Certified Gastroenterology RN Infection Control and Safety 2 — Questions and Answers
Question 1: According to Spaulding classification, how are flexible GI endoscopes categorized because they contact intact mucous membranes?
- Critical items requiring sterilization
- Semi-critical items requiring high-level disinfection (Correct answer)
- Noncritical items requiring low-level disinfection
- Environmental items requiring cleaning only
Correct answer: Semi-critical items requiring high-level disinfection
Endoscopes touch mucous membranes but not sterile tissue, making them semi-critical items that require at least high-level disinfection.
Question 2: What is the FIRST step that must occur immediately after an endoscope is removed from the patient?
- High-level disinfection
- Bedside precleaning to prevent biofilm and drying of secretions (Correct answer)
- Alcohol flush and forced-air drying
- Sterilization in the reprocessing room
Correct answer: Bedside precleaning to prevent biofilm and drying of secretions
Bedside precleaning wipes the insertion tube and flushes channels to remove debris before it dries and forms biofilm.
Question 3: Why is a leak test performed during endoscope reprocessing?
- To measure water temperature in the channels
- To detect damage to the scope's exterior or internal channels before immersion (Correct answer)
- To verify the disinfectant concentration
- To confirm the drying cabinet is functioning
Correct answer: To detect damage to the scope's exterior or internal channels before immersion
Leak testing identifies breaches in the scope so a damaged instrument is not immersed and further contaminated or damaged.
Question 4: Which agent is commonly used as a high-level disinfectant for flexible endoscopes?
- 70% isopropyl alcohol
- Ortho-phthalaldehyde (OPA) (Correct answer)
- Chlorhexidine gluconate
- Quaternary ammonium compound
Correct answer: Ortho-phthalaldehyde (OPA)
Ortho-phthalaldehyde is a widely used high-level disinfectant effective for GI endoscopes.
Question 5: Manual cleaning of an endoscope must be completed within what timeframe to be most effective?
- Within the manufacturer-specified time, generally as soon as possible after use (Correct answer)
- Only after 24 hours of soaking
- Exactly one week after the procedure
- Whenever the reprocessing room is free
Correct answer: Within the manufacturer-specified time, generally as soon as possible after use
Prompt cleaning per the manufacturer's instructions prevents debris from drying and biofilm from forming.
Question 6: After high-level disinfection, why are endoscope channels flushed with alcohol and dried with forced air?
- To sterilize the outer sheath
- To remove residual water that promotes microbial growth during storage (Correct answer)
- To restore disinfectant potency
- To lubricate the channels for the next use
Correct answer: To remove residual water that promotes microbial growth during storage
Alcohol and forced-air drying eliminate moisture that would otherwise allow waterborne organisms to multiply.
Question 7: How should reprocessed endoscopes be stored to maintain their clean status?
- Coiled tightly in the transport case
- Hung vertically in a ventilated cabinet with caps and valves removed (Correct answer)
- Immersed in disinfectant solution
- Lying flat on a countertop covered with a towel
Correct answer: Hung vertically in a ventilated cabinet with caps and valves removed
Vertical hanging in a ventilated cabinet allows drainage and drying, reducing contamination risk.
Certified Gastroenterology RN Infection Control and Safety 2
According to Spaulding classification, how are flexible GI endoscopes categorized because they contact intact mucous membranes?