CNOR Infection Prevention and Control 2 — Questions and Answers
Question 1: Which microorganism is most commonly associated with surgical site infections (SSIs) in the perioperative setting?
- Staphylococcus aureus (Correct answer)
- Escherichia coli
- Pseudomonas aeruginosa
- Candida albicans
Correct answer: Staphylococcus aureus
Staphylococcus aureus, including MRSA strains, is the most frequently identified pathogen in surgical site infections.
Question 2: When should prophylactic antibiotics be administered to achieve the highest benefit in preventing SSIs?
- Within 60 minutes before surgical incision (Correct answer)
- At the time of incision
- 30 minutes after the patient enters the OR
- Immediately postoperatively in the PACU
Correct answer: Within 60 minutes before surgical incision
Prophylactic antibiotics should be administered within 60 minutes before incision to ensure adequate tissue levels at the time of the cut.
Question 3: A patient is scheduled for a cardiac procedure. The scrub person notes a small, healing laceration on their own forearm. What is the most appropriate action?
- Cover the laceration with a sterile glove and continue
- Report to the charge nurse and be assessed for fitness to scrub (Correct answer)
- Apply a bandage and proceed without notification
- Wear two pairs of gloves and continue as planned
Correct answer: Report to the charge nurse and be assessed for fitness to scrub
Any open wound or skin break on a scrub team member must be assessed by a supervisor to determine if the employee poses an infection risk.
Question 4: Which class of SSI involves infection only of the skin and subcutaneous tissue of the incision?
- Superficial incisional SSI (Correct answer)
- Deep incisional SSI
- Organ/space SSI
- Remote infection
Correct answer: Superficial incisional SSI
A superficial incisional SSI is limited to the skin and subcutaneous tissue without involvement of deeper fascial layers.
Question 5: Flash sterilization (IUSS) should be used in which circumstance?
- When a dropped instrument is urgently needed and no alternative exists (Correct answer)
- For all implants to save time
- As a routine sterilization method for high-use instruments
- When the sterile processing department is backlogged
Correct answer: When a dropped instrument is urgently needed and no alternative exists
IUSS is reserved for urgent situations when a dropped or contaminated item is needed immediately and no sterile alternative is available.
Question 6: What is the primary purpose of the surgical hand scrub performed before donning sterile gloves?
- To remove transient flora and reduce resident flora to as low a level as possible (Correct answer)
- To completely sterilize the hands
- To remove all resident flora permanently
- To substitute for wearing sterile gloves during minor procedures
Correct answer: To remove transient flora and reduce resident flora to as low a level as possible
The surgical hand scrub reduces microbial counts on the hands but cannot achieve sterilization; it eliminates transients and suppresses residents.
Question 7: During a laparoscopic cholecystectomy, the laparoscope is inadvertently dropped on the floor. Which action is most appropriate?
- The circulator retrieves it and passes it back after wiping with a sterile towel
- A replacement sterile laparoscope is obtained or the dropped scope is sent for IUSS if urgently needed (Correct answer)
- The scrub tech rinses it with sterile saline and returns it to the field
- The surgeon continues without the laparoscope to avoid delay
Correct answer: A replacement sterile laparoscope is obtained or the dropped scope is sent for IUSS if urgently needed
Any instrument that falls to the floor is considered contaminated and must be replaced with a sterile item or processed via IUSS if no replacement exists.
CNOR Infection Prevention and Control 2
Which microorganism is most commonly associated with surgical site infections (SSIs) in the perioperative setting?