CMT Infection Control Practices — Questions and Answers
Question 1: The single most effective method for preventing the spread of infection in healthcare settings is:
- Wearing gloves at all times
- Hand hygiene (Correct answer)
- Using antibiotics prophylactically
- Wearing N95 respirators
Correct answer: Hand hygiene
Hand hygiene, including handwashing and alcohol-based hand sanitizer use, is the most effective infection prevention measure.
Hand hygiene is universally recognized as the most important measure to prevent healthcare-associated infections (HAIs). The CDC and WHO recommend hand hygiene at five key moments: before patient contact, before aseptic procedures, after body fluid exposure, after patient contact, and after touching patient surroundings. Alcohol-based hand rub (60-95% alcohol) is preferred for routine decontamination when hands are not visibly soiled. Soap and water must be used when hands are visibly contaminated or after caring for patients with C. difficile or norovirus.
Question 2: Which type of precaution requires a negative-pressure isolation room?
- Contact precautions
- Droplet precautions
- Airborne precautions (Correct answer)
- Standard precautions
Correct answer: Airborne precautions
Airborne precautions require a negative-pressure airborne infection isolation room (AIIR) to prevent transmission of airborne pathogens.
Airborne precautions are used for pathogens that remain suspended in air for prolonged periods and travel long distances (greater than 6 feet). A negative-pressure room has lower air pressure than surrounding areas, preventing contaminated air from escaping when the door opens. Air is exhausted outside or through HEPA filtration. Diseases requiring airborne precautions include tuberculosis, measles, varicella (chickenpox), and disseminated herpes zoster. Healthcare workers must wear N95 respirators (fit-tested) when entering these rooms.
Question 3: How long should a standard surgical hand scrub last?
- 15-30 seconds
- 1-2 minutes
- 2-6 minutes (Correct answer)
- 10-15 minutes
Correct answer: 2-6 minutes
A surgical hand scrub should last 2-6 minutes depending on the product used and institutional protocol.
Surgical hand antisepsis requires 2-6 minutes of scrubbing with an antimicrobial agent (chlorhexidine gluconate or povidone-iodine) to eliminate transient flora and reduce resident flora on hands and forearms. The traditional counted-stroke method involves scrubbing each surface a specific number of strokes. Newer alcohol-based surgical hand rub protocols may take 1.5-3 minutes. Routine handwashing requires only 20 seconds minimum. Nails must be short, and artificial nails and jewelry must be removed before surgical scrubbing.
Question 4: Sharps containers should be replaced when they reach what fill level?
- Completely full
- Three-quarters full (Correct answer)
- Half full
- One-quarter full
Correct answer: Three-quarters full
Sharps containers should be replaced when they are three-quarters (75%) full to prevent overfilling and needlestick injuries.
OSHA regulations require that sharps containers be closable, puncture-resistant, leakproof, and labeled with the biohazard symbol. They must be replaced when contents reach the fill line, typically at three-quarters capacity. Overfilling sharps containers is a leading cause of needlestick injuries. Containers should be mounted at eye level and within arm's reach of the point of use. Used needles must never be recapped, bent, or broken. All sharps (needles, scalpels, broken glass) must go directly into the container immediately after use.
Question 5: Which organism is most commonly associated with healthcare-associated infections from improper catheter care?
- Streptococcus pneumoniae
- Escherichia coli (Correct answer)
- Mycobacterium tuberculosis
- Haemophilus influenzae
Correct answer: Escherichia coli
E. coli is the most common cause of catheter-associated urinary tract infections (CAUTIs).
Catheter-associated urinary tract infections (CAUTIs) account for approximately 75% of all hospital-acquired UTIs. E. coli is the most common causative organism, followed by Klebsiella, Enterococcus, and Pseudomonas. Prevention strategies include: inserting catheters only when medically necessary, using aseptic technique during insertion, maintaining a closed drainage system, keeping the collection bag below bladder level, performing regular perineal hygiene, and removing catheters as soon as clinically appropriate.
Question 6: What color bag is used for disposing of regulated medical waste (biohazardous materials)?
- Black
- Clear
- Red (Correct answer)
- Blue
Correct answer: Red
Red bags marked with the biohazard symbol are used for regulated medical waste disposal.
Red biohazard bags are used for regulated medical waste including blood-soaked items, pathological waste, microbiological waste, and items contaminated with blood or other potentially infectious materials (OPIM). Regular trash goes in clear or black bags. OSHA's Bloodborne Pathogens Standard requires biohazard labeling on all containers of regulated waste. Improper segregation of waste increases disposal costs and creates safety hazards. Medical technicians must know their facility's waste segregation policies and ensure proper disposal at the point of care.
Question 7: Standard precautions apply to which of the following?
- Only patients with known infectious diseases
- Only patients in isolation rooms
- All patients regardless of diagnosis (Correct answer)
- Only surgical patients
Correct answer: All patients regardless of diagnosis
Standard precautions are applied to all patients in all healthcare settings, regardless of known or suspected infection status.
Standard precautions were established by the CDC as the minimum infection prevention practices that apply to all patient care. They assume that every person is potentially infectious. Components include: hand hygiene, use of PPE based on anticipated exposure, safe injection practices, safe handling of contaminated equipment and surfaces, respiratory hygiene/cough etiquette, and proper sharps handling. Standard precautions replaced the older concept of 'universal precautions' and are supplemented by transmission-based precautions (contact, droplet, airborne) when specific pathogens are known or suspected.
Question 8: The term 'nosocomial infection' refers to:
- An infection acquired in the community
- A surgically implanted infection
- A healthcare-associated infection (Correct answer)
- A congenital infection
Correct answer: A healthcare-associated infection
Nosocomial infections are infections acquired in healthcare facilities, now more commonly called healthcare-associated infections (HAIs).
Nosocomial (healthcare-associated) infections develop 48 hours or more after hospital admission and were not present or incubating at the time of admission. The four most common HAIs are: catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSIs), surgical site infections (SSIs), and ventilator-associated pneumonia (VAP). The CDC estimates 1 in 31 hospitalized patients develops at least one HAI. Prevention bundles—evidence-based practice sets—have significantly reduced HAI rates when consistently implemented.
Question 9: Which level of disinfection is required for semicritical medical devices that contact mucous membranes?
- Low-level disinfection
- Intermediate-level disinfection
- High-level disinfection (Correct answer)
- Sterilization
Correct answer: High-level disinfection
Semicritical items that contact mucous membranes require high-level disinfection, which kills all microorganisms except high numbers of bacterial spores.
The Spaulding classification system categorizes medical devices by infection risk: Critical items (enter sterile tissue—require sterilization), Semicritical items (contact mucous membranes or non-intact skin—require high-level disinfection), and Noncritical items (contact intact skin—require low/intermediate-level disinfection). High-level disinfection eliminates all microorganisms except large numbers of bacterial spores. Common high-level disinfectants include glutaraldehyde, ortho-phthalaldehyde (OPA), and hydrogen peroxide. Processing time and temperature must follow manufacturer instructions.
Question 10: When donning full PPE, which item should be put on first?
- Gloves
- Face mask or respirator
- Gown (Correct answer)
- Eye protection
Correct answer: Gown
The gown should be donned first, followed by the mask/respirator, eye protection, and gloves last.
The CDC-recommended PPE donning sequence is: (1) gown—ties at neck and waist, (2) mask or respirator—secure ties/elastic, fit to face, (3) goggles or face shield—adjust to fit, (4) gloves—extend over gown cuffs. The doffing (removal) sequence prioritizes removing the most contaminated items first: (1) gloves—using glove-to-glove then skin-to-skin technique, (2) gown—unfasten and pull away from body, rolling inside out, (3) eye protection—remove by headband or earpieces, (4) mask/respirator—remove by ties/elastic without touching front. Hand hygiene is performed after removing all PPE.
Question 11: What is the correct temperature range for an autoclave used for standard sterilization?
- 100-110°C (212-230°F)
- 121-134°C (250-273°F) (Correct answer)
- 150-160°C (302-320°F)
- 180-200°C (356-392°F)
Correct answer: 121-134°C (250-273°F)
Autoclaves use pressurized steam at 121-134°C (250-273°F) to achieve sterilization.
Steam autoclaving is the most common and reliable sterilization method for heat- and moisture-stable items. Standard cycles run at 121°C (250°F) for 15-30 minutes at 15 psi, or 134°C (273°F) for 3-10 minutes at 30 psi (flash sterilization for urgent needs). The combination of temperature, pressure, and time ensures destruction of all microorganisms including bacterial spores. Biological indicators (Geobacillus stearothermophilus spore tests) are used to verify sterilization effectiveness. Chemical indicators change color to confirm exposure to sterilization conditions but do not confirm sterility.
Question 12: The chain of infection includes six links. Which of the following is NOT one of them?
- Reservoir
- Portal of entry
- Antibiotic resistance (Correct answer)
- Susceptible host
Correct answer: Antibiotic resistance
Antibiotic resistance is not a link in the chain of infection. The six links are: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host.
The chain of infection describes the sequence required for infection transmission: (1) Infectious agent (pathogen), (2) Reservoir (where pathogen lives—humans, animals, environment), (3) Portal of exit (how pathogen leaves reservoir—respiratory, GI, skin, blood), (4) Mode of transmission (contact, droplet, airborne, vehicle, vector), (5) Portal of entry (how pathogen enters new host—respiratory, GI, breaks in skin, mucous membranes), (6) Susceptible host (person unable to resist infection due to immune status, age, chronic disease). Infection control strategies target breaking one or more links.
CMT Infection Control Practices
The single most effective method for preventing the spread of infection in healthcare settings is:
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