ABFAS Safety and Infection Control 3 — Questions and Answers
Question 1: A foot and ankle surgeon sustains a needlestick from a patient with unknown HIV status. What is the recommended first step?
- Immediately wash the site with soap and water and report to occupational health (Correct answer)
- Start prophylactic antibiotics without testing the patient
- Ignore the injury if the wound is small
- Apply iodine and continue the procedure
Correct answer: Immediately wash the site with soap and water and report to occupational health
Immediate wound cleansing with soap and water followed by prompt reporting allows timely HIV risk assessment and post-exposure prophylaxis if indicated.
Question 2: What class of surgical wound is a diabetic foot debridement procedure for an infected ulcer?
- Class IV (Dirty/Infected) (Correct answer)
- Class I (Clean)
- Class II (Clean-Contaminated)
- Class III (Contaminated)
Correct answer: Class IV (Dirty/Infected)
Wounds with established infection or perforated viscera at the time of surgery are classified as Class IV (Dirty/Infected).
Question 3: Which of the following best describes the 'sterile field' concept during foot and ankle surgery?
- All items within the sterile zone must be sterile and handled only by scrubbed personnel (Correct answer)
- The area within one meter of the operating table is considered sterile
- Only the drapes need to be sterile; instrument tables may be unsterile
- Sterility applies only to instruments that enter the joint space
Correct answer: All items within the sterile zone must be sterile and handled only by scrubbed personnel
The sterile field encompasses all sterile items and surfaces, and must only be contacted by sterile-gloved and gowned personnel to prevent contamination.
Question 4: What is the recommended minimum time for high-level disinfection of reusable foot and ankle scopes using glutaraldehyde at room temperature?
- 20–45 minutes (Correct answer)
- 2–3 minutes
- 5–10 minutes
- 2 hours
Correct answer: 20–45 minutes
High-level disinfection with 2% glutaraldehyde requires a minimum contact time of 20–45 minutes to eliminate vegetative bacteria, most viruses, and fungi.
Question 5: During a foot and ankle procedure, a circulating nurse notices that the scrub technician's gown sleeve touches the non-sterile mayo stand. What should occur?
- The contaminated gown must be changed and the involved items replaced or re-draped (Correct answer)
- Continue the procedure if the contact was brief
- Simply re-drape the mayo stand and proceed
- Apply antiseptic spray to the contaminated area
Correct answer: The contaminated gown must be changed and the involved items replaced or re-draped
Any break in sterile technique requires immediate correction, including changing the gown and replacing or reprocessing contaminated items.
Question 6: Which precaution type is required when caring for a patient with methicillin-resistant Staphylococcus aureus (MRSA) wound colonization?
- Contact precautions (Correct answer)
- Droplet precautions
- Airborne precautions
- Standard precautions alone
Correct answer: Contact precautions
MRSA is transmitted via direct or indirect contact, requiring contact precautions (gloves and gown) in addition to standard precautions.
Question 7: What is the primary advantage of using a tourniquet in foot and ankle surgery from an infection control perspective?
- It provides a bloodless surgical field that improves visualization and reduces operative time (Correct answer)
- It eliminates the need for sterile draping
- It prevents bacterial seeding from the bloodstream
- It replaces the need for prophylactic antibiotics
Correct answer: It provides a bloodless surgical field that improves visualization and reduces operative time
A bloodless field achieved by tourniquet use improves visualization and reduces operative time, indirectly lowering infection risk by shortening exposure.
ABFAS Safety and Infection Control 3
A foot and ankle surgeon sustains a needlestick from a patient with unknown HIV status.
What is the recommended first step?