ABA Safety and Infection Control 3 — Questions and Answers
Question 1: Which anesthetic agent is CONTRAINDICATED in a patient with known malignant hyperthermia susceptibility?
- Propofol
- Sevoflurane (Correct answer)
- Ketamine
- Dexmedetomidine
Correct answer: Sevoflurane
All volatile halogenated anesthetics (including sevoflurane) and succinylcholine are MH triggers and must be avoided in susceptible patients.
Question 2: When a needlestick injury occurs in the OR, what is the FIRST immediate action the exposed healthcare worker should take?
- Immediately report to employee health and request post-exposure prophylaxis
- Wash the wound thoroughly with soap and water (Correct answer)
- Apply a tourniquet proximal to the injury site
- Squeeze blood from the wound to remove potential pathogens
Correct answer: Wash the wound thoroughly with soap and water
Immediate wound washing with soap and water is the first step; reporting and PEP evaluation follow promptly afterward.
Question 3: Which class of pathogens is MOST associated with prion disease transmission and requires specialized decontamination beyond standard sterilization?
- Gram-negative bacteria
- Lipid-enveloped viruses
- Prions (misfolded proteins) (Correct answer)
- Spore-forming bacteria
Correct answer: Prions (misfolded proteins)
Prions are resistant to conventional sterilization; instruments used in high-risk neurological procedures require specific protocols (e.g., NaOH treatment or prolonged autoclaving).
Question 4: An anesthesiologist accidentally administers a medication intended for another patient due to look-alike/sound-alike vials. Which system-level intervention MOST effectively prevents this error?
- Verbal verification of drug name by the anesthesiologist alone
- Standardized color-coded labeling and tall-man lettering on drug vials (Correct answer)
- Locking drug carts between cases
- Restricting drug preparation to pharmacy only for all cases
Correct answer: Standardized color-coded labeling and tall-man lettering on drug vials
Standardized labeling with tall-man lettering and color coding is a proven human-factors strategy that reduces look-alike/sound-alike medication errors.
Question 5: Which antiseptic is PREFERRED for central venous catheter insertion site preparation due to its superior residual activity?
- Povidone-iodine 10% aqueous solution
- Isopropyl alcohol 70% alone
- Chlorhexidine gluconate 2% with 70% isopropyl alcohol (Correct answer)
- Hydrogen peroxide 3%
Correct answer: Chlorhexidine gluconate 2% with 70% isopropyl alcohol
Chlorhexidine-alcohol combination provides rapid kill and prolonged residual antimicrobial activity superior to povidone-iodine for CVC insertion.
Question 6: In the context of anesthesia machine safety, what does 'fail-safe' valve function ensure?
- It prevents delivery of more than 100% oxygen
- It shuts off all gases if oxygen supply pressure falls below a threshold (Correct answer)
- It triggers an alarm when N2O concentration exceeds 50%
- It automatically converts to manual ventilation during power failure
Correct answer: It shuts off all gases if oxygen supply pressure falls below a threshold
The fail-safe valve interrupts or reduces the flow of hypoxic gases (like N2O) proportionally if the oxygen supply pressure drops below a set threshold.
Question 7: Which measure is MOST effective in reducing ventilator-associated pneumonia (VAP) risk in the ICU?
- Routine nasogastric tube placement in all ventilated patients
- Head-of-bed elevation to 30-45 degrees (Correct answer)
- Daily chest radiographs to monitor lung consolidation
- Prophylactic systemic antibiotics for all intubated patients
Correct answer: Head-of-bed elevation to 30-45 degrees
Semirecumbent positioning (30-45° HOB elevation) reduces aspiration of oropharyngeal and gastric secretions, a key mechanism of VAP.
ABA Safety and Infection Control 3
Which anesthetic agent is CONTRAINDICATED in a patient with known malignant hyperthermia susceptibility?