Surg 101--Chapter 17 (B&K)

Question 1

Degree of microbial load on an item before sterilization.

Answer 1

bioburden

Question 2

Microbial load attached to a surface in a fluid environment.

Answer 2

biofilm

Question 3

Process by which chemical or physical agents are used to clean inanimate, concritical surfaces; a specific contact time is not specified.

Answer 3

decontamination

Question 4

Water that has been processed through synthetic cation-anion resins to remove the positively or negatively charged ions.

Answer 4

deionized water

Question 5

Chemical or physical process of destroying most forms of pathogenic microorganisms excepts bacterial endospores; used on inanimate objects but not on tissue.

Answer 5

disinfection

Question 6

The degree of _____ depends primarily on the strength of the agent, the nature of the contamination, and the purpose for the process.

Answer 6

disinfection

Question 7

Process that destroys all microorganisms except high numbers of bacterial endospores.

Answer 7

high-level disinfection

Question 8

Process that inactivates vegetative bacteria, including M. tuberculosis, and most fungi and viruses but does not kill bacterial endospores.

Answer 8

intermediate-level disinfection

Question 9

Process that kills most bacteria, some viruses, and some fungi but does not destroy resistant microorganisms, such as M. tuberculosis or bacterial endospores.

Answer 9

low-level disinfection

Question 10

The process of evaporating water and creating condensation from the steam that is collected for future uses.

Answer 10

distilled water

Question 11

Protective capsule that forms inside specific bacterial species encircles and protects the genetic matter to resist destructive forces, such as disinfection or sterilization.

Answer 11

endospore

Question 12

Heating process kills many pathogenic microorganisms that are found in biosubstances such as milk or wine.

Answer 12

pateurization

Question 13

The decontamination process renders soiled instruments safe for _____, but not safe for _____.

Answer 13

handling

patient use

Question 14

A sterile processing certification program accredited by the National Commission for Certifying Agencies (NCCA).

Answer 14

Certification Board of Sterile Processing and Distribution (CBSPD)

Question 15

CBSPD offers five levels of certification:

Answer 15

1. technician
2. supervisor
3. manager
4. surgical instrument processor
5. ambulatory surgery

Question 16

What can be applied to the instruments to prevent debris from drying during transport to the central service area.

Answer 16

enzymatic foam or solution

Question 17

True or False: All instruments on the table during a surgical procedure require decontamination before processing to the required level of safety for patient use.

Answer 17

True

Question 18

Decontamination combines _____ or _____ and a physical or chemical microbial process.

Answer 18

mechanical or manual cleaning

Question 19

Done in the processing department to render the instrumentation safe for handling by CS personnel.

Answer 19

prerinsing, washing, rinsing, and disinfection/sterilizing

Question 20

Should be worn at all times while using chemical disinfectant agents.

Answer 20

PPE

Question 21

What is the purpose of prerinsing or presoaking?

Answer 21

To prevent blood and debris from drying on instruments or to soften and remove dried blood and debris.

Question 22

_____ or _____ instruments with enzymatic solution in the OR can make further processing more efficient.

Answer 22

Prerinsing or presoaking

Question 23

What is the purpose of manual cleaning?

Answer 23

To remove residual blood and debris before terminal sterilization or high-level disinfection

Question 24

Personnel in the processing area wear PPE such as:

Answer 24

• caps
• gloves
• waterproof aprons
• face shields

Question 25

When cleaning instruments manually, fill the washing sink with clean, _____ to which a concorrosive, _____, low-sudsing, free-rinsing detergent has been added.

Answer 25

warm water | neutral pH

Question 26

An alkaline detergent (pH more than _____) can stain instruments.

Answer 26

8.5

Question 27

An acidic detergent (pH less than _____) can corrode or pit instruments.

Answer 27

6

Question 28

What type of detergents are preferred when manually cleaning instruments?

Answer 28

liquid

Question 29

When manually cleaning instruments by hand, rinse them thoroughly in _____water at the temperature recommended by the manufacturer.

Answer 29

distilled or deionized

Question 30

Some enzymes can be inactivated by extreme temeratures, the water should not exceed _____ to prevent burns of the skin.

Answer 30

140 F (60 C)

Question 31

A washer sterilizer requires instruments to be prewashed by hand in germicidal solution at _____ before being placed in the machine.

Answer 31

110 F (43.3 C)

Question 32

The temperature of the washer-sterilizer ranges from _____ and would cause coagulation and crusting or protein.

Answer 32

250 - 280 F (121 - 138 C)

Question 33

A cycle in a washer-sterilizer makes the instruments _____ with the bare hands, but does not render the instrument safe for immediate _____.

Answer 33

safe to handle | patient use or sterile storage

Question 34

A washer-decontaminator does not reach the same temperature as a washer-sterilizer. It cleans at a maximum temperature of _____, rendering the instrument safe to handle without gloves at the end of the cycle.

Answer 34

140 - 180 F (60 - 82 C)

Question 35

Using high-frequency sound waves, ultrasonic energy thoroughly cleans by a process of _____.

Answer 35

cavitation

Question 36

For ultrasonic cleaning the temperature of the water should be between _____ to enhance the effectiveness of the detergent.

Answer 36

100 - 140 F (37.7 - 60 C)

Question 37

True or False: An ultrasonic cleaner is not a sterilizer like the washer-sterilizer.

Answer 37

True

Question 38

In an ultrasonic cleaner, rinse instruments thoroughly in _____ after the cleaning cycle to remove any surface debris and detergent residue.

Answer 38

hot deionized water

Question 39

For lubrication, instruments are immersed in an _____ that is steam penetrable.

Answer 39

antimicrobial water-soluble lubricant

Question 40

What are not used to lubricate instruments because they leave a residue that interferes with steam or ethylene oxide sterilization.

Answer 40

mineral oil, silicone, and machine oils

Question 41

To use most lubricants, instruments are completely immersed for _____.

Answer 41

30 - 45 seconds

Question 42

With normal use, good-quality surgical instruments have an expected life of at least _____.

Answer 42

10 years

Question 43

What are the most common causes of instrument breakage.

Answer 43

misuse and abuse

Question 44

Disinfection differs from sterilization by its lack of _____.

Answer 44

sporicidal power

Question 45

Disinfection can be accomplished with _____.

Answer 45

chemical and physical agents

Question 46

A reconstituted chemical container should be labeled with the _____ and _____.

Answer 46

date of mixing and date of expiration

Question 47

Spaulding system developed when?

Answer 47

1968

Question 48

Must be sterile because they enter sterile tissue, break the mucosal barrier, or come into contact with the vascular system.

Answer 48

critical items

Question 49

Is sterilization required for critical items?

Answer 49

yes

Question 50

High-level chemical disinfection should not be confused with _____.

Answer 50

chemical sterilization

Question 51

Come into contact with intact skin and mucous membranes and require high-level disinfection, although that also may be sterilized.

Answer 51

semicritical items

Question 52

Used in contact only with intact skin. Intermediate or low-level disinfection is adequate.

Answer 52

noncritical items

Question 53

The process of destroying or inhibiting growth of pathogenic microorganisms on inanimate objects.

Answer 53

disinfection

Question 54

Disinfection reduces the risk of microbial contamination but does not provide the same level of assurance as _____ because all endospores are not killed.

Answer 54

sterilization

Question 55

Disinfection levels are classified by the _____.

Answer 55

effectiveness of the process

Question 56

Disinfection level that kills all bacteria, viruses, and fungi.

Answer 56

high-level disinfection

Question 57

Disinfection level that may kill endospores if contact time is sufficient and other conditions are met.

Answer 57

high-level disinfection

Question 58

Disinfection level that should be used is a semicritical item is disinfected rather than sterilized for use in contact with nonintact skin or mucous membranes.

Answer 58

high-level disinfection

Question 59

Exposure of a clean item to 2% glutaraldehyde for _____ at _____ produces high-level disinfection.

Answer 59

20 minutes at 68 F (20 C)

Question 60

Disinfection level that kills most bacteria, viruses, and fungi on noncritical items.

Answer 60

intermediate-level disinfection

Question 61

Disinfection level that does not attack endospores but inactivates M. tuberculosis.

Answer 61

intermediate-level disinfection

Question 62

Disinfection level that kills most vegetative bacteria, fungi, and the least resistant viruses on noncritical items, including HIV.

Answer 62

low-level disinfection

Question 63

A record of the agent, concentration, and time of exposure should be maintained for _____ that have undergone high-level disinfection.

Answer 63

semicritical items

Question 64

The level of disinfection that can be achieved depends on:

Answer 64

- the type and concentration of the agent - contact time - bioburden

Question 65

Chemical agents for disinfection are registered with the _____.

Answer 65

Pesticide Regulation Division of the EPA

Question 66

Water are some chemicals that are considered hazardous?

Answer 66

- isopropyl alcohol - sodium hypochlorite - formaldehyde - glutaraldehyde - phenol

Question 67

To be labeled for hospital use, a chemical disinfectant should be proved effective against:

Answer 67

- Staphylococcus aureus (g-pos) - Salmonella choleraesuis (g-neg) - Pseudomonas aeruginosa (g-neg)

Question 68

The EPA defines a _____ as an agent that kills growing or vegetative forms of bacteria.

Answer 68

disinfectant

Question 69

Sterile and high-level disinfected items will require the use of _____ as a rinse.

Answer 69

sterile water

Question 70

Semicritical and noncritical items can be rinsed with _____.

Answer 70

tap water

Question 71

Isopropyl alcohol

Answer 71

- intermediate level of disinfection - virucidal (but not enterovisuses) - Fungicidal - Tuberculocidal

Question 72

Cidex activated alkaline 2.4% dialdehyde

Answer 72

- Sterile and high-level of disinfection - 10 hours at 25 C (sterile) - 45 minutes at 25 C (high level) - Virucidal - Fingicidal - Sporicidal - Tuberculocidal - 30-day use period

Question 73

Cidex OPA-(0.55%) orthophthalaldehyde:

Answer 73

- high level of disinfection - 12 minutes at 20 C - Virucidal - Fingicidal - Tuberculocidal

Question 74

Cidex OPA-(5.75%) orthophthalaldehyde concentrate:

Answer 74

- high level of disinfection | - 5 minutes at 50 C

Question 75

Chlorine and chlorine compounds:

Answer 75

- Low to high based on concentration - 10-30 minutes - Virucidal - Fingicidal - Tuberculocidal

Question 76

Ethyl or isopropyl alcohol, _____ to _____, kills microorganisms by coagulation of cell proteins.

Answer 76

70% to 95%

Question 77

Alcohol can disinfect _____ instruments.

Answer 77

semicritical

Question 78

When using alcohol, to prevent corrosion of metal, 0.2% _____ is added.

Answer 78

sodium nitrate

Question 79

Alcohol loses its microbial activity below a concentration of _____.

Answer 79

50%

Question 80

Chlorine compounds kill microorganisms by the _____.

Answer 80

oxidation of enzymes

Question 81

Sodium hypochlorite (household bleach) 1:10 dilution of 5.25%, is a _____ disinfectant.

Answer 81

low-level

Question 82

Formaldehyde kills microorganisms by _____ of protein in cells.

Answer 82

coagulation

Question 83

The solution may be _____ formaldehyde in water or _____ formaldehyde in 70% isopropyl alcohol..

Answer 83

37% | 8%