CNOR Infection Prevention and Control 3 — Questions and Answers
Question 1: Which personal protective equipment (PPE) combination is required when handling a patient with active pulmonary tuberculosis in the OR?
- N95 respirator, gown, gloves, and eye protection (Correct answer)
- Surgical mask, gown, and gloves only
- Powered air-purifying respirator (PAPR) alone
- Standard surgical mask and gloves are sufficient
Correct answer: N95 respirator, gown, gloves, and eye protection
Airborne precautions for TB require a fit-tested N95 or higher respirator along with gown, gloves, and eye protection.
Question 2: Which action best prevents the transmission of Clostridioides difficile (C. diff) in the perioperative environment?
- Handwashing with soap and water rather than alcohol-based hand rub (Correct answer)
- Using alcohol-based hand rub consistently before and after patient contact
- Wearing double gloves during all cases
- Applying chlorhexidine gluconate solution to all surfaces
Correct answer: Handwashing with soap and water rather than alcohol-based hand rub
C. diff spores are resistant to alcohol; soap and water physically remove spores from hands and are required for C. diff precautions.
Question 3: A surgical technologist has a needlestick injury during a case. What is the first action to take?
- Immediately remove glove, wash the wound with soap and water, and report to supervisor (Correct answer)
- Finish the case and report to employee health afterward
- Apply an alcohol swab to the puncture site and continue
- Squeeze the wound to remove blood and then apply a sterile dressing
Correct answer: Immediately remove glove, wash the wound with soap and water, and report to supervisor
Immediate wound washing with soap and water followed by prompt reporting initiates the exposure response protocol.
Question 4: What is the recommended room air exchange rate per hour in an operating room to reduce airborne contamination?
- A minimum of 15 air changes per hour, with at least 3 of outdoor air (Correct answer)
- 5 air changes per hour total
- 25 air changes per hour of recirculated air only
- 10 air changes per hour with HEPA filtration optional
Correct answer: A minimum of 15 air changes per hour, with at least 3 of outdoor air
AORN and CDC guidelines recommend a minimum of 15 total air changes per hour with at least 3 fresh outdoor air changes in the OR.
Question 5: Which type of wound is considered a Class III (contaminated) surgical wound?
- Open traumatic wound with gross spillage from the GI tract (Correct answer)
- Elective clean procedure with no break in aseptic technique
- Infected wound with devitalized tissue present
- Clean elective procedure on an uninfected hollow viscus
Correct answer: Open traumatic wound with gross spillage from the GI tract
Class III wounds include open traumatic wounds, operations with major breaks in sterile technique, or gross GI spillage.
Question 6: Which statement about sterile field maintenance is correct regarding a team member who steps away from the sterile field?
- The team member must be considered unsterile and cannot return to the sterile field without re-gowning and re-gloving (Correct answer)
- The team member may return if they were gone fewer than five minutes
- The team member may return if their back was facing away from the field
- The team member may return after reapplying sterile gloves only
Correct answer: The team member must be considered unsterile and cannot return to the sterile field without re-gowning and re-gloving
Once a scrubbed team member steps away from the sterile field, their sterility cannot be guaranteed and full re-gowning and re-gloving is required.
Question 7: Preoperative chlorhexidine gluconate (CHG) bathing of a surgical patient is most beneficial for which purpose?
- Reducing skin bacterial burden to lower SSI risk (Correct answer)
- Eliminating all skin flora permanently before surgery
- Replacing the need for surgical site hair removal
- Substituting for intraoperative antiseptic prep
Correct answer: Reducing skin bacterial burden to lower SSI risk
Preoperative CHG bathing reduces colonization on the patient's skin, which is associated with decreased SSI rates.
CNOR Infection Prevention and Control 3
Which personal protective equipment (PPE) combination is required when handling a patient with active pulmonary tuberculosis in the OR?