Chapter 9 - Preventive Medicine and Infection Control Flashcards
0
Q
What is the Manual of Naval Preventive Medicine?
A
NAVMED P-5010
1
Q
What is considered the most desirable means of maintaining good health?
A
Prevention and control of diseases
2
Q
What term is defined as the hygienic means of promoting health through prevention of human contact with hazards of wastes and this terms goal is to provide personnel with a clean and healthy work and living environment?
A
Sanitation
3
Q
What affects the morale of shipmates when unclean or have disagreeable odor and promotes health and prevents diseases?
A
Personal Hygiene
4
Q
Who performs sanitation inspections and provides recommendations to the Commanding Officer?
A
HM or the Medical Department Representative (MDR)
5
Q
Air ventilation, heating, and air conditioning are factors that can affect what?
A
Habitability
6
Q
What is any animal capable of transmitting pathogens or producing human or animal discomfort or injury called? (i.e. inspectors arthropods and rodents)
A
Vector
7
Q
These are organisms (insects, rodents, snakes, etc.) that adversely affect military operations and the well being of man and animal; attack real property, supplies, and equipment; or are otherwise undesirable?
A
Pests
8
Q
Who may be given the responsibility of inspecting food, food-service facilities, and investigating food-borne illness outbreaks when assigned as the Medical Department Representative (MDR) for a command or station?
A
HM
9
Q
What instruction is the Food Service Training Program?
A
SECNAVINST 4061.1
10
Q
Who inspects Navy and Marine Corps food-service facilities Together with the food-service manager, officer, or designated representative?
A
MDR
11
Q
What form is the “Food Service Sanitation Inspection”?
A
NAVMED Form 6240/1
12
Q
Who’s major role is to minimize disability by emphasizing immunization programs?
A
Preventive Medicine’s
13
Q
Vaccines used to protect Navy and Marine Corps personnel against certain diseases before exposure to infection are called what?
A
Prophylactic Immunizations
14
Q
Immunizations procured for the Armed Forces are required to meet the minimum standards set by whom?
A
Department of Health and Human Services (HHS)
15
Q
What instruction is “Immunizations and Chemoprophylaxis”?
A
BUMEDINST 6230.15
16
Q
Communicable diseases may be transmitted from a carrier to a _______ _______.
A
Susceptible host
17
Q
The illness produced is the result of __________ ________ invading and multiplying in the host, or from the release of their toxins.
A
Infectious agents
18
Q
An important step in the control of communicable disease is the expeditious preparation and submission of the what?
A
Medical Event Report
19
Q
Control of Communicable Disease Manual
A
NAVMED P-5038
20
Q
What instruction sets the standards for drinking water for U.S. Naval establishments both ashore and afloat?
A
BUMEDINST 6240.1
21
Q
What is considered unsafe until properly disinfected and tested in the field?
A
Water
22
Q
Aeration, coagulation, flocculation, filtration, reverse osmosis, and disinfection are all process for what?
A
Water treatment
23
Q
What are the three sources where potable water for shipboard come from?
A
Ship’s distillation plant, shore-to-ship delivery, or ship-to-ship transfer
24
What section of the ship determines the quantity stored or produced and performs the actual chlorination or bromination?
Ship's engineering section
25
Published by the American Public Health Association (APHA), American Water Works Association (AWWA), and the Water Pollution Control Federation (WPCF): What latest edition do naval vessels follow for water testing requirements and procedures?
Standard Methods for the Examination of Water and Wastewater
26
The medical departments aboard ships are required to include ice samples in any bacteriological analyses they perform on water. True or False?
True
27
The proper water disposal of water waste materials control what water-borne diseases?
Cholera and typhoid fever
28
What are the approved method for disposing of wastes from shore activities?
Municipal or regional Wastewater collection and disposal systems
29
What is the instruction for "Nosocomial Infection Control Program"?
BUMEDINST 6220.9
30
What is the instruction for "Dental Infection Control Program"?
BUMEDINST 6600.10
31
Who must appoint, in writing, a Infection Control Officer (ICO) to assist in implementing an infection control program?
Commanding Officer (CO's) and Officers in Charge (OIC)
32
What term is defined as the state of being free of pathogenic organisms?
Asepsis
33
What is a set of specific practices and procedures performed under carefully controlled conditions with the goal of minimizing contamination by pathogens?
Aseptic Technique
34
What is the number of microorganism contaminating an object; known as billboard or microbial load?
Bioburden
35
What is a non-sterile diagnostic test of a pre-vacuum sterilizer's ability to remove air from the chamber and detect air leaks?
Bowie-Dick Type Test
36
What is the term used for chemical dyes that determine whether conditions required for sterilization are met; known as internal or external indicators, dosage indicator, or process indicator?
Chemical indicator
37
What term is used for Instruments and materials that penetrate the skin, mucous membranes, or bone; must be sterile before use. (Surgical instruments, periodontal knives, and suture needles).
Critical items
38
__________ are instruments that frequently contact mucous membranes, but cannot be sterilized because of their design or inability to withstand heat? (Radiographic positioning devices and plastic impression trays).
Semi-critical Items
39
___________ are instruments, equipment, or material that do not orally penetrate or contact mucous membranes , but which are exposed to splatters, sprays, or splashing of blood, or are touched by contaminated hands? (Dental unit and medical exam table).
Non-critical Items
40
___________ is a surgical entry into the tissues, cavities, organs, or repair of major traumatic injuries such as manipulation, cutting, or removal of any oral or perioral tissue during which bleeding occurs, or the potential for bleeding exists?
Invasive procedures
41
________ is an infection resulting from treatment in a hospital and is secondary to the patient's original condition and unrelated to the primary diagnosis?
Nosocomial infection
42
__________ is an acceptable method of cleaning and disinfecting?
Spray-Wipe-Spary
43
__________ are methods of managing environmental and health by placing a barrier between the contamination and the rest of the site, thus limiting exposure pathways?
Engineered Controls
44
What are classified as bacteria, bacterial spores, viruses, Protozoa, and fungi?
Micro-organisms
45
What classification of microorganism take on the forms of a spore's shell-like coating to withstand unfavorable conditions and resistant to the effects of heat, drying, and most bactericidal chemicals?
Bacteria
46
Which microorganism classification vary in size from a single protein molecule to complicated bacterial cell and divided into three subgroups (bacterial, animal, and plant). Examples are: colds, smallpox, measles, rubella, herpes simplex, AIDS, and hepatitis. Most are susceptible to immersion in boiling water for at least twenty minutes (except hepatitis) and autoclaving is the preferred method of sterilization?
Viruses
47
Which microorganism classification are single-celled animals that do not have a rigid cell wall. Those living on dead organic matter or bacteria are harmless and those that are pathogenic survive freely in nature and must be spread by a carrier (Malaria)?
Protozoa
48
Which classification of microorganism are plants that lack chlorophyll. Mold and yeast are forms of this, usually having firm cell walls and resembles plants more than animal? (Destroyed by heat and common examples are athletes foot and ringworm. Penicillin is derived from this).
Fungi
49
What are the two types of flora the skin harbors?
Resident (normal) flora and transient flora
50
Which flora is characterized as: can survive and will multiply on the skin; can be cultured repeatedly from the skin; and are usually of low virulence and are not easily removed?
Resident
51
Which flora is characterized as: do not survive and will not multiply on the skin; are not firmly attached to the skin; and are effectively removed by rubbing of the hands together and rinsing them under running water?
Transient
52
What are the two main hand washing agents used in the Navy?
Water-based and waterless
53
The following agents are what type of hand washing agents: chlorhexidine, alcohol, and iodophors among the active antimicrobial ingredients approved for hand washing?
Water-Based cleaning agents
54
What water based cleaning agent is an antiseptic marked as 4% chlorhexidine gluconate and with 4% isopropyl alcohol in a sudsy base that reduces transient and resident microbial with no adverse skin affect? (Approved as a surgical scrub).
Chlorhexidine Gluconate
55
What water based cleaning agent are water soluble complexes of iodine with organic compounds that are effective against all gram-positive and gram-negative bacteria and viruses; may cause severe drying of the skin?
Iodophors
56
What hand washing agent contain 70% isopropyl alcohol and virtually disinfect the skin in 20 seconds; effective against bacilli, fungi, and viruses; volatile, flammable, evaporate quickly and dry the skin; and alcohol-based should only be used when hands are not visibly soiled?
Waterless Hand Washing Agents
57
Which type of gloves are the highest quality, most expensive and best fitting; used for surgical and invasive procedures?
Sterile Surgical Gloves
58
Which type of gloves are sterile surgical gloves that are worn underneath the primary surgical gloves (double gloving); green and blue in color allowing more protection from needle sticks and making small punctures in the top gloves more visible?
Under Gloves
59
Which type of gloves are manufactured like sterile surgical gloves but are non-sterile that offer the highest quality and best fit at a greatly reduced cost when sterile surgical gloves are not required?
Procedural Gloves
60
Which type of gloves are the least expensive type of non-sterile gloves and usually corn-starched to ease putting them on that are commonly used in routine procedures?
Latex Examination Gloves
61
Which type of gloves can be sterile or unsterile examination gloves made of synthetic latex that offer 3 times more puncture and tear resistance than rubber?
Nitrile Gloves
62
All personnel must wear what in the surgical suite, dental treatment rooms (DTR), medical treatment rooms (MTR) and central sterilization room (CSR) where aerosols, particulates and splashes will be a possibility?
Face mask and shield
63
Which type of mask is made from paper or other non-woven material and is worn by health professionals during surgery and at other times to catch the bacteria shed in liquid droplets and aerosols from the wearer's mouth and nose?
Surgical mask
64
Which type of mask is a stiff, woven mask used for simple procedures for protection from splashing and aerosols?
Cone Masks
65
Which type of mask is a lightweight, nose-and-mouth respirator that can provide some level of protection from viruses and small particles during surgery or airborne precautions?
N95 Respirator
66
Eyewear or goggles, must have ________ side shields to provide maximum protection for all dental exams and treatments.
Solid
67
What type of head protection must be washed daily?
Cloth scrub
68
What are the second tier of infection prevention that has been designed for patients with confirmed or suspected pathogens that can be spread by airborne, droplet, or direct contact with the patient?
Transmission-based precautions
69
Where can clinical apparel be worn?
In the MTF/DTF only
70
Protective eyewear must have a slotted splash shields to provide maximum protection. True or False?
True
71
What transmission-based precautions occurs by the evaporation of droplets that can remain in the air for long periods or spread by dust particles that contain the infectious agent (measles, tuberculosis, chicken pox, etc.)?
Airborne precautions
72
The following are precautions for what transmission-based precautions:
- Place patient in a private, negative pressure room (6-12 exchanges per hour) with air being pumped outside or through a HEPA filter
- All personnel must wear Occupational Safety and Health Administration (OSHA) specified respiratory protection (N95 mask)
- Place a surgical mask over patient's nose and mouth while transporting.
Airborne precautions
73
What transmission-based precaution are used for patients infected with microorganisms spread by coughing, sneezing, or talking such as influenza virus, adenovirus, and rhinovirus?
Droplet precautions
74
The following actions are taken for what transmission-based precaution:
- Patient should be placed in a private room or one with another patient infected with the same organism. If this is not possible a 3 ft partition should be maintained between the infected patient and any other patient.
- All healthcare provider should wear a mask within 3 ft of the patient.
- Place surgical mask over the patient's nose and mouth while transporting.
Droplet precautions
75
What transmission-based precaution should be used for patients infected or colonized with organisms that can be transmitted by direct contact with a provider or indirect contact ( Methicillin Resistant Staphylococcus Aureus (MRSA) and Vancomycin Resistant E. coli (VRE))?
Contact precautions
76
The following precautions are for what transmission-based precaution:
- Place patient in a private room or one with another patient with the same organism and no other infections.
- Gloves and disposable gowns are worn. Both are removed before leaving the patients room and hands must be washed after glove removal.
- Patient care equipment is dedicated to a single patient. If not possible, the equipment is thoroughly cleaned and disinfected before another patient uses it.
Contact precautions
77
What personal protective equipment (PPE) item is not necessarily worn while treating a patient under contact precautions?
Mask (Avoid touching the face with contaminated items)
78
What transmission-based precaution requires limited transport EXCEPT for essential purposes?
Contact precautions
79
All personnel providing direct patient care, including civilian employees, volunteers, laboratory, and repair personnel who are potentially exposed to blood and saliva, must receive what vaccine?
Hepatitis B Virus (HBV) vaccine
80
How many years are active duty healthcare personnel tested for HIV?
Every 2 years
81
How often are active duty healthcare personnel tested/screened for tuberculosis?
Annually
82
What describes those practices used to prevent or interrupt the transfer of pathogenic organisms from person to person, place to place, or person to place?
Medical Asepsis
83
What is the name for a man (most frequent), animal, plants, or soil where infectious agents lives, multiplies, and reproduces so it can be transferred to a susceptible host?
Reservoir
84
What is the avenue (In a man: respiratory, intestinal, genitourinary tracts, and open lesions) by which the infectious agent leaves its reservoir?
Portal of Exit
85
What is the mechanism by which the infectious agent is transmitted from its reservoir to a susceptible host (i.e. air, water, food, dust, dirt, insects, inanimate objects, and other persons)?
Mode of Transmission
86
What is the avenue (respiratory and gastrointestinal tracts, break in the skin, or by direct infection of the mucous membrane) by which the infectious agent enter the susceptible host?
Portal of Entry
87
What is a man or another living organism that affords an infectious agent nourishment or protection to survive and multiply?
Susceptible Host
88
The removal or control of any one component in the following chain will control the infectious process. True or False?
1. Reservoir of Infectious Agents
2. Portal of Exit
3. Mode of Transmission
4. Portal of Entry
5. Susceptible Host
True
89
What consists of the daily measures taken to control the spread of pathogenic organisms while the patient is considered infectious?
Concurrent Disinfection
90
What consists of measures taken to destroy pathogenic organisms remaining after the patient is discharged from isolation which is based on the recommendation of an Infection Control Committee?
Terminal Disinfection
91
In a DTR, at the beginning of the day, the unit water lines and hoses should be flushed for how long? How long between patients?
1 minute. 30 seconds in between patients.
92
What can be lowered and minimize the potential risk by employing the following procedures:
- Clean cavity preparations with water, air, or an air and water combination.
- Use high-volume evacuator (HVE).
- Use rubber dams.
- Cover ultrasonic tanks when in use.
Aerosol
93
What technique is used to clean and disinfect all unprotected "high touch" areas?
Spray-Wipe-Spray technique
94
What do you not use as a surface disinfectant because of its caustic vapors and high cost?
2% Glutaraldehyde
95
Who will handle, disinfect, lubricate, and sterilize the dental hand pieces?
Central Sterilization Room (CSR) technician
96
To perform hand piece maintenance on dental hand pieces the HM should remove hand pieces, lubricate and then operate it for how long?
30 seconds
97
After completing the disinfecting of the contaminated items, the HM can take all metal and heat stable items where for sterilization?
Central Sterilization Room (CSR)
98
How long do you cleanse the puncture site or flush the eye with cool water for personnel who are exposed to a penetrating injury (needle stick or cut) or a splash (into the eye or onto mucous membranes) with contaminated fluids?
15 minutes
99
What instruction is used to report an incident as a mishap to the command safety officer and command risk manager?
OPNAVINST 5102.1
100
What instruction is the "Management of Infectious Waste"?
BUMEDINST 6280.1
101
What is defined as liquid or solid waste containing pathogens in sufficient numbers and of sufficient virulence to cause infectious disease in susceptible hosts exposed to the waste?
Infectious waste
102
Infectious waste are placed in containers and bags (double) labeled with the universal symbol and word of?
"BIOHAZARD" or be red in color
103
After twisting the top of the biohazard bag, tape twisted portion going towards the opening of the bag; What is the technique called when you bend the neck in half and tape the neck to it self known as?
Goose necking
104
Needles, scalpels,and sutures (sharps) should be disposed of in what container?
Rigid, puncture resistant red sharps container with a BIOHAZARD symbol.
105
Pour liquid regulated waste into the sanitary sewer system through clinical sinks (not hand washing sinks)" unless what regulation prohibits this practice?
Local or state regulations
106
Treat used disposable sharps,such as needles, scalpel blades, capsules, disposable syringes, used burs, and broken instruments as ________ ________.
Regulated waste
107
Bed linens, towels, smocks, trousers and other protective attire are classified as?
Ordinary laundry
108
What type of laundry is considered when any laundry is soiled with blood or other potentially infectious material (OPIM) that is packed in a red biohazard container or bag, or in a leak proof plastic bag with a biohazard label?
Contaminated
109
Which type of infectious waste is treated by steam sterilization, chemical, disinfection, and incineration; and is disposed by sanitary landfill?
Microbiological
110
Which types of infectious waste is treated by incineration and is disposed by sanitary landfill or burial?
Pathological
111
Which type of infectious waste is treated by gelatinization and is disposed by sanitary sewer or sanitary landfill?
Bulk blood and other potentially infectious liquids
112
Which type of infectious waste is treated by steam sterilization or incineration and disposed by sanitary landfill?
Sharps in sharps containers
113
For effective sterilization, the temperature must be maintained at what degree Celsius for at least 90 minutes, at 15 pounds per square inch of gauge pressure?
121 degrees C (250 degrees F)
114
How often are Bacillus Stearothermophilus spore strips used to test the sterilization process?
Weekly
115
At the beginning of each day, all the fixtures, equipment, and furniture in each operating room will be damp-dusted with what type of solution?
Antiseptic germicide
116
What method of cleaning is used for an area of the floor occupied by the surgical team?
Wet vacuum method
117
What is the least desirable method of cleaning is used in the operating room?
The use of mops
118
What is the term used to describe the sterilization, storage and handling of articles to keep them free of pathogenic organisms?
Surgical aseptic technique
119
Scrub suits, gowns, head coverings, and face masks are considered what type of attire?
Operating room attire
120
If there is doubt about the sterility of an item, consider it ___________.
Unsterile
121
What color of drapes and gowns (may vary from each MTF) is considered sterile and should not be touched by anyone but the "scrubbed in" surgical staff?
Blue or green
122
This is usually a nurse or HM that is not scrubbed in that is free to grab gear for procedures and assist the surgical team?
Circulator
123
When the HM is preparing for a surgical case, what is the maximum length of the fingernail to avoid puncturing the gloves?
No longer than the tips of the fingers.
124
While gowning the surgeon who is responsible for tying the gown?
Circulator
