CER Microbiology and Infection Control Questions and Answers 5 — Questions and Answers
Question 1: An automated endoscope reprocessor (AER) cycle fails mid-process due to a power interruption. The endoscope should be:
- Considered adequately disinfected up to the cycle point reached and stored normally
- Removed, manually inspected, and reprocessed from the beginning with a complete cycle (Correct answer)
- Placed back in the AER and run only the remaining cycle steps
- Quarantined until engineering inspects the AER, then stored
Correct answer: Removed, manually inspected, and reprocessed from the beginning with a complete cycle
An incomplete AER cycle cannot guarantee HLD; the scope must undergo a full reprocessing cycle from the start before patient use.
Question 2: In infection control, the term 'reservoir' refers to:
- The sterile water tank in an automated endoscope reprocessor
- The person, animal, or environment where an infectious agent normally lives and multiplies (Correct answer)
- A storage cabinet for reprocessed endoscopes
- The holding solution used during an endoscope procedure
Correct answer: The person, animal, or environment where an infectious agent normally lives and multiplies
A reservoir is the natural habitat or source where a pathogen survives and replicates before being transmitted to a susceptible host.
Question 3: Which reprocessing protocol modification is specifically recommended for duodenoscopes following multiple CRE outbreak investigations?
- Triple-cycle high-level disinfection for all duodenoscopes
- Microbiological culturing and quarantine-until-negative or additional sterilization methods (Correct answer)
- Replacement of glutaraldehyde with peracetic acid for all GI endoscopes
- Mandatory single-use duodenoscope policy mandated by SGNA
Correct answer: Microbiological culturing and quarantine-until-negative or additional sterilization methods
FDA and CDC have recommended enhanced reprocessing including microbiological surveillance culturing with quarantine-until-negative results or sterilization due to duodenoscope elevator mechanism contamination risks.
Question 4: Hand hygiene with soap and water is PREFERRED over alcohol-based hand rubs when hands are visibly soiled or contaminated with which organism?
- MRSA (methicillin-resistant Staphylococcus aureus)
- Clostridium difficile (Correct answer)
- Vancomycin-resistant Enterococcus (VRE)
- Carbapenem-resistant Klebsiella pneumoniae
Correct answer: Clostridium difficile
Alcohol does not kill C. difficile spores; soap and water mechanically removes spores from hands more effectively than alcohol-based products.
Question 5: What does the term 'reuse life' refer to in the context of high-level disinfectant solutions?
- The shelf life of an unopened container of HLD concentrate
- The maximum number of days or cycles a prepared HLD solution can be used without losing efficacy (Correct answer)
- The number of scopes that can be disinfected in one container of diluted HLD
- The time between AER maintenance cycles recommended by manufacturers
Correct answer: The maximum number of days or cycles a prepared HLD solution can be used without losing efficacy
Reuse life is the validated period during which an activated/diluted HLD solution maintains minimum effective concentration when tested with MEC strips and not exceeded in volume capacity.
Question 6: Which of the following BEST describes the chain of infection that endoscope reprocessing is specifically designed to break?
- Eliminating the susceptible host by providing prophylactic antibiotics before each procedure
- Removing or inactivating the infectious agent on the instrument before it contacts the next patient (Correct answer)
- Blocking the portal of entry by using sterile drapes around the patient during endoscopy
- Eliminating the reservoir by destroying all biological waste generated during procedures
Correct answer: Removing or inactivating the infectious agent on the instrument before it contacts the next patient
Reprocessing targets the infectious agent link in the chain of infection by reducing or eliminating viable pathogens on the endoscope before the next patient contact.
Question 7: A technician preparing ortho-phthalaldehyde (OPA) solution for HLD is NOT required to perform which of the following steps that IS required for glutaraldehyde?
- Testing the solution with MEC test strips before each use
- Activating the solution by mixing a two-part formula (Correct answer)
- Wearing appropriate PPE including gloves and eye protection
- Documenting solution preparation date and expiration
Correct answer: Activating the solution by mixing a two-part formula
OPA is supplied as a ready-to-use single-component solution requiring no activation, unlike glutaraldehyde which requires mixing an activator to become effective.
CER Microbiology and Infection Control Questions and Answers 5
An automated endoscope reprocessor (AER) cycle fails mid-process due to a power interruption.
The endoscope should be: