CIR CIR Quality Assurance & Equipment Management 2 — Questions and Answers
Question 1: Stent inventory in the cardiac cath lab is best managed using which tracking system to ensure sterility and prevent expired product use?
- First-in, first-out (FIFO) with lot number tracking (Correct answer)
- Last-in, first-out (LIFO) only
- Alphabetical ordering by manufacturer
- Color-coded bins without expiration checks
Correct answer: First-in, first-out (FIFO) with lot number tracking
FIFO inventory management with lot number and expiration date tracking ensures oldest stock is used first and expired implants are removed from service.
Question 2: A cath lab staff member receives 4.5 mSv of occupational radiation dose in a single quarter. This exceeds which regulatory threshold?
- Monthly dose limit
- Annual occupational whole-body effective dose limit of 5 mSv/quarter warning level (Correct answer)
- Lifetime dose limit
- Single-procedure dose limit
Correct answer: Annual occupational whole-body effective dose limit of 5 mSv/quarter warning level
The NRC annual occupational whole-body limit is 50 mSv/year; quarterly monitoring at 1.25 mSv/quarter is the action level, and 4.5 mSv/quarter warrants immediate investigation.
Question 3: Which quality indicator best reflects the technical success of percutaneous coronary intervention (PCI)?
- Procedure duration
- Residual stenosis <20% with TIMI 3 flow post-PCI (Correct answer)
- Number of contrast injections
- Fluoroscopy time per case
Correct answer: Residual stenosis <20% with TIMI 3 flow post-PCI
Angiographic success after PCI is defined as residual stenosis < 20% with TIMI grade 3 (normal) flow in the target vessel.
Question 4: A defibrillator in the cath lab must be checked with a test shock log at minimum:
- Monthly
- Daily, before the first case (Correct answer)
- Weekly
- Annually
Correct answer: Daily, before the first case
Defibrillators used in procedural areas must undergo a daily operational check before the first case to confirm readiness for emergencies.
Question 5: Which document must be completed and retained for each fluoroscopic procedure in the cath lab to comply with Joint Commission radiation dose standards?
- Patient allergy form
- Radiation dose record including DAP or cumulative air kerma (Correct answer)
- Billing code sheet
- Vendor equipment service log
Correct answer: Radiation dose record including DAP or cumulative air kerma
TJC and state regulations require documentation of patient radiation dose (dose area product or cumulative air kerma) for all fluoroscopy-guided procedures.
Question 6: Hemostasis devices such as closure plugs and suture-mediated closure systems are single-use items primarily because:
- They are too expensive to reprocess
- Reprocessing cannot ensure sterility or structural integrity for vascular closure (Correct answer)
- They are made of materials that cannot be cleaned
- Manufacturers prefer disposable revenue
Correct answer: Reprocessing cannot ensure sterility or structural integrity for vascular closure
Single-use vascular closure devices cannot be reliably resterilized to maintain structural integrity needed to achieve hemostasis, creating patient safety risk if reused.
CIR CIR Quality Assurance & Equipment Management 2
Stent inventory in the cardiac cath lab is best managed using which tracking system to ensure sterility and prevent expired product use?