 - C. Reacts to two or more of the critical parameters of sterilization 5. Class 5 - A. integrating>>reacts to all critical parameters over a specific range of sterilization cycles; performance has been correlated to the performance of the stated test organism under labeled conditions of use 6. Class 6 - B. Emulating>>reacts of all of the critical parameters of a specific cycle

Match each term with the appropriate definition A. disinfection B. decontamination C. sterilization D. high level disinfection 1. the use of physical or chemical means to remove, inactivate, or destroy blood borne or other pathogens on a surface or item 2. the process of destroying all microorganisms on a substance by exposure to physical and chemical agents; the complete elimination of all forms of microorganisms 3. a process that destroys all microorganisms with the exception of high numbers of bacterial spores 4. a chemical or physical process of destroying all pathogenic microorganisms, except spores, on inanimate objects

A. disinfection - 4. a chemical or physical process of destroying all pathogenic microorganisms, except spores, on inanimate objects B. decontamination - 1. the use of physical or chemical means to remove, inactivate, or destroy blood borne or other pathogens on a surface or item C. sterilization - 2. the process of destroying all microorganisms on a substance by exposure to physical and chemical agents; the complete elimination of all forms of microorganisms D. high level disinfection - 3. a process that destroys all microorganisms with the exception of high numbers of bacterial spores

shelf life is related to: A. exposure to external events B. methods of sterilization C. materials D. number of personnel who may handled the package E. time from initial sterilzation

A. exposure to external events C. materials D. number of personnel who may handled the package

based on what you have learned about the peracetic acid sterilization, identify the facts which are true regarding peracetic acid sterilization A. it is a liquid chemical sterilization method B. it uses low temperatures C. it is equal in efficacy to steam and ethylene oxide (EO) sterilization D. it requires the use of a special unit designed for this type of sterilization E. it can be used for all surgical items

A. it is a liquid chemical sterilization method B. it uses low temperatures C. it is equal in efficacy to steam and ethylene oxide (EO) sterilization D. it requires the use of a special unit designed for this type of sterilization

packaging systems should: A. permit sterilization to take place B. maintain sterility for a limited period. C. be structured to provide for aseptic delivery of contents onto the sterile field D. be compatible with the sterilization process E. be used according to the manufacturer's written instructions

A. permit sterilization to take place C. be structured to provide for aseptic delivery of contents onto the sterile field D. be compatible with the sterilization process E. be used according to the manufacturer's written instructions

based on what you have learned about prion disease, identify the facts that are true about prions. A. prions are not bacteria or viruses but rather malformed proteins B. creutzfeldt-jakob disease (cjd) is a generative neurologic disease that appears to be caused by prions C. prions appear to be resistant to most forms of sterilization used in health care settings D. prions appear to have a marked vulnerability towards moist heat

A. prions are not bacteria or viruses but rather malformed proteins B. creutzfeldt-jakob disease (cjd) is a generative neurologic disease that appears to be caused by prions C. prions appear to be resistant to most forms of sterilization used in health care settings

Surgical conscience demands the recognition of improper practices observed during surgery by: A. the surgeon B. the anesthesiologist C. the perioperative nurse D. any member of the health care team

D. any member of the health care team

scrub attire, head cover, gloves, f=gowns, eye protection, and masks or face shields must be worn in which of the following work areas? A. sterilization processing B. preparation and packaging C. sterile storage D. decontamination

D. decontamination

during the decontamination process, any soil left on an item will act as a barrier between the item and the sterilant. coagulated protein may cover and protect bacteria from coming in contact with the sterilizing agent. which of the following may help remove debris on items heavily soiled with dried on protein? A. warm water rinse B. automated wash C. appropriate detergent D. enzymatic wash

D. enzymatic wash

Risk factors which contribute to postoperative infection include all below except for: A. age B. nutritional status C. length/type of surgery D. ethnicity E. surgical technique

D. ethnicity

while all prion diseases are infectious, infectivity is based primarily on laboratory studies of different prion dieases in humans and animals. central nervous system tissue ( brain, spinal cord, pituitary) has been shown to be highly infectious. which of the following has also been shown to be highly infectious ( as opposed to a lower level of infectivity or no infectivity)? A. skeletal muscle B. heart muscle C. Feces D. optic nerve

D. optic nerve

a packaging system for items undergoing sterilization should possess which of the following characteristics? A. compatible with all sterilization processes B. made of only disposable materials C. maintains sterility of the items for a specific length of time D. permits aseptic delivery of contents to the sterile field

D. permits aseptic delivery of contents to the sterile field