CNOR - Certification Infection Prevention and Control Questions and Answers — Questions and Answers
Question 1: A patient undergoing a colon resection is diagnosed postoperatively with a surgical site infection (SSI). Which of the following is the MOST common source of microorganisms causing this type of infection?
- Contaminated surgical instruments
- The patient's own endogenous flora (Correct answer)
- The operating room air
- A break in sterile technique by the surgical team
Correct answer: The patient's own endogenous flora
The most common source of microorganisms causing surgical site infections is the patient's own endogenous flora from their skin, mucous membranes, or gastrointestinal tract. While other sources are possible, the patient's own bacteria are the primary culprits in most SSIs.
Question 2: According to the most recent CDC and AORN guidelines, which of the following is the recommended practice for preoperative patient bathing to prevent surgical site infections?
- The patient must shower with chlorhexidine gluconate (CHG) soap the morning of surgery.
- A full-body shower or bath with either antimicrobial or non-antimicrobial soap is advised at least the night before surgery. (Correct answer)
- Preoperative bathing is no longer recommended as it does not significantly reduce SSI rates.
- The surgical site should be shaved with a razor and cleansed with an antiseptic agent the evening before surgery.
Correct answer: A full-body shower or bath with either antimicrobial or non-antimicrobial soap is advised at least the night before surgery.
Current CDC guidelines recommend that patients shower or bathe their full body with either an antimicrobial or a non-antimicrobial soap at least the night before the operative day. Shaving with a razor is discouraged due to the risk of micro-abrasions; if hair removal is necessary, clippers should be used.
Question 3: A perioperative nurse is preparing for a case involving a patient with known methicillin-resistant Staphylococcus aureus (MRSA) in a draining wound. In addition to Standard Precautions, which type of transmission-based precautions should be implemented?
- Airborne Precautions
- Droplet Precautions
- Contact Precautions (Correct answer)
- Protective Environment
Correct answer: Contact Precautions
MRSA is primarily transmitted through direct or indirect contact with the infected person or contaminated surfaces. Therefore, Contact Precautions are required, which include wearing gloves and a gown upon entering the patient's room or care area.
Question 4: During room turnover after a surgical case, what is the correct sequence for environmental cleaning and disinfection?
- From dirtiest to cleanest areas to contain contaminants.
- From top to bottom, and from cleanest to dirtiest areas. (Correct answer)
- From the floor up to the ceiling to capture falling dust.
- Simultaneously cleaning all surfaces to maximize efficiency.
Correct answer: From top to bottom, and from cleanest to dirtiest areas.
The correct procedure for cleaning the operating room is to start from top to bottom (e.g., lights before floors) and to move from the cleanest areas (e.g., periphery of the room) to the dirtiest areas (e.g., the area immediately around the operating table). This method prevents the contamination of already cleaned surfaces.
Question 5: Which of the following statements about surgical attire is most consistent with current AORN guidelines for infection prevention?
- Shoe covers are mandatory for all personnel entering the semi-restricted areas.
- Surgical masks may be untied and worn around the neck between cases.
- Lanyards made of porous material are acceptable if they remain under a cover gown.
- Surgical attire contaminated with blood or body fluids should be changed promptly before leaving the work area. (Correct answer)
Correct answer: Surgical attire contaminated with blood or body fluids should be changed promptly before leaving the work area.
AORN guidelines emphasize that surgical attire visibly contaminated with blood, body fluids, or other potentially infectious materials should be changed as soon as possible. Wearing masks around the neck and the routine use of lanyards are discouraged as they can become contaminated and serve as a vehicle for transmission. Shoe cover requirements are determined by the facility's risk assessment.
Question 6: A surgical instrument tray wrapped in a woven textile has been processed in a steam sterilizer. The external chemical indicator has changed color, but the internal indicator has not. What is the most appropriate action for the perioperative nurse to take?
- Use the instruments since the external indicator shows the package was processed.
- Open the tray in the sterile field but inspect instruments for any visible residue before use.
- Send the tray to be re-sterilized immediately without opening it. (Correct answer)
- Document the discrepancy and use the instruments for the current case only.
Correct answer: Send the tray to be re-sterilized immediately without opening it.
If the internal chemical indicator has not changed appropriately, it signifies a failure in the sterilization process; the sterilant may not have penetrated the package or reached the necessary parameters. The tray is considered unsterile and must be removed from service and reprocessed. The external indicator only shows that the package has been exposed to the process, not that sterility was achieved.
CNOR - Certification Infection Prevention and Control Questions and Answers
A patient undergoing a colon resection is diagnosed postoperatively with a surgical site infection (SSI).
Which of the following is the MOST common source of microorganisms causing this type of infection?