Quiz Questions: Patient Care/ Principles, Asepsis & Infection Control Flashcards
Injury due to improper positioning can result in ALL members being sued for ____.
negligence
Accountability is defined as a(n) ____.
Obligation
Negligence is a breach of duty and is defined as ____.
An omission
Whose responsibility is it to identify the surgical patient?
. transportation personnel
. holding area nurse
. anesthesia provider
Everyone the surgical team
Who is responsible for checking diagnostic tests such as X-rays and CT scans to confirm the proper area or side before an incision is made?
Surgeon
What does not need to be counted before beginning an exploratory laparotomy?
Suction
Loss or mishandling of a specimen could be considered negligence and could result in ____.
. another surgical procedure
. improper specimen preparation
. improper specimen analysis
Whose responsibility is it to remove a patient’s personal items in the operating room?
circulator
____ is truly the best medicine when taking care of the surgical patient.
Prevention
____ is a term that refers to permission being given for an action.
Consent
A properly written, informed consent should contain the ____.
Patient’s signature
Informed consent may be given under specific circumstances, by any of the following EXCEPT ____.
Answer: an incompetent adult
Correct other options for consent:
. the parent or legal guardian of a minor
. the temporary guardian
. the courts
In the health care field, the term ____ is used broadly to refer to the placing of information into a patient’s medical record.
Documenting
The medical record of a surgical patient will typically include all of the following EXCEPT the ____.
Answer: family members’ names
Correct other options:
. identification of the patient
. treatment plan
. health care providers involved in the patient’s care
Malpractice and negligence fall under what kind of law?
unintentional tort
A “time out” period should take place immediately before starting the procedure in order to verify:
correct patient, procedure, side/site, implants, and that all team members agree
____ is the term used if a member of the surgical team leaves a patient who is dependent on his or her presence as a caregiver.
Abandonment
Consent may be given in either of two formats: ____.
expressed and implied
The written instructions dealing with the right of an incapacitated patient to self-determination is called a(n) ____.
advanced directive
The ____ is the first-ever federal standards that establishes privacy standards to protect patients’ medical records and other health-related information.
Health Insurance Portability and Accountability Act
the obligation to disclose details for evaluation; commonly used to mean “to be held responsible for”
Accountability
jurisdiction given to federal courts in cases involving the interpretation and application of the U.S. Constitution, acts of Congress, and treaties
Federal Law
court-appointed protector for an individual incapable of making his or her own decisions
Guardian
an injury resulting from the activity of health care professionals
Iatrogenic injury
a civil wrong; may be intentional or unintentional
Tort
actual act of harmful or unwarranted contact with a person without consent
Battery
causes a patient to fear that they will be touched without consent or authority
Assault
oral or written statements that damages a person’s reputation or good name
Defamation
photorgaphing a patient without consent
Invasion of Privacy
disparaging remarks made about a patient that hurt their feelings
Intentional Infliction of emotional distress
According to Maslow’s hierarchy, which are the most basic needs?
physiological
Several components make up an individual. Any need or activity related to genetics, physiology, or anatomy is termed a ____ need.
physical
Any need or activity related to one’s identification or interaction with another individual or group is termed a ____ need.
social
Any need or activity related to the identification and understanding of one’s place in an organized universe (expressions may involve theology, philosophy, mythology, and intuition) is termed a ____ need.
spiritual
A nonspecific response of the body to demand is known as ____.
stress
When an injury or illness takes place, certain stressors affect the patient physically and mentally. Adult patients are worried about ____.
Money
When an injury or illness takes place, certain stressors affect the patient physically and mentally. Pediatric patients fear ____.
abandonment
Which religious group does not permit blood transfusions?
Jehovah’s Witness
Which term describes the following coping mechanism: “The patient does not want to accept the truth of what is occurring”?
denial
Which term describes the following coping mechanism: “The patient returns to an earlier stage of life such as that of a child and exhibits behaviors unique to that stage of life”?
regression
Which term describes the following coping mechanism: “A patient tries to give excuses as to why he or she has a particular illness”?
rationalization
In which religion is birth control not allowed?
Roman Catholic
What should take place immediately after the patient is moved from the stretcher to the operating room table?
apply the safety strap
____ is an integrated system developed by hospitals for the prevention and control of areas of potential liability.
Risk management
The goal of the surgical consent is to ____.
inform the patient of the specifics of the procedure, medical reasons, and risks
Bacilli are typically found to be in the shape of ____.
rods
Bacteria that require oxygen to sustain life are called ____.
aerobic
Which pathogen leads in the percentage of surgical site infections?
Staphylococcus aureus
What dormant structure can some bacteria form to survive adverse environmental conditions?
spore
A nonliving particle that is completely reliant on the host cell for survival is called a ____.
virus
The primary source of airborne bacteria transmission in the operating room is the ____.
surgical team
A bloodborne pathogen that puts health care workers at particular risk is ____.
hepatitis C
Most surgical infections occur because of ____.
contamination during the procedure
Infection contracted within the health care setting is known as ____.
nosocomial
A type of relationship between organism in which one organism benifits and the other neither benefits nor is harmed is:
Commensalism
A type of relationship between organism in which one organism is harmed by the presence of the other
Parasitism
Parasitic worms in the medical profession are called:
Helminths
Organisms that require oxygen in order to reproduce:
Aerobic
A type of bacterial morphology that present as a sphere or round forms
Cocci
Which is a direct contact transmission?
Answer: Kissing
Not examples:
Eating contaminated food
contact with vectors
fomites
Many SSIs are attributed to the patient’s own flora contaminating the wound by direct contact.
True
Preoperative hair removal through shaving decreases the risk of SSI.
False
The primary source of airborne bacteria in the OR is the patient
False
Surgical concience is when an STSR recognizes and corrects breaks in aseptic technique even when not noticed by other personnel
True
The primary purpose of wearing gowns, hair covers and mask is to provide a barrier to contamination, both from personnel to patient and from patient to personnel
True
Pathogens associated with SSI: HIV and Hepatitis B
Virus
Pathogens associated with SSI: Rhinocerebral zygomycosis
Fungi
Pathogens associated with SSI: Entamoeba histolytica
Parasite
Pathogens associated with SSI: Staphylococcus aureus
Bacteria
Pathogens associated with SSI: Creutzfeldt-Jakob disease
Prion
____ means microbes and infection are absent.
Sterile
Microbes that live on the skin and inside the human body are referred to as ____.
Indigenous Microflora
Substances that destroys bacteria
bacteriocidal
Substances that inhibits the growth and reproduction of bacteria
bacteriostatic
The circulator may pass between two sterile areas as long as there will be no direct contact?
True or False?
False
Sterile surgical team members should either pass while facing one another or pass back to back by rotating 360 degrees?
True or False
True
A non sterile individual must maintain a minimum distance of 6 inches from any sterile item?
True or False
False
The number of microbes or organic debris that exist at a given time is referred to as ____.
bioburden
The contamination of a person or object by another person or object is called ____.
cross contamination
Methods used to prevent contamination of the sterile field are referred to as ____.
sterile technique
When wearing a sterile gown and gloves, why should you NOT fold the arms with the hands in the axilla?
The area cannot be viewed.
Sterile items and individuals may ____.
contact sterile items
Members of the sterile surgical team should pass each other within the sterile field by facing one another or ____.
pass back to back
Nonsterile items and individuals may ____.
only contact nonsterile items
The basis for the practice of strict adherence to sterile technique is called ____.
surgical conscience
The term used to describe when both organisms benefit from and depend on one another to a certain extent is known as ____.
mutualism
Bacteria is also classified by its need for oxygen and carbon dioxide. Which type of bacteria grow best in high concentration of carbon dioxide?
capnophiles
Which is the most commonly transmitted bacteria in the operating room?
Staphylococcus aureus
Which bacteria can be found as common flora of the skin, hair, and nose?
Staphylococcus aureus
Which microorganism is capable of causing post-op surgical site infection?
Staphylococcus aureus
Once sterile drapes have been placed, they should not be repositioned
The top of the sterile, draped table is the only potion that is considered sterile
Any item extending or falling below the table edge is considered nonsterile.
True or False
True
True or False
Intstuments that have made contact with the patient’s skin should not be reused
The STSR must check the chemical indicators
True
True or False
For procedures with clean and dirty portions, one setup should be prepared
False
True or False?
The sterile field should be created as early as possible prior to the procedure
False
True or False
The sterile field should be monitored at all times
The sterile field should never be covered with a sterile drape to be moved to another OR
True
True or False
The back of the sterile gown is considered sterile
Wrong
True or False
The surgical gown is considered sterile from the waist to the mid-chest level in front
Hands should never be allowed to fall below the waist or table level
The arms should not be folded with the hands in the axillary region
Trur
Chemical agent that kills most microbes, but usually not the spores, ususally used on inanimate objects
disinfectant
The STSR must place basins and/or medicine cups to be filled at the center of the sterile table to prevent accidental spilling by the circulator
False
If a towel clip punctures a sterile drape, it should be removed immediately
False
The cuffs of a surgical gown sleeve is considered not sterile
True
Preoperative hair removal is a risk factor for developing SSI
True
If in doubt about the sterility of an item, consider it non sterile
True
A seperate sterile table should be used for gowning and gloving to avoid contamination of the back table
True
Nonsterile items and individuals may touch sterile items
False
____ means microbes and infection are absent.
Sterile
The physical removal of blood and body fluids or gross debris from an inanimate object is called ____.
mechanical cleaning
The process that ensures that all microorganisms, including spores, are killed is called ____.
sterilization
Instruments with multiple parts should be ____ prior to cleaning.
disassembled
When stainless steel instruments are manually cleaned, a(n) ____ should be used to avoid scratching the surface of the instrument.
back-and-forth motion
What is a limitation of using water as a presoaking solution?
ineffective at removing dried debris
Why should saline NOT be used to clean stainless steel surgical instruments?
Salt will pit the stainless steel.
An enzyme is usually used as a(n) ____.
soaking solution
The ultrasonic washer is an example of a ____.
mechanical decontamination unit
The washer decontaminator does NOT render the instruments ____.
sterile
An intermediate level of disinfection may be appropriate for ____.
semicritical items
Low-level disinfection may be appropriate for ____.
noncritical items
The number of microbes or organic debris that exist at a given time is referred to as ____.
bioburden
Methods used to prevent contamination of the sterile field are referred to as ____.
sterile technique
Which chemical solution kills spores and is used to terminally sterilize endoscopes?
Glutaraldehyde is used as a disinfectant agent and sterilizing agent and is sporicidal after an item has been left in the solution for a minimum of 10 hours.
Which of the following levels of disinfection kills all microorganisms, including spores, if the contact time with the item(s) is sufficient?
High-level disinfectants kill all microorganisms but require a certain length of time in contact with an item in order to be sporicidal.
Which of the following statements is false with regards to decontamination practices in the OR during the intraoperative phase?
a basin with saline water should be available in the sterile field for the soaking and cleaning of instruments
Which of the following statements is false with regards to environmental decontamination in the OR?
contaminated linen must be rinsed and sorted in the area of use
The circulator is responsible for the following decontamination practices in the OR during the intraoperative phase, EXCEPT for?
flushing instruments with a lumen periodically with sterile water to prevent clogging
It is the physical removal of blood, body fluids or gross contaminants
Mechanical Cleaning
You must mix disinfectant solutions together for hard to clean instruments to have a greater disinfectant efficiency.
False
Surgical instruments that become contaminated by falling on the floor should be immediately retrieved by the STSR and placed in a basin that contains sterile water or disinfectant.
False
Gluteraldehyde can be used both as a disinfectant and a sterilant
True
Do not clean the surgical lights if they have not yet cooled off because they can break upon contact with the cleaning solution.
True
The effectiveness of disinfection is decreased when blood, body fluids, or tissue are present on an item..
True
Physical factors that affect the efficiency of disinfection are ____.
temperature, gross debris, bioburden
Instrument preparation begins after decontamination and involves the following steps in this order:
inspection, reassembly, preparation
If an item wrapped in an impervious wrapper drops to the floor, what action should be taken?
Use the item if not wet
The item can be immediately used if the floor and impervious wrapper are not wet, but it should not be placed back in the sterile storage.
Positive assurance of sterility can be accomplished only with the use of:
Biologic indicator
Positive assurance of the sterility of an item(s) can be accomplished only with the use of biologic indicators.
When wrapping an item with either woven or nonwoven wrap, how many wrappers should be used?
Two
Items or instruments trays wrapped with either woven or nonwoven wrapper must be sequentially wrapped with two layers of wrap.
Items that are mechanically cleaned and chemically disinfected, but not sterile are said to be:
Surgically clean
Items that have been either manually or mechanically cleaned (e.g., ultrasonic washer or washer-decontaminator) with a chemical disinfectant are considered surgically clean, but not sterile, since spores may still be present on the items.
When steam is used to sterilize an instrument with a lumen:
a residual of distilled water should be left inside the lumen
Gravity displacement sterilizer utilizes _______ to destroy microorganisms
steam
When using a high-level disinfectant, always
rinse items with sterile distilled water before using
The chemical sterilant used in the STERIS method of sterilizing is
peracetic acid
The ____ is used to remove small organic particles and soil from areas of instruments that are difficult to clean manually.
ultrasonic washer
To avoid damage, stainless steel instruments should NOT be placed next to ____ in the washer sterilizer.
instruments made from other metals
Instrument preparation begins after decontamination and involves the following steps in this order:
inspection, reassembly, preparation?
The method not recommended for sterilizing an endoscope is:
Steam
Endoscopes are damaged by the high temperature and moisture of the steam sterilization process. The preferred methods that don’t damage the endoscopes are peracetic acid, EtO, and glutaraldehyde.
Which of the following methods of sterilization is the most inexpensive, economical, and safest?
Steam
Steam sterilization is the safest, most inexpensive and economical method of sterilizing surgical supplies, instruments and equipment.
Wrapped instrument sets must be sterilized for _____ minutes at 250°F for steam sterilization
30
Which of the following would be considered a biological monitor?
Vial with B stearothermophilus
An example of a biological monitor is a vial containing the bacteria B stearothermophilus in the spore stage used for steam sterilization.
If an item wrapped in an impervious wrapper drops to the floor, what action should be taken?
Use the item if not wet
The item can be immediately used if the floor and impervious wrapper are not wet, but it should not be placed back in the sterile storage.
Positive assurance of sterility can be accomplished only with the use of:
Biologic indicator
Positive assurance of the sterility of an item(s) can be accomplished only with the use of biologic indicators.
When wrapping an item with either woven or nonwoven wrap, how many wrappers should be used?
Two
Items or instruments trays wrapped with either woven or nonwoven wrapper must be sequentially wrapped with two layers of wrap
A chemical indicator on a package confirms:
Exposure to sterilizing conditions
A chemical indicator does not confirm sterility of an item(s); it only verifies exposure to sterilizing conditions.
Items that are mechanically cleaned and chemically disinfected, but not sterile are said to be:
Surgically clean
Items that have been either manually or mechanically cleaned (e.g., ultrasonic washer or washer-decontaminator) with a chemical disinfectant are considered surgically clean, but not sterile, since spores may still be present on the items.
An item dropped on the floor is considered safe only if
it is enclosed in an impervious material
What is the standard safety margin on peel package wrappers?
1 inch
When flipping a sterile item onto the field, the circulator may
project item without reaching over the sterile field
Positive assurance that sterilization conditions have been achieved can only be obtained through
biologic control test
The minimum exposure time for unwrapped instruments in a flash sterilizer that is set at 270°F (132°C) is
3 minutes
When steam is used to sterilize an instrument with a lumen:
a residual of distilled water should be left inside the lumen
Gravity displacement sterilizer utilizes _______ to destroy microorganisms
steam
All of the following statements regarding instrument sets are true EXCEPT
Correct Answer: . all instruments must be closed
Trues Statements:
. instruments must be placed in perforated trays
. heavy instruments are placed on the bottom
. all detachable parts must be disassembled
The chemical agent used in gas sterilization is
ethylene oxide
What chemical system uses peracetic acid as the sterilant?
Steris
In a high-speed flash sterilizer, unwrapped instruments are exposed for a minimum of
3 minutes
To kill spores, an item must be immersed in a 2% aqueous solution of glutaraldehyde for
10 hours
