BUMEDINST 6600.10, Dental Infection Control Program

Question 1

Each year, approximately how many health care workers become infected with the Hepatitis B virus (HBV)?

Answer 1

18,000

Question 2

The CDC estimates that HBV infection in health care personnel actually results in some 600 hospitalizations and how many deaths annually?

Answer 2

200

Question 3

Commanding officers and officers in charge must develop and implement universal protocols of infection control strategies to prevent transmission of HBV and other pathogens of what type?

Answer 3

Bloodborne pathogens

Question 4

The ability of HBV to survive in the environment, coupled with its high titers in the blood, makes it an excellent model for which practices?

Answer 4

Infection control

Question 5

COs and OICs must appoint who in writing to assist in implementing the infection control program?

Answer 5

Infection Control Office (ICO)

Question 6

Infection control involves taking steps to prevent the spread of what?

Answer 6

Infectious agents

Question 7

What is the process of preventing the access of micro-organisms?

Answer 7

Asepsis

Question 8

The use of rubber, plastic, paper, foil, or other fluid resistant materials to cover surfaces and protect them from contamination is known as what technique?

Answer 8

Barrier technique

Question 9

What is the number of micro-organisms contaminating an object and is sometimes also known as bioload or microbial load?

Answer 9

Bioburden

Question 10

What is an unprocessed biological monitor from the same lot as the test monitor and when cultured serves as a control by verifying the viability of the unexposed organisms?

Answer 10

Biological control

Question 11

What is a bacterial endospore test designed assess whether sterilization has actually occurred?

Answer 11

Biological monitor

Question 12

What are pathogenic micro-organisms that are present in human blood and capable of causing disease in humans?

Answer 12

Bloodborne pathogens

Question 13

What test is a diagnostic test of a prevacuum sterilizer’s ability to remove air from the chamber and prevent air reentrant?

Answer 13

Bowie-dick

Question 14

What is the destruction of inhibition of most viruses and bacteria while in their active growth phase?

Answer 14

Chemical disinfection

Question 15

What are chemical dyes used to determine whether the conditions required for sterilization are met?

Answer 15

Chemical indicators

Question 16

The presence or reasonably expected presence of blood or other potentially infectious material on an item or surface is said to be what?

Answer 16

Contaminated

Question 17

What is the propagation and growth of micro-organisms or living tissue cells in or on a nutrient medium?

Answer 17

Culture

Question 18

Dental items are classified in one of three ways, based on the pathways through which cross contamination may occur and the location and technique of instrument use. They are what?

Answer 18

Critical
Semi-critical
Non-critical

Question 19

What items are instruments, and materials that penetrate the skin, mucous membranes, or bone?

Answer 19

Critical

Question 20

What items are instruments, equipment, or materials that frequently contact mucous membrane but cannot be sterilized due to their design or inability to withstand heat?

Answer 20

Semi-critical

Question 21

What items are instruments, equipment, or materials that do not normally penetrate or contact mucous membranes but which are exposed to splatter, spray, or splashing of blood, or are touched by contaminated hands?

Answer 21

Non-critical

Question 22

What are equipment or methods which isolate or remove bloodborne pathogens from the workplace?

Answer 22

Engineering controls

Question 23

A surgical entry into the tissues, cavities, organs or repair of major traumatic injuries is what type of procedure?

Answer 23

Invasive

Question 24

Bacteria, fungi, viruses, and bacterial spores are classified as what?

Answer 24

Micro-organisms

Question 25

An infection originating in the environment of a hospital or freestanding dental treatment facility is a what?

Answer 25

Nosocomial infection

Question 26

What is a process which uses steam heat under pressure for sufficient length of time to kill all forms of micro-organisms?

Answer 26

Saturated steam sterilization

Question 27

What is an acceptable method of cleaning and disinfecting?

Answer 27

Spray-wipe-spray

Question 28

The process which destroys all types and forms of micro-organisms is called what?

Answer 28

Sterilization

Question 29

The quantity of materials or supplies required to treat a single patient is called what?

Answer 29

Unit dose

Question 30

The ICO must ensure that infection control functions are addressed at least how often as part of the command quality assurance program?

Answer 30

Quarterly

Question 31

The ICO must review and revise all infection control policies and procedures at least how often?

Answer 31

Annually

Question 32

The ICO must include a briefing in the command orientation for all new employees and staff on infection control policies and infectious disease hazards in the workplace per what instruction?

Answer 32

BUMEDINST 6010.13

Question 33

Who directs continuous review and upgrade of the sterilization and infection control syllabus at the Naval School of Dental Assisting and Technology (NSDAT) for the dental technician, basic "A" school?

Answer 33

BUMED

Question 34

Commands must review and upgrade their staff and new employee orientation presentation as directed. As a minimum, all personnel will receive initial training within how many days of reporting onboard and at least annually thereafter?

Answer 34

90

Question 35

All personnel assigned duties in sterilization areas or functioning as surgical assistants will receive additional documented training in sterilization and what other techniques?

Answer 35

Aseptic

Question 36

Commands must document infection control training sessions with names of persons attending and conducting, dates, and a summary of the contents of the training and mush maintain these records for at least how many years?

Answer 36

3

Question 37

Commands must use what, through the appropriate chain of command, to identify total resources required to meet the guidelines of this directive and those of OHSA and EPA?

Answer 37

PPBS

Question 38

A period of up to how long often exists between the time a person becomes infected with a virus and the time when laboratory tests can detect the antigens or antibodies to it?

Answer 38

Several weeks

Question 39

Approximately what percentage of patients with HIV or HBV show no symptoms and may be unaware of their infectious disease state?

Answer 39

80%

Question 40

The same infection control practices must be used with all patients regardless if they show symptoms or not and this approach is known as what?

Answer 40

Universal precautions

Question 41

Since what infection is presently the standard model for infection control practices and is more infectious than HIV, those established procedures known to prevent the spread of it serve as the basis for universal precautions?

Answer 41

HBV

Question 42

Which instruction mandates that all active duty health care personnel receive HIV testing on an annual basis during each calendar year?

Answer 42

SECNAVINST 5300.30C

Question 43

Since washing increases the porosity of gloves up to what percent, repeated use of a single pair of gloves is not permitted?

Answer 43

60%

Question 44

What must have solid side shields to provide maximum protection?

Answer 44

Eyewear or goggles

Question 45

What particles can remain airborne long after a procedure is completed, making it so staff and patients must not eat or drink in the DTRs?

Answer 45

Aerosol

Question 46

At the beginning of each work day when preparing the DTR, flush each of the unit water lines and hoses for at least how long, beginning with the cup filler and cuspidor even if their use is not anticipated?

Answer 46

1 minute

Question 47

When preparing the DTR after each patient, remove the handpiece, lubricate and run for how long?

Answer 47

30 seconds

Question 48

Dental procedures usually generate aerosol particles that average how many microns in diameter?

Answer 48

1.3

Question 49

When inhaled, particles less than how many microns in diameter can penetrate directly to the terminal bronchioles and alveoli of the lungs?

Answer 49

5

Question 50

Having patients brush their teeth or rinse with a mouthwash before treatment reduces the microbial concentration of their oral flora. Three 10 second rinses will temporarily reduce a patient's microbial count by up to what percent?

Answer 50

97%

Question 51

Use of a chlorhexidine gluconate preoperative rinse of what percentage significantly decreases the infectivity of an aerosol?

Answer 51

0.12%

Question 52

Using opened, properly decanted irrigation solutions is acceptable for up to how long when used for nonsurgical use?

Answer 52

1 week

Question 53

Using opened, properly decanted irrigation solutions is acceptable for up to how long when used for surgical procedures?

Answer 53

1 day

Question 54

Never recap a needle using a two-handed technique. Instead, use one of the commercially available sheath holders or what technique

Answer 54

Scoop technique

Question 55

Sterilizable or disposable syringe tips are recommended. For nonsterilizable tips, flush water syringe for 30 seconds. Disinfect by wiping with a high-level disinfectant to clean, then wrap with disinfectant saturated gauze for how long?

Answer 55

10 minutes

Question 56

Do not use 2 percent glutaraldehyde as a surface disinfectant because of what?

Answer 56

Caustic vapors

Question 57

When securing a DTR at the end of the work day you must flush each unit water line and hose for how long?

Answer 57

30 seconds

Question 58

To clean uncarpeted floors and other horizontal surfaces regularly and when spills occur use launderable mops with a detergent and an EPA-registered disinfectant or a detergent with sodium hypocholorite at what dilution?

Answer 58

1:100

Question 59

Mops must not be used for more than how long without laundering?

Answer 59

1 day

Question 60

Contaminated laundry may be laundered on-site if OSHA and CDC guidelines are followed. A wash cycle must be of at least 25 minutes duration with a water temperature of at least what?

Answer 60

160 degrees F

Question 61

Infectous waste must be placed in closable, leak-proof containers or bags that are labeled as what?

Answer 61

Biohazard

Question 62

What is one of the most important procedures in preventing the transfer of micro-organisms from one person to another?

Answer 62

Handwashing

Question 63

The skin harbors two types of flora. What are they?

Answer 63

Resident | Transient

Question 64

What can survive and multiply on the skin, can be cultured repeatedly from the skin, are usually of low virulence and are not easily removed?

Answer 64

Resident organisms

Question 65

What do not survive and multiply on the skin and are not firmly attached?

Answer 65

Transient bacteria

Question 66

The mere mechanical action of rubbing the hands together and rinsing them under running water is effective in removing what?

Answer 66

Transient bacteria

Question 67

What are water soluble complexes of iodine with organic compounds which are effective against all gram positive and gram negative bacteria and viruses?

Answer 67

Iodophors

Question 68

Chlorhexidine gluconate antiseptic is an effective antiseptic for reducing transient and resident microbial hand flora, has a sustained antimicrobial effect and does not appear to affect what adversely?

Answer 68

Skin

Question 69

Seventy percent isopropyl alcohol also known as waterless handwashing agents virtually disinfects the skin in how long?

Answer 69

20 seconds

Question 70

Personnel should empty, disassemble, and clean all refillable hand cleansing agents dispensers at what interval?

Answer 70

Weekly

Question 71

What sterilization is preferable for all equipment and materials that can withstand high temperatures?

Answer 71

Heat

Question 72

What is safer and more effective than manual scrubbing?

Answer 72

Ultrasonic cleaning

Question 73

What is the most effective means of sterilization for almost all items used in dentistry?

Answer 73

Steam under pressure

Question 74

Dry heat at temperatures above what will achieve sterilization?

Answer 74

320 degrees F

Question 75

A typical dry heat cycle is how many minutes at 320-345 degrees F, plus the time required to bring the load up to sterilization temperature?

Answer 75

90

Question 76

A mixture of alcohols, formaldehyde, water, and other chemicals heated under pressure forms a gas that can achieve sterilization, also known as what type of sterilization?

Answer 76

Chemical vapor

Question 77

Chemical vapor sterilization requires 20 minutes at what temperature?

Answer 77

270 degrees F

Question 78

Sterilization at relatively low temperatures is possible with what type of gas?

Answer 78

Ethylene oxide

Question 79

Using a heated unit, ethylene oxide sterilization can be achieved in how long at 120 degrees F?

Answer 79

2-3 hours

Question 80

COs should not purchase new ethylene oxide equipment, it may not survive in today's dental health care environment because ethylene oxide is a serious problem of what sort?

Answer 80

OSHA problem

Question 81

Who classifies chemical disinfectants that are sporicidal as disinfectant or sterilants?

Answer 81

EPA

Question 82

As a minimum you should perform biological monitoring how often?

Answer 82

Weekly

Question 83

Use dosage indicators inside and process indicators outside each what?

Answer 83

Instrument pack

Question 84

What is a less lethal process than sterilization?

Answer 84

Disinfection

Question 85

EPA classifies disinfectants as what, based on the contact time of the solution and the biocidal activity of an agent against bacterial spores, mycobacterium tuberculosis, lipid and non-lipid viruses, and vegetative bacteria?

Answer 85

High, intermediate, or low level

Question 86

Glutaraldehyde-based solutions are classified as what level disinfectant or sterilant?

Answer 86

High-level

Question 87

Iodophors are classified as what level disinfectants if the product label claims tuberculodical activity?

Answer 87

Intermediate-level

Question 88

Chlorine dioxide-based solutions have limited use patterns because of their what?

Answer 88

Corrosiveness

Question 89

All semi-critical category items require at least what level disinfection?

Answer 89

High-level

Question 90

All non-critical category items require at least what level disinfection?

Answer 90

Intermediate-level

Question 91

Infection control in prosthodontics and orthodontics is divided into two distinctly different areas, what are they?

Answer 91

DTR and the dental laboratory

Question 92

You should soak reusable impression trays in an EPA-registered disinfectant for how long, scrub in soapy water, and seal in peel packs before autoclaving?

Answer 92

10 minutes

Question 93

You should consider all prosthetic devices received contaminated and scrub them with a brush using a bacteriocidal soap. Store the brush in a glutaraldehyd solution of what percentage between uses?

Answer 93

2%

Question 94

After scrubbing a prosthetic device, place the prosthesis in a container filled with an EPA-registered disinfectant such as an iodophor, chlorine dioxide, or a synthetic phenol compound. Place the container in an ultrasonic cleaner for how long?

Answer 94

10 minutes

Question 95

It is extremely important to pay attention to infection control when taking what?

Answer 95

Radiographs

Question 96

When disposable covers are not available, treat bite blocks as you would a what?

Answer 96

Film holding device

Question 97

For an X-ray chair you should disinfect at least daily or when visibly contaminated using an EPA-registered disinfectant at what level?

Answer 97

Intermediate-level