CNOR Infection Prevention and Control 5 — Questions and Answers
Question 1: Which factor is most directly linked to an increased risk of developing a surgical site infection postoperatively?
- Prolonged operative time greater than the 75th percentile for the procedure (Correct answer)
- Patient age under 40 years
- Male sex
- Use of general anesthesia rather than regional anesthesia
Correct answer: Prolonged operative time greater than the 75th percentile for the procedure
Prolonged operative time increases SSI risk by extending exposure of the wound to environmental contaminants and reducing host defenses.
Question 2: When performing surgical site skin preparation, which technique is correct for applying an antiseptic solution?
- Use a circular motion from the incision site outward to the periphery (Correct answer)
- Apply from the periphery inward toward the incision site
- Scrub back and forth across the entire site in a horizontal pattern
- Apply in a single pass without overlapping strokes
Correct answer: Use a circular motion from the incision site outward to the periphery
Prep solution is applied from the clean incision center outward in concentric circles to prevent dragging contamination toward the incision.
Question 3: Which is the correct criterion for removing a surgical case from an IUSS (immediate-use steam sterilization) cycle and using the item?
- The biological and chemical indicators confirm a successful cycle and the item is used immediately without storage (Correct answer)
- The item is cooled, double-wrapped, and stored for up to 24 hours
- Only a chemical indicator is needed; biological monitoring is optional for IUSS
- The operator visually confirms steam penetration before releasing the item
Correct answer: The biological and chemical indicators confirm a successful cycle and the item is used immediately without storage
IUSS items must pass all cycle parameters and be delivered immediately to the sterile field without storage, wrapping, or delay.
Question 4: How should the perioperative nurse respond when a visitor or observer in the OR is observed repeatedly touching their face and then touching the sterile field?
- Immediately instruct the observer to move away from the sterile field and notify the surgeon (Correct answer)
- Inform the observer quietly after the case ends
- Document the incident and submit an incident report after the procedure
- Continue monitoring and intervene only if they touch the patient directly
Correct answer: Immediately instruct the observer to move away from the sterile field and notify the surgeon
Any breach of the sterile field must be addressed immediately to prevent patient harm; the nurse is accountable for maintaining aseptic technique.
Question 5: In the context of CNOR infection prevention, what does the term 'standard precautions' require?
- Treating blood, body fluids, non-intact skin, and mucous membranes of all patients as potentially infectious (Correct answer)
- Using full PPE only for patients with known infectious diseases
- Wearing gloves only when drawing blood or starting IV lines
- Applying isolation precautions based on the patient's diagnosis
Correct answer: Treating blood, body fluids, non-intact skin, and mucous membranes of all patients as potentially infectious
Standard precautions apply to all patients regardless of diagnosis and treat all blood and body substances as potentially infectious.
Question 6: Which action represents a break in sterile technique during a total knee arthroplasty?
- The scrub person reaches across the sterile field to hand an instrument to the surgeon on the opposite side (Correct answer)
- The circulator opens a sterile package and drops the contents onto the sterile field
- The surgeon requests a second pair of sterile gloves mid-case
- The scrub person keeps hands above the level of the sterile drapes at all times
Correct answer: The scrub person reaches across the sterile field to hand an instrument to the surgeon on the opposite side
Reaching across the sterile field risks contamination from unsterile areas above and around the drapes, violating aseptic technique.
Question 7: Which environmental control measure most effectively reduces airborne particle counts in the OR during an orthopedic implant procedure?
- Keeping OR doors closed throughout the procedure to maintain positive pressure and laminar airflow (Correct answer)
- Opening the OR doors to increase air circulation from the corridor
- Using portable HEPA filter units instead of the fixed HVAC system
- Reducing the number of overhead lights to decrease heat-driven air movement
Correct answer: Keeping OR doors closed throughout the procedure to maintain positive pressure and laminar airflow
Keeping OR doors closed maintains positive pressure and laminar airflow, which minimizes the influx of contaminated corridor air.
CNOR Infection Prevention and Control 5
Which factor is most directly linked to an increased risk of developing a surgical site infection postoperatively?