Certified Gastroenterology RN Infection Control and Safety 5 — Questions and Answers
Question 1: Which multidrug-resistant organism has been linked to contaminated duodenoscopes during ERCP procedures?
- Methicillin-sensitive Staphylococcus aureus
- Carbapenem-resistant Enterobacteriaceae (CRE) (Correct answer)
- Group A Streptococcus
- Rhinovirus
Correct answer: Carbapenem-resistant Enterobacteriaceae (CRE)
CRE outbreaks have been associated with the complex elevator mechanism of duodenoscopes that is difficult to clean.
Question 2: Why does the duodenoscope elevator mechanism pose a special reprocessing challenge?
- It cannot be immersed in water
- Its complex moving parts can harbor debris and resist thorough cleaning (Correct answer)
- It is made of disposable plastic
- It does not contact patient tissue
Correct answer: Its complex moving parts can harbor debris and resist thorough cleaning
The intricate elevator mechanism has crevices that trap organic material and are difficult to clean and disinfect fully.
Question 3: What surveillance practice helps detect endoscope reprocessing failures early?
- Random patient interviews
- Periodic microbiological culturing of endoscope channels (Correct answer)
- Weighing the scopes
- Counting the number of procedures performed
Correct answer: Periodic microbiological culturing of endoscope channels
Routine culturing of scope channels can detect persistent contamination and reprocessing breakdowns before patient harm.
Question 4: A biofilm on an endoscope channel is best described as what?
- A harmless soap residue
- A protective layer of microorganisms adhered to the surface, resistant to disinfection (Correct answer)
- The manufacturer's lubricant coating
- A layer of disinfectant
Correct answer: A protective layer of microorganisms adhered to the surface, resistant to disinfection
Biofilm is a community of microbes embedded in a protective matrix that shields them from disinfectants.
Question 5: If reprocessing documentation for a specific scope is incomplete, what is the appropriate action before patient use?
- Use the scope and document later
- Do not use the scope until reprocessing is verified or repeated (Correct answer)
- Discard the scope permanently
- Use it only for low-risk patients
Correct answer: Do not use the scope until reprocessing is verified or repeated
Without verified reprocessing, the scope must not be used until it is confirmed or reprocessed to ensure patient safety.
Question 6: Which staff protection is required by law and reduces occupational risk of hepatitis B in GI nurses?
- Annual chest X-rays
- Employer-provided hepatitis B vaccination series (Correct answer)
- Daily antibiotic prophylaxis
- Mandatory quarterly blood transfusions
Correct answer: Employer-provided hepatitis B vaccination series
OSHA requires employers to offer the hepatitis B vaccine to at-risk healthcare workers at no cost.
Question 7: What is the primary purpose of an Automated Endoscope Reprocessor (AER)?
- To replace the need for any manual cleaning
- To provide standardized, reproducible high-level disinfection after manual cleaning (Correct answer)
- To dry the scope only
- To store scopes long-term
Correct answer: To provide standardized, reproducible high-level disinfection after manual cleaning
An AER standardizes high-level disinfection but does not eliminate the required manual precleaning step.
Certified Gastroenterology RN Infection Control and Safety 5
Which multidrug-resistant organism has been linked to contaminated duodenoscopes during ERCP procedures?