Exam Review Flashcards

1
Q

Used to repair and reconstruct teeth and jawbones

A

Dental Drill

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2
Q

Used in ear surgery and for driving very small wires through bone:

A

Micro drill

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3
Q

Drill used in open heart surgery:

A

Sternal Drill

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4
Q

Drill used to removecement:

A

Cebatome

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5
Q

Allows for visual inspection of the lower part of the large intestine:

A

Sigmoidoscope

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6
Q

Allows for visual inspection of the upper digestive tract:

A

Gastroscope

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7
Q

Used to visualize the urethra and the bladder:

A

Cystoscope

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8
Q

Used to visualize the tracheobronchial tree:

A

Bronchoscope

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9
Q

Used to visualize the large intestine:

A

Colonoscope

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10
Q

Leak testing should be performed on each flexible endoscope annually:

A

False, should be performed during each processing cycle.

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11
Q

A method of stock rotation that ensures that older items are used first:

A

FIFO

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12
Q

Minimum amount of time that a packaging material should be held at room temperature and at 35-70% relative humidity

A

2 hours

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13
Q

Max density per cubic foot of a linen pack:

A

7.2 lbs

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14
Q

All soiled instruments and materials are received from the user units into this CS area:

A

Decontamination

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15
Q

Which gland is located at the base of the brain and is considered the master gland?

A

Pituitary

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16
Q

Which is the circular opening of the eye which controls light that enters the eye:

A

Pupil

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17
Q

What types of bacteria develops spores?

A

Grampositive

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18
Q

Bacteria that causes diesease

A

Pathogens

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19
Q

What type of hepatitis vaccine is strongly recommended for healthcare workers:

A

Hep B

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20
Q

The part of the cell that controls the function is:

A

Nucleus

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21
Q

Involuntary muscles:

A

Work without consciousness

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22
Q

Rod shaped bacteria:

A

Bacillus

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23
Q

Air pressure in the decon area should be negative:

A

True

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24
Q

Regulations under the clean air act are administered by:

A

EPA

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25
Q

Agency which imposes very strict labeling requirements on manufacturers of chemical used in cs dept:

A

FDA

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26
Q

What class device is a chemical indicator?

A

class II

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27
Q

What class device is a heart valve and pacemaker?

A

Class III

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28
Q

who do you report suspected medical device related deaths to?

A

hospital and device manufacturer

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29
Q

how many patients develop a hospital acquired infection each year?

A

2 million

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30
Q

Watches and jewelry should be avoided in cs because:

A

They harbor bacteria

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31
Q

Minimum time to wash hands is:

A

15 seconds

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32
Q

To be protected from splashes and spills, cs techs should wear:

A

fluid resistant gowns

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33
Q

The main theory of standard precautions is:

A

patients may pose risk of infection whether they have been diagnosed or not. Treat all bodily fluids as infectious.

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34
Q

what is NOT a requirement of OSHA regarding the bloodborne pathogen standard:

A

Keep biohazard areas locked

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35
Q

Following standard precautions is required by who?

A

OSHA

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36
Q

Department dress code applies to:

A

everyone in the cs department

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37
Q

Inanimate objects that can transmit bacteria are called:

A

Fomites

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38
Q

Floors in the department:

A

should be wet mopped daily

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39
Q

The absence of microorganisms that cause disease is called:

A

asepsis

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40
Q

“endo”

A

within

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41
Q

Hemi

A

half

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42
Q

Decon area temp and humidity:

A

60-65, negative pressure, 30-60% humidity

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43
Q

What is the air exchange rate and pressure type for decon?

A

Negative pressure, 10 air exchanges per hour

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44
Q

What is the area temp for the sterile storage area:

A

68-75 degrees, 35-70% humidity

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45
Q

What is the air exchange rate and pressure type for the sterile storage area?

A

Positive, 4 air exchanges per hour

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46
Q

What is the area temp and humidity for the prep area?

A

68-73 degrees, 35-70% humidity no lower than 35%

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47
Q

What is the air exchange rate and pressure type for the prep and pack area?

A

10 air exchanges under positive pressure

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48
Q

which establishes sterilization practice standards based on opinion, research, and or theory:

A

AAMI

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49
Q

epa, fda and osha primarily issue:

A

regulations

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50
Q

Standards for CS practices are written by:

A

AAMI

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51
Q

Hyper

A

above or excessive

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52
Q

hypo

A

below or deficient

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53
Q

para

A

beside or near

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54
Q

peri

A

around

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55
Q

inter

A

between

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56
Q

intra

A

within or inside

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57
Q

anti

A

against

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58
Q

ante

A

before

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59
Q

endo

A

within

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60
Q

neo

A

new

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61
Q

“-a”

A

without

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62
Q

post

A

after

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63
Q

supra

A

above

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64
Q

-ostomy

A

creation of an opening

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65
Q

-otomy

A

incision to an organ

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66
Q

-ectomy

A

surgical removal

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67
Q

-oscopy

A

visual examination

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68
Q

-cide

A

to kill

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69
Q

-cise

A

to cut

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70
Q

cysto

A

bladder

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71
Q

cranio

A

skull

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72
Q

gastro

A

stomach

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73
Q

cardio

A

heart

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74
Q

chole

A

bile

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75
Q

derma

A

skin

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76
Q

herni

A

rupture

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77
Q

litho

A

stone

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78
Q

hyster

A

uterus or womb

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79
Q

gyne

A

woman

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80
Q

arthro

A

joint

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81
Q

lipo

A

fat

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82
Q

Create a new opening in the colon

A

colostomy

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83
Q

removal of part of the large intestine

A

colectomy

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84
Q

visual exam of the uterus

A

hysteroscopy

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85
Q

removal of the uterus

A

hysterectomy

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86
Q

create an opening into the thoracic cavity to give surgeons access to the lungs and heart

A

thoracotomy

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87
Q

removing a salivary gland because of a tumor formation:

A

parotidectomy

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88
Q

removing plaque from the carotid artery that causes lack of brain oxygen:

A

carotid endartectomy

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89
Q

removing a vein from the lower limb to bypass a blocked coronary artery of the heart

A

coronary artery bypass graft

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90
Q

removal of a kidney

A

nephrectomy

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91
Q

making an incision into the tympanic membrane to permit fluid to drain and placing small tubes un the membrane to permit continuous drainage:

A

myringotomy

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92
Q

a repair to the muscles and ligaments of the shoulder joint

A

rotator cuff repair

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93
Q

removing disc tissue pressing on the lower spine area, inserting a pieceof bone between the vertebrae and fusing the area with plates and screws:

A

posterior lumbar interbody fusion

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94
Q

removing lymph tissue in the pharynx:

A

tonsillectomy

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95
Q

removal of the gallbladder

A

cholecystectomy

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96
Q

straightening or removing of cartilage in the nose when the septum is deformed

A

septoplasty

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97
Q

removing both fallopian tubes and ovaries

A

bilateral salpingo-oopherectomy

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98
Q

removing of tissue or displaced bone in the wrist area to release pressure:

A

carpal tunnel repair

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99
Q

moving an undescended testicle

A

orchiopexy

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100
Q

reconstructing the ear drum so sound waves can be sent to the middle and inner ear:

A

tympanoplasty

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101
Q

this organ pumps blood through the body

A

heart

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102
Q

the process by which cartilage is replaced by bone

A

ossification

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103
Q

anyplace where 2 bones meet

A

joint

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104
Q

the main control unit of the cns

A

brain

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105
Q

considered the master gland

A

pituitary

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106
Q

a somewhat flexible muscular tube that helps move food into the stomach

A

esophagus

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107
Q

a type of connective tissue fluid that moves through the body

A

blood

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108
Q

a cord of fibrous tissue that connescts a muscle to bone

A

tendon

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109
Q

largest organ of the body

A

skin

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110
Q

pseudomonas are sometimes called

A

water bug

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111
Q

bacteria that is often pathogenic to humans because they grow best at body temp

A

mesophiles

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112
Q

herpes simplex is a ___ disease

A

viral

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113
Q

bacteria that requires oxygen to grow

A

aerobic

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114
Q

bacteria are divided into three main shapes

A

coccus, bacillus, and spirilla

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115
Q

microorganisms that are capable of forming a thick wall to survive adverse conditions

A

spores

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116
Q

Match the surgery to the system: Thoracotomy

A

Respiratory

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117
Q

match the surgery to the body system: Parotidectomy

A

Digestive

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118
Q

Match the surgery to the body system: Carotid endarterectomy

A

circulatory

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119
Q

match the surgery to the body system: coronary artery bypass graft

A

circulatory

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120
Q

match the surgery to the body system: nephrectomy

A

urinary

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121
Q

match the surgery to the body system: myringotomy

A

nervous

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122
Q

match the surgery to the body system: rotator cuff repair

A

muscular

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123
Q

match the surgery to the body system: posterior lumbar interbody fusion

A

skeletal

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124
Q

match the surgery to the body system: tonsillectomy

A

circulatory

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125
Q

match the surgery to the body system: cholecystectomy

A

digestive

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126
Q

match the surgery to the body system: septoplasty

A

respiratory

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127
Q

match the surgery to the body system: bilateral salpingo oopherectomy

A

reproductive

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128
Q

match the surgery to the body system: carpal tunnel repair

A

nervous

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129
Q

match the surgery to the body system: orchiopexy

A

reproductive

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130
Q

match the surgery to the body system: tympanoplasty

A

nervous system

131
Q

The bacterial reproductive process that takes place when a mother cell divides into 2 daughter cells :

A

binary fission

132
Q

cjd is caused by this abnormal form of protein:

A

prions

133
Q

___is defined as the state of being soiled or infected by contact with infectious organisms or other material:

A

Contamination

134
Q

most bacteria are how big:

A

1-2 microns

135
Q

sunlight is lethal to pathogens during this stage:

A

vegetative

136
Q

a pick list contains information that:

A

identifies the supplies and instruments needed for a specific doctor or procedure

137
Q

the basic unit of a living organism:

A

cell

138
Q

what is the name of the surgical procedure where an opening is made into the skull:

A

craniotomy

139
Q

the decontamination area of the cs department is where instruments are carefully checked for cleanliness and function:

A

False

140
Q

the term periosteal elevator means:

A

an instrument to remove tissue around the bone

141
Q

viruses:

A

have no means of movement on their own

142
Q

Bka refers to:

A

removal of leg below the knee

143
Q

the bodys main control center

A

brain/cns

144
Q

the muscular system:

A

assists w movement, produces heat and pumps blood

145
Q

Microbes:

A

can be found in hair and skin, are useful to break down sewage and can produce toxins

146
Q

Prions are:

A

abnormal forms of protein

147
Q

a herniorraphy is:

A

surgical procedure to repair a muscle layer that is allowing all of part of an organ to project through an opening

148
Q

the abbreviation CR :

A

Treating a bone fracture without a surgical incision

149
Q

this organization specializes in endoscopy issues and has established standards for the effective processing of flexible endoscopes:

A

society of gastrointestinal nurses and associates

150
Q

furthers international cooperation in improving health conditions

A

WHO

151
Q

Develops nationally recognized guidelines for the perioperative setting:

A

association of perioperative registered nurses

152
Q

protects workers from occupationally caused illness and injury

A

osha

153
Q

proposed standards are submitted from members such as the association for the advancement of medical instrumentation

A

ISO

154
Q

Provides standards and evaluations for healthcare facilities every 3 years:

A

joint comission

155
Q

Creates and enforces laws relating to transport of medical waste

A

dot

156
Q

is considered one of the major resources for healthcare guidelines

A

association for the advancement of medical instrumentation

157
Q

creates and revises standards for processing water irrigation

A

us pharmocopeia national formulary

158
Q

creates and enforces laws relating to water air and land

A

epa

159
Q

a voluntary international organization dedicated to the prevention and control of infections and its relasted outcomes

A

association for professionals in infection control and epidemiology

160
Q

international standards to reduce the burden of fire and other hazards

A

national fire protection association

161
Q

prevents and controls diseases

A

cdc

162
Q

responsible for pre and post market medical device requirements, recalls and classifications

A

fda

163
Q

enhances the global competitiveness and quality of life by promoting standards and ensuing their integrity

A

joint commission

164
Q

Agencies responsible for regulating ethylene oxide

A

osha and epa

165
Q

agency responcible for medwatch

A

fda

166
Q

voluntary or involuntary? osha:

A

regulatory

167
Q

Voluntary or regulatory: WHO:

A

voluntary

168
Q

voluntary or regulatory: ANSI

A

voluntary

169
Q

voluntary or regulatory: DOT

A

Regulatory

170
Q

voluntary or regulatory: epa

A

regulatory

171
Q

voluntary or regulatory:

A
172
Q

Information technology is often the cornerstone of initiatives to transform healthcare

A

True

173
Q

Disposable items increase combustible load in a healthcare facility

A

True

174
Q

Enabling people to use information gained to interact with others is known as

A

Human relations

175
Q

At this time, tracking systems are unable to track worker productivity information

A

True

176
Q

A step in communication that occurs when a listener asks a question is called

A

Feedback

177
Q

Improving professional development skills is an important part of

A

Career advancement

178
Q

The US FDA Class II chemical indicator used for testing and ran daily in dynamic air removal sterilizers is called a

A

Bowie-dick test

179
Q

Always wearing PPE in the Decon unit is a quality process

A

True

180
Q

Where are product expiration dates located

A

There is no standard place for an expiration date

181
Q

When patient equipment enters a facility, it must be safety checked by a

A

Biomedical technician

182
Q

Used to break down fatty tissue on instruments

A

Lipase enzymes

183
Q

Anaerobic bacteria require oxygen to live

A

False. Can survive with no oxygen

184
Q

The absence of microorganisms that cause disease is called

A

Asepsis

185
Q

Immediate use steam sterilization was developed to process items when the facility does not have enough instruments to perform a surgery

A

False

186
Q

When an instrument has a shiny surface it is said to have a — Finish

A

Mirror

187
Q

Lumens should be moist when using hydrogen peroxide

A

False

188
Q

Most cs departments employ some sort of automated information management system

A

True

189
Q

Ethylene oxide gas should be stored

A

In a containment locker

190
Q

Knowing what is expected and consistently exceeding those expectations is a part of

A

Professional behavior

191
Q

Sterile packages should be stored no lower than 8-10 inches from the floor

A

True

192
Q

If soiled items are transported to an offsite facility for processing

A

They should be transported following the US or DOT guidelines

193
Q

The decon area is where instruments are checked for cleanliness and function

A

False

194
Q

Arthroscopy instruments are used during

A

Joint surgery

195
Q

Some plastics including formulations of spun bonded polyolefin Are intended for use solely in these sterilization processes

A

Ozone and hydrogen peroxide

196
Q

The amount of time an item must remain wet with a disinfectant is called

A

Wet contact time

197
Q

The drain screen in the steam sterilizer should be cleaned

A

Daily

198
Q

Removal of the uterus

A

Hysterectomy

199
Q

Which is not a result of computer integration

A

Automatically provides critical updates to industry standards

200
Q

A plane crash is an example of an external disaster

A

True

201
Q

Movement of supplies throughout the healthcare facility is called

A

Distribution

202
Q

All patient care equipment that was dispensed for use must be considered— and handled as such regardless of its appearance

A

Contaminated

203
Q

What is the preferred ph for detergents used in most cleaning products

A

Neutral

204
Q

All microorganisms are harmful

A

False

205
Q

Inanimate objects that transmit bacteria

A

Fomites

206
Q

All items that are sterilized or high level disinfected at point of use must be carefully monitored and logged

A

True

207
Q

Instrument packing tape should be wrapped approximately this many times around the instrument

A

1.5

208
Q

Hydrogen peroxide kills microorganisms by a process called

A

Oxidation

209
Q

Event related shelf life means items are safe until open for use

A

False

210
Q

Ectomy

A

Surgical removal

211
Q

Proper handling of instrumentation is the responsibility of

A

All of those who handle the item

212
Q

A pick list contains information that

A

Identifies the supplies and instruments needed for a specific doctor

213
Q

Cellulose materials can not be processed with a hydrogen peroxide sterilizer

A

True must use bonded plastic specific for oxidation

214
Q

Which would be the best choice for high level disinfection of instruments

A

Ortho phthalates

215
Q

This organization is responsible for standards relating to flexible endoscopes

A

Sgna (society of gastroenterology nurses and associates )

216
Q

Which of the following dress code requirements applies to the clean assembly area

A

Semi restricted

217
Q

Computerized tracking systems are fast but manual tracking are more effective

A

False

218
Q

Which is not included on a safety data sheet

A

Required inventory levels

219
Q

Which of the following is not a feature of an instrument tracking system

A

Product updates and recalls

220
Q

This process helps a person to understand one’s needs

A

Communication

221
Q

Safety data sheets are provided by

A

Product manufacturers

222
Q

Sterilizer load records should contain

A

Items and quantity sterilized

223
Q

The quality method failure mode and effects analysis is a

A

Quality method to prevent problems before they occur

224
Q

Disadvantage of exchange cart system

A

Requires duplicate inventory

225
Q

Patient care equipment should be stored in a what condition

A

Ready to dispense

226
Q

Cleaning brushes

A

Should have a larger diameter than the lumen, wire bristles and cleaned daily

227
Q

Microbiology is the study of

A

Life, microorganisms, human immune systems

228
Q

Basics of aseptic technique

A

Know chain of infection, prevent infection, follow blood borne pathogen standard

229
Q

In order to flash sterilize an item, the manufacturer must state it is safe to do so

A

True

230
Q

Are laser finished instruments coated with a durable protective finish that can’t be chipped or scratched

A

No, false.

231
Q

Information regarding a devices compatibility with a certain sterilization process should be obtained from the device manufacturer

A

True

232
Q

Temperature in sterile storage

A

64-75

233
Q

The suffix -tome means

A

Cutting instrument

234
Q

Is it acceptable to transport both clean and soiled items if they are kept on separate shelves

A

No. False.

235
Q

Soiled instruments and other items are received in the —- area of the cs dept

A

Decon

236
Q

Which of the following should be used to thoroughly rinse all traces of disinfectant from an endoscopes channels

A

Treated water

237
Q

When placing instruments that open on an instrument tray

A

Unlock and open instrument

238
Q

Items that are introduced directly into the bloodstream or other normally sterile areas of the body are classified as

A

Critical items

239
Q

Gravity steam sterilizer uses a pump or water injector to remove air from the chamber

A

False. Uses gravity

240
Q

Failure to receive accreditation from the joint commission can cause loss of Medicaid and Medicare

A

True

241
Q

Which provides real time tracking methods

A

Rfid radio frequency identification tags

242
Q

Documentation for immediate use sterilization should include

A

Patient I’d and reason

243
Q

Supplies like disposable wraps are considered

A

Consumable

244
Q

Preventative maintenance

A

Designed to identify potential problems before they occur

245
Q

Detergents should be

A

Low foaming

246
Q

When cleaning prions, no special cleaning is required. Follow all standard cleaning protocols and manufacturers instructions of use

A

False. Additional cleaning

247
Q

Oseotome

A

Used to cut or shave bone

248
Q

Woven fabrics are ideal for ozone sterilization

A

True

249
Q

Sterile items should be how many inches below sprinkler heads

A

18

250
Q

When placing instruments in a peel pack, the point must face the plastic side

A

True

251
Q

When combining loads hard goods should be placed on top to prevent condensate

A

False. Placed on bottom

252
Q

When cleaning pseudomonas

A

There are no specific cleaning requirements

253
Q

Before an item can be low temp sterilized it must be

A

Cleaned

254
Q

Endoscope cameras are sealed instruments so fluid invasion is not a concern

A

True

255
Q

What class device is a sterile pack

A

Class II

256
Q

Humidity for assembly area

A

30/60

257
Q

Tungsten carbide Jaws

A

Have gold handles

258
Q

Pasteurizers disinfect using

A

Heated water

259
Q

When loading steam sterilizer, basins should be

A

Placed on edge

260
Q

which of the following is the agent used for sterilization for antibiotics and heat liable liquid substances in clinical labs?

A

Filtration

261
Q

which one of the following is used in the manufacturing of bleach?

A

sodium hypochlorite

262
Q

what is the required temperature range for pasteurization?

A

62-72 degrees Celsius

263
Q

name some cleaning agents

A

detergents/degreasers

264
Q

which of the following is not a disinfection method?

A

ionizing radiation is not a disinfecting method

265
Q

you are cleaning your living room with a vacuum cleaner. Which statement below describes the correct order so that the room becomes clean?

A

dust and then vacuum

266
Q

how often should the warehouse be disinfected?

A

annually

267
Q

you are packaging heavy and light instruments in a truck. Which ones should go in first?

A

the heavy items should be on the bottom while the light items should be on top

268
Q

what is the preferred exchange RATE of air in the prep room?

A

10%

269
Q

what is the best temp for flowers in the prep room?

A

33-37 degrees farenheit

270
Q

what is the oldest packaging material in the world?

A

glass

271
Q

what type of pressure is used to package food and beverages?

A

high pressure

272
Q

which of the following shows the processes of sterilization?

A

chemicals, irradiation and heat

273
Q

which of the following options is used to mechanically sterilize medical equipment?

A

ultrasonic waves

274
Q

microorganisms are destroyed using a steam reaction known as?

A

first order

275
Q

which of the following processes only shows sterilization methods:

A

heat, radiation and chemical agents

276
Q

i want to use batch sterilization for medical tools. What is the best temperature?

A

121 degrees celsius. the high temp has high pressure to kill microorganisms

277
Q

sterilization deactivates different spores of organisms. Which one is referred to as control?

A

exospores

278
Q

which item of clinical equipment can you use to stop a person’s bleeding?

A

hemostat clamp

279
Q

a patient is brought to a hospital with a high fever. Which tool will you use to measure their temp?

A

clinical thermometer

280
Q

Which tool is used to test pupil dilation?

A

penlight

281
Q

which statement describes the minimum required spd sterile storage conditions?

A

controlled humidity and temperature

282
Q

what is the substance inside the abc extinguisher?

A

ammonium phosphate

283
Q

in inventory management, where are delivery and requisitions recorded?

A

Demand

284
Q

which statement best describes the correct order of naming a file for easy accessibility to all parties?

A

department, date, serial number

285
Q

which of the following documents is not useful to a companies staff?

A

product how to guides

286
Q

why is it important to evenly distribute instruments in a set?

A

extra condensation will make the set more difficult to dry

287
Q

which of the following best describes the overall role of the CS/SPD?

A

to provide dependable service to enhance patient care

288
Q

which of the following regulates environmental disinfectants?

A

epa

289
Q

medical grade kraft paper can not be used with which of the processes?

A

low temp gas palsma

290
Q

during cycle counts, items that have a large dollar amount but arenot used frequently are classified as:

A

class a

291
Q

anatomy is the science that deals with the ____ of body parts

A

structure

292
Q

which of the following transports molecules within the cell:

A

cytoplasm

293
Q

which of the following sets would be considered high risk for special prion processing?

A

craniotomy set

294
Q

which of the following organs produces bile?

A

liver

295
Q

microorganisms are measured in

A

microns

296
Q

with respect to rigid sterilization container testing, which term defines the sterilizers ability to sterilize under actual conditions?

A

maximum load testing

297
Q

what is the ideal human body temp?

A

98.6

298
Q

which of the following is true of capsules?

A

it is resistant to heat and chemicals

299
Q

pulmonary capillaries are found in which system?

A

respiratory

300
Q

a microorganism that is testing and had a hard shell like outer covering is called:

A

spore

301
Q

spongiform encephalopathy is caused by:

A

prions

302
Q

nails, tissues, and money are examples of:

A

fomites

303
Q

cholera is transmitted by

A

contaminated food and water

304
Q

in the final step of hand washing, the fingers should be rinsed with the fingertips facing :

A

up

305
Q

water less hand antiseptics contain what percentage of alcohol?

A

60-95

306
Q

all of the following play a role in how bones support other body systems except:

A

distribution of hormones

307
Q

osha requires that containers of potentially infectious materials be

A

leakproof

308
Q

round or spherical bacteria are called:

A

cocci

309
Q

the removal of contamination from an item to the extent necessary for further processing is called:

A

cleaning

310
Q

which of the following should be cleaned daily:

A

floors and work surfaces

311
Q

whcih of the following is a true statement regarding the use of ppe in decon

A

failure to wear ppe can result in disciplinary action

312
Q

before the medical device is cleaned and processed:

A

the manufacturers instructions must be obtained

313
Q

which is not a consideration when selecting a detergent?

A

cost

314
Q

the relative acidity or alkalinity of a solution is referred to as:

A

pH

315
Q

clostridium botulinum is harbored in the

A

soil

316
Q

a solution with a pH of 3 is considered:

A

acidic

317
Q

a solution with a pH of 13 is considered:

A

alkaline

318
Q

which of the following are major non living reservoirs of infectious diseases?

A

soil and water

319
Q

alkaline detergents are best for mechanical washers because of

A

lack of friction in washing

320
Q

which of the following is used to remove severe stains on stainless steel instruments

A

organic acid detergent

321
Q

one method of preventing biofilm formation on instruments is to:

A

rinse with distilled water and dry them out

322
Q

an ultrasonic lumen cleaner is used to clean

A

laparascopic instruments

323
Q

to reduce the potential for instrument corrosion, the multi step process is in a mechanical washer consists of:

A

alkaline, wash, acid, rinse, regular rinse