Principles of Aseptic Technique II.docx

Principles of ASEPTIC Technique II Check the lettered phrase below that best answers or completes each question or statement. Reference number following each question refers to reference listed with the answers. To find the correct answers and references, refer to page number listed in the index....

Principles of ASEPTIC Technique II Check the lettered phrase below that best answers or completes each question or statement. Reference number following each question refers to reference listed with the answers. To find the correct answers and references, refer to page number listed in the index. 1\. Which are the potential sources for surgical infection: 1. circulating air, 2. patient's bronchial tree, 3. scrub team's hair, 4. patient's circulating blood, 5. instruments, 6. patient's and scrub team's skin? A. 1, 3, 5 B. All but 4 C. 1, 2, 4, 5 D. All of the above Correct answer: D. All of the above Explanation: All of the listed items, including the patient\'s circulating blood, are potential sources of surgical infection. Here\'s why each item is a potential source: Circulating air: Can carry airborne pathogens. Patient\'s bronchial tree: Can harbor respiratory pathogens that may be released during intubation or extubation. Scrub team\'s hair: Can shed bacteria or skin cells if not properly covered. Patient\'s circulating blood: While typically sterile, it can be a source of infection if the patient has a bloodstream infection (bacteremia or septicemia). Instruments: Can introduce pathogens if not properly sterilized. Patient\'s and scrub team\'s skin: Natural habitat for various microorganisms. The key point here is that even though blood is usually sterile, it can be a source of infection in some cases, which is why \"All of the above\" is the correct answer. This question highlights the importance of considering all potential sources of contamination in a surgical setting to maintain proper infection control. 2\. Which statement regarding the use of masks is false? A. Handle masks only by the strings B. They should be changed procedures C. Cross strings behind the head for better aeration D. Cloth or gauze masks are no longer acceptable for OR use Correct answer: C. Cross strings behind the head for better aeration Explanation: Crossing strings behind the head does not improve aeration and is not a recommended practice. Proper mask use involves securing it tightly to the face to prevent air leakage. The other options are correct practices for mask use in the operating room. 3\. The soaking of moisture through unsterile layers to sterile layers or vice versa is: A. Permeation B. Strike-through C. Fall out D. Denaturation Correct answer: B. Strike-through Explanation: Strike-through refers to the phenomenon where moisture penetrates through unsterile layers to sterile layers or vice versa. This can compromise the sterile barrier and potentially lead to contamination. 4\. Which statement concerning the use of boiling water as a sterilizing agent is false? A. It does not sterilize instruments B. Spores will withstand water boiling at 212ºF C. Minimum boiling period is 10 minutes D. Boiling points of water vary at different altitudes Correct answer: C. Minimum boiling period is 10 minutes Explanation: This statement is false because boiling water is not considered a sterilization method at all. It\'s a high-level disinfection method that doesn\'t reliably kill all spores. The other statements are correct, highlighting why boiling water is not an adequate sterilization method. 5\. The OR ventilating system ensures controlled air supply: \_\_\_\_\_\_\_\_\_\_\_\_ air exchanges per hour are recommended for infection control and a \_\_\_\_\_\_\_\_\_\_\_\_ percent humidity is mandatory to suppress static electricity. A. 25, 50 B. 15, 60 C. 20, 40 D. 30, 30 Correct answer: A. 25, 50 Explanation: For proper infection control in operating rooms, 25 air exchanges per hour are recommended. A 50% humidity level is considered optimal to suppress static electricity while not promoting microbial growth. 6\. Which draping principle is false? A. Always cuff drape over gloved hands B. Discard the drape if incorrectly placed C. Drape far side of nonsterile table first D. Points of towel clip through drape are contaminated Correct answer: C. Drape far side of nonsterile table first Explanation: This principle is false because when draping a nonsterile table, you should always start from the near side and work your way to the far side. This prevents reaching over the sterile field and potentially contaminating it. 7\. Which are not essential considerations in the design of an OR suite: 1. hospital size, 2. traffic control, 3. windows, 4. supply flow system, 5. top floor location, 6. central corridor? A. 1 and 5 B. 3, 5, 6 C. 2, 3, 4 D. All of the above are essential Correct answer: B. 3, 5, 6 Explanation: Windows, top floor location, and central corridor are not essential considerations in OR suite design. Traffic control and supply flow systems are crucial for maintaining sterility and efficiency. Hospital size may influence design but is not a critical factor in the OR suite itself. 8\. Which statement regarding sterile items is false? A. Discard every sterile package that falls to the floor B. Covered sterile setups may be used later in the day C. Sterile packages found in nonsterile workroom may not be used D. Do not use any item if uncertain about sterilizer timing Correct answer: B. Covered sterile setups may be used later in the day Explanation: This statement is false, which makes it the correct answer to the question \"Which statement regarding sterile items is false?\" The reason this statement is false is that covered sterile setups should not be used later in the day. Once a sterile setup is prepared, it should be used immediately or within a very short time frame. The longer a sterile setup remains unused, even if covered, the higher the risk of contamination. Here\'s why the other statements are true: A. Discard every sterile package that falls to the floor - This is true because items that fall to the floor are considered contaminated. C. Sterile packages found in nonsterile workroom may not be used - This is actually a true statement. Sterile packages can be used regardless of where they are stored, as long as the packaging is intact and not compromised. D. Do not use any item if uncertain about sterilizer timing - This is true because if there\'s any doubt about the sterilization process, it\'s safer to assume the item is not sterile. The key principle here is that sterile technique requires constant vigilance and a conservative approach to maintaining sterility. Using covered setups later in the day introduces unnecessary risk, as the sterile field could have been compromised without anyone noticing. 9\. When is the open glove technique preferred over the closed glove technique? A. When a scrub nurse self-gloves to set up B. Always, as it reduces chances of contamination C. To change a glove during a procedure D. Never Correct answer: C. To change a glove during a procedure Explanation: The open glove technique is preferred when changing a glove during a procedure because it allows for easier application without assistance while maintaining sterility. The closed technique is generally preferred for initial gloving due to lower risk of contamination. 10\. The first step in the decontamination process of instruments after a procedure should be: A. Hand scrubbing of soiled instruments B. Mechanical decontamination washer-sterilizer C. Sonic cleaning D. Rinsing in a detergent Correct answer: B. Mechanical decontamination washer-sterilizer Explanation: The first step in instrument decontamination should be mechanical cleaning, which removes gross soil and reduces the bioburden before manual cleaning or further processing. This reduces the risk of exposure to contaminated instruments for staff. 11\. Which antiseptic solutions are effective against both gram-negative and gram-positive microorganisms: 1. iodophors, 2. chlorhexidine gluconate, hexachlorophene, 4. alcohol? A. 1 and 3 B. 1 and 2 C. All but 4 D. All of the above Correct answer: B. 1 and 2 Explanation: Iodophors and chlorhexidine gluconate are effective against both gram-negative and gram-positive bacteria. Hexachlorophene is primarily effective against gram-positive bacteria, while alcohol, though broad-spectrum, is not typically classified as an antiseptic solution in this context. 12\. Which statement regarding sterile technique is false? A. Tables are sterile only at table level B. Contents of a sterile bottle, once opened, must be discarded C. Wrapper edges are considered unsterile D. Paper or peel-open packages are torn to expose contents Correct answer: D. Paper or peel-open packages are torn to expose contents Explanation: This statement is false. Paper or peel-open packages should be carefully opened along designated areas, not torn, to maintain the sterility of the contents. Tearing could introduce contaminants from the outer surface into the sterile field. 13\. Which is (are) used to check the effectiveness of sterilizers: 1. chemical indicator, 2. biological spore strip, 3. indicator strip, 4. recording thermometer? A. 1 and 2 B. All but 4 C. Only 2 D. All of the above Correct answer: C. Only 2 Explanation: The biological spore strip (option 2) is considered the most reliable and definitive method for checking the effectiveness of sterilizers. Here\'s why: Biological spore strips contain highly resistant bacterial spores (usually Geobacillus stearothermophilus for steam sterilization or Bacillus atrophaeus for ethylene oxide sterilization). These spores are more resistant to sterilization than most pathogens. When these spore strips are processed through a sterilization cycle and then cultured, they provide direct evidence of whether the sterilizer was able to kill even the most resistant microorganisms. This method is considered the \"gold standard\" for sterilizer monitoring because it directly tests the sterilizer\'s ability to kill microorganisms, rather than just measuring physical parameters. While the other methods mentioned (chemical indicators, indicator strips, and recording thermometers) are useful for monitoring aspects of the sterilization process, they don\'t directly confirm microbial kill: 14\. Which statement concerning ethylene oxide sterilization is false? A. Gas is highly flammable and explosive in air B. Polyvinyl chloride wrappers are recommended C. All porous materials are permeated in the process D. It takes longer than steam sterilization Correct answer: B. Polyvinyl chloride wrappers are recommended Explanation: This statement is false. Polyvinyl chloride (PVC) wrappers are not recommended for ethylene oxide sterilization because they can absorb the gas, leading to incomplete aeration and potential toxicity. Materials that allow gas permeation and evacuation are preferred. 15\. Predisposing factors that substantially increases the risk of infection are: 1. duration of operation, 2. invasive monitoring techniques, 3. indiscriminate use of antibiotics, 4. gastrointestinal surgery, 5. prosthetic devices. A. 1, 4, 5 B. All but 3 C. 1, 2, 4 D. All of the above Correct answer: D. All of the above Explanation: All listed factors can increase the risk of surgical site infections. Longer operations increase exposure time, invasive monitoring can introduce pathogens, antibiotic misuse can lead to resistant bacteria, gastrointestinal surgery involves potential contamination, and prosthetic devices provide surfaces for bacterial colonization. 16\. An area of a gown considered sterile is (are) the \_\_\_\_\_\_\_\_\_\_\_\_, while the \_\_\_\_\_\_\_\_\_\_\_\_ is (are) considered unsterile. A. Sleeves, neck B. Back of wrap-around gown, axillae C. Shoulders, area below table level D. Neck, damp area Correct answer: A. Sleeves, neck Explanation: The sleeves of a surgical gown are considered sterile, while the neck area is considered unsterile. The sterile area typically extends from the chest and shoulders to the level of the sterile field, with the back and neck being non-sterile. 17\. Which is the major source of contamination in the operating room? A. Circulating air B. Patient\'s respiratory tract C. Patient\'s skin D. Personnel Correct answer: D. Personnel Explanation: Personnel are considered the major source of contamination in the operating room. The movement, talking, and potential breaks in sterile technique by staff members pose the greatest risk for introducing microorganisms into the sterile field. 18\. Which is (are) not effective method (s) of disinfection in an operating room: 1. mercurial compounds, 2. iodophors, 3. fogging, 4. formaldehyde, 5. phenolic compounds? A. Only 1 B. 4 and 5 C. 1 and 3 D. All of the above Correct answer: C. 1 and 3 Explanation: Mercurial compounds are no longer used due to toxicity concerns, and fogging is not considered an effective method of OR disinfection. Iodophors, formaldehyde, and phenolic compounds are still used in various disinfection applications. 19\. Which statement concerning pathogenic Streptococci species of microorganism is false? A. Primary source is the human respiratory tract B. They are non-sporeformers C. Steam under pressure easily destroys them D. They are gram-negative, nonmotile organisms Correct answer: D. They are gram-negative, nonmotile organisms Explanation: This statement is false. Streptococci are gram-positive, not gram-negative organisms. They are indeed non-sporeformers, primarily found in the human respiratory tract, and are easily destroyed by steam under pressure. 20\. The preferred method of sterilization for heat-sensitive items and anesthesia equipment when EO sterilization is impractical is soaking in: A. Benzalkonium chloride B. Activated glutaraldehyde C. Ethyl alcohol D. Aqueous solution of formaldehyde Correct answer: B. Activated glutaraldehyde Explanation: Activated glutaraldehyde is the preferred method for sterilizing heat-sensitive items when ethylene oxide (EO) sterilization is not practical. It provides high-level disinfection and sterilization for items that cannot withstand heat sterilization methods. 21\. Which is considered a disadvantage in use of muslin as wrapper material for sterile packs and items? A. It is memory-free B. It must be laundered to rehydrate C. It can be reused D. Small holes can be heat sealed Correct answer: B. It must be laundered to rehydrate Explanation: The need to launder muslin to rehydrate it is a disadvantage. This process is time-consuming and can potentially introduce contamination if not done properly. The other options are actually advantages of using muslin as a wrapper material. 22\. Which statement regarding hexachlorophene as an antiseptic solution is false? A. A cumulative suppressive action develops with routine use B. It is neutralized by alcohol C. It is ineffective against gram-negative organisms D. It is soluble in water Correct answer: D. It is soluble in water Explanation: This statement is false. Hexachlorophene is not readily soluble in water; it requires an emulsifying agent to create a solution. The other statements about its properties and effectiveness are correct. 23\. Completely unwrapped items may be sterilized in a flash sterilizer at \_\_\_\_\_\_\_\_\_\_\_\_ pounds of pressure, \_\_\_\_\_\_\_\_\_\_\_\_ degrees F, for \_\_\_\_\_\_\_\_\_\_\_\_ minutes A. 15, 250, 5 B. 27, 270, 3 C. 18, 200, 10 D. 20, 150, 8 Correct answer: B. 27, 270, 3 Explanation: Flash sterilization for unwrapped items typically uses higher pressure and temperature for a shorter time. The parameters of 27 pounds of pressure at 270°F for 3 minutes are standard for flash sterilization of unwrapped items. 24\. The foundation for the practice of strict aseptic and sterile technique is: A. A surgical conscience B. Patient safety C. Standardization of principles D. Infection control Correct answer: A. A surgical conscience Explanation: A surgical conscience, which refers to the ethical commitment to maintaining aseptic technique at all times, is considered the foundation for strict aseptic and sterile technique. It encompasses the personal responsibility and accountability of each team member to adhere to sterile principles. 25\. Factors that have adverse affects on the shelf life of sterile items include: 1. open cabinets, 2. high temperature, 3. dust covers, 4. extremes in humidity, 5. heat-sealed packaging. A. 2 and 5 B. all but 3 C. 1, 2, 4 D. All of the above Correct answer: C. 1, 2, 4 Explanation: Open cabinets (1), high temperature (2), and extremes in humidity (4) can adversely affect the shelf life of sterile items. Dust covers (3) actually protect items and extend shelf life, while heat-sealed packaging (5) is a method used to maintain sterility for longer periods.