AORN Infection Prevention and Control 2 — Questions and Answers
Question 1: Which microorganism is most commonly associated with surgical site infections (SSIs) in perioperative patients?
- Escherichia coli
- Staphylococcus aureus (Correct answer)
- Pseudomonas aeruginosa
- Candida albicans
Correct answer: Staphylococcus aureus
Staphylococcus aureus, including MRSA strains, is the most frequently isolated pathogen in surgical site infections.
Question 2: According to AORN guidelines, when should antimicrobial prophylaxis be administered before a surgical procedure?
- Within 30-60 minutes before incision (Correct answer)
- 2 hours before incision
- Immediately after the patient is positioned
- At the time of anesthesia induction only
Correct answer: Within 30-60 minutes before incision
AORN and SCIP guidelines recommend administering prophylactic antibiotics within 30-60 minutes before surgical incision to ensure adequate tissue levels.
Question 3: What is the primary purpose of a surgical safety checklist item addressing known allergies before incision?
- To satisfy accreditation requirements
- To prevent adverse drug reactions including allergy-related infections (Correct answer)
- To document patient history for billing
- To alert the pharmacy department
Correct answer: To prevent adverse drug reactions including allergy-related infections
Verifying allergies before incision prevents administering contraindicated prophylactic agents that could cause reactions or require alternative (less effective) antibiotic choices.
Question 4: During an orthopedic joint replacement, the circulating nurse notices the surgical drape has a visible strike-through from blood. What is the correct action?
- Apply an additional drape over the wet area
- Continue the case as long as the field looks clean
- Replace the compromised drape to re-establish sterile field integrity (Correct answer)
- Notify the surgeon only if the patient has a known infection
Correct answer: Replace the compromised drape to re-establish sterile field integrity
Strike-through moisture compromises the sterile barrier; the drape must be replaced to prevent contamination by wicking microorganisms from the non-sterile underside.
Question 5: Which personal protective equipment (PPE) is required when handling a patient with Clostridioides difficile (C. diff) in the perioperative setting?
- N95 respirator and face shield
- Gown and gloves with contact precautions (Correct answer)
- Surgical mask and eye protection only
- Powered air-purifying respirator (PAPR)
Correct answer: Gown and gloves with contact precautions
C. difficile requires contact precautions — gown and gloves — because it spreads via the fecal-oral route and spores are not killed by alcohol-based hand rubs.
Question 6: What is the recommended minimum air exchanges per hour in an operating room to reduce airborne contamination?
- 5 air exchanges per hour
- 10 air exchanges per hour
- 15 air exchanges per hour
- 20 air exchanges per hour (Correct answer)
Correct answer: 20 air exchanges per hour
AORN and ASHRAE standards require a minimum of 20 total air exchanges per hour in the OR, with at least 4 being fresh outside air.
Question 7: A scrub person accidentally touches the non-sterile OR table edge with a sterile-gloved hand. What should occur?
- The scrub person should continue if the contamination was brief
- The glove must be changed and the contaminated area of the sterile field discarded (Correct answer)
- The area should be wiped with a sterile sponge soaked in antiseptic
- The surgeon should be notified and the procedure paused for 10 minutes
Correct answer: The glove must be changed and the contaminated area of the sterile field discarded
Any contact between a sterile item and a non-sterile surface constitutes contamination; the glove must be replaced and affected sterile items removed from the field.
AORN Infection Prevention and Control 2
Which microorganism is most commonly associated with surgical site infections (SSIs) in perioperative patients?