ABA Safety and Infection Control 2 — Questions and Answers
Question 1: A patient with active pulmonary tuberculosis requires emergency surgery. Which respiratory precaution is MOST appropriate for the OR team?
- Standard surgical masks for all personnel
- N95 respirators with fit-testing for all personnel (Correct answer)
- Powered air-purifying respirators (PAPR) are mandatory
- Contact precautions only are sufficient
Correct answer: N95 respirators with fit-testing for all personnel
N95 respirators (or higher) are required for airborne precautions when caring for patients with active TB during aerosol-generating procedures.
Question 2: Which of the following is the MOST effective method to prevent transmission of Clostridioides difficile in the perioperative setting?
- Alcohol-based hand sanitizer
- Soap and water hand washing (Correct answer)
- Glove use alone
- Chlorhexidine hand scrub
Correct answer: Soap and water hand washing
Alcohol-based hand sanitizers are ineffective against C. difficile spores; soap and water physically removes spores from hands.
Question 3: During a 'time-out' procedure prior to surgery, which of the following is a core component according to The Joint Commission?
- Verification of the patient's insurance status
- Confirmation of correct patient, site, and procedure (Correct answer)
- Review of the anesthesiologist's credentials
- Assessment of blood type compatibility
Correct answer: Confirmation of correct patient, site, and procedure
The Universal Protocol time-out requires confirmation of correct patient identity, surgical site, and planned procedure before incision.
Question 4: What is the primary purpose of maintaining positive pressure ventilation in the operating room?
- To prevent hypothermia in patients
- To prevent outside contaminants from entering the sterile field (Correct answer)
- To increase oxygen delivery to the patient
- To reduce anesthetic gas scavenging requirements
Correct answer: To prevent outside contaminants from entering the sterile field
Positive pressure in the OR keeps potentially contaminated corridor air from flowing in, protecting the sterile surgical field.
Question 5: A reusable laryngoscope blade should undergo which level of reprocessing between patients?
- Low-level disinfection with a quaternary ammonium compound
- High-level disinfection or sterilization (Correct answer)
- Simple wiping with an alcohol swab
- No reprocessing needed if used on a healthy patient
Correct answer: High-level disinfection or sterilization
Laryngoscope blades contact mucous membranes and require high-level disinfection (or sterilization) between uses to eliminate pathogens.
Question 6: Which action BEST reduces the risk of a retained surgical item (RSI) during a complex abdominal case?
- Relying solely on the surgeon's visual inspection before closure
- Performing standardized surgical counts at key intervals with reconciliation (Correct answer)
- Using only non-radiopaque sponges to minimize imaging artifacts
- Limiting the number of instrument trays opened during the case
Correct answer: Performing standardized surgical counts at key intervals with reconciliation
Standardized counting protocols performed by two individuals at opening, during closure, and at skin closure are the primary defense against RSIs.
Question 7: Malignant hyperthermia (MH) susceptibility is BEST confirmed by which diagnostic test?
- Serum creatine kinase level at baseline
- In-vitro contracture test (IVCT/CHCT) of skeletal muscle biopsy (Correct answer)
- Genetic testing for RYR1 mutation alone
- Elevated resting core body temperature
Correct answer: In-vitro contracture test (IVCT/CHCT) of skeletal muscle biopsy
The caffeine-halothane contracture test (CHCT in North America) on a fresh muscle biopsy remains the gold-standard diagnostic test for MH susceptibility.
ABA Safety and Infection Control 2
A patient with active pulmonary tuberculosis requires emergency surgery.
Which respiratory precaution is MOST appropriate for the OR team?