CNOR Infection Prevention and Control 4 — Questions and Answers
Question 1: What is the minimum required concentration of isopropyl alcohol for a waterless alcohol-based surgical hand rub to be considered effective?
- 60–95% alcohol (Correct answer)
- 30–50% alcohol
- 10–30% alcohol
- Greater than 95% alcohol
Correct answer: 60–95% alcohol
The CDC recommends alcohol-based hand hygiene products containing 60–95% alcohol for effective antimicrobial activity.
Question 2: In the OR, which surface is considered a critical zone requiring the highest level of environmental decontamination between cases?
- The operating table and immediately surrounding sterile field areas (Correct answer)
- The anesthesia cart located at the head of the bed
- The scrub sink located in the sub-sterile corridor
- The wall-mounted clock and overhead lights
Correct answer: The operating table and immediately surrounding sterile field areas
The operating table and areas directly involved in patient contact are critical zones requiring thorough terminal decontamination between cases.
Question 3: Which sterilization method is most appropriate for heat-sensitive flexible endoscopes used in the OR?
- Low-temperature hydrogen peroxide gas plasma (Sterrad) or ethylene oxide (EtO) (Correct answer)
- Steam autoclave at 270°F (132°C)
- Dry heat sterilization at 320°F (160°C)
- Flash sterilization at prevacuum settings
Correct answer: Low-temperature hydrogen peroxide gas plasma (Sterrad) or ethylene oxide (EtO)
Heat-sensitive devices like flexible endoscopes require low-temperature sterilization methods such as hydrogen peroxide plasma or EtO.
Question 4: A scrub person's sterile gown is torn above the elbow during a case. What is the correct action?
- Immediately leave the sterile field, change the gown, and re-glove before returning (Correct answer)
- Cover the tear with sterile drape material and continue
- Inform the surgeon and continue if the tear is small
- Apply a sterile glove over the sleeve to maintain sterility
Correct answer: Immediately leave the sterile field, change the gown, and re-glove before returning
A torn or wet gown is no longer considered sterile and requires immediate replacement before the team member can continue in the sterile field.
Question 5: Which action is required when a sterile package is found with a small hole or tear before opening?
- The package must be considered contaminated and returned to SPD for reprocessing (Correct answer)
- The item can be used if the hole is smaller than 2 mm
- The hole can be covered with sterile tape and the item used immediately
- The circulator inspects the contents; if uncontaminated, use is acceptable
Correct answer: The package must be considered contaminated and returned to SPD for reprocessing
Any compromised packaging — holes, tears, moisture, or missing seals — renders the item non-sterile and it must be reprocessed.
Question 6: What does the Spaulding classification system categorize as 'critical' items requiring sterilization?
- Items that enter sterile tissue or the vascular system (Correct answer)
- Items that contact intact mucous membranes only
- Items that contact only intact skin
- Items used exclusively in the substerile corridor
Correct answer: Items that enter sterile tissue or the vascular system
Critical items contact sterile body tissue or the bloodstream and carry the highest infection risk, requiring sterilization before use.
Question 7: Which transmission-based precaution category applies to diseases spread by large respiratory droplets such as influenza?
- Droplet precautions (Correct answer)
- Airborne precautions
- Contact precautions
- Standard precautions alone
Correct answer: Droplet precautions
Droplet precautions are used for pathogens transmitted via large droplets (>5 µm) that travel short distances, such as influenza.
CNOR Infection Prevention and Control 4
What is the minimum required concentration of isopropyl alcohol for a waterless alcohol-based surgical hand rub to be considered effective?