CNOR Trivia 3 — Questions and Answers
Question 1: Which sterilization method is considered the gold standard for heat-stable surgical instruments?
- Ethylene oxide (EO) gas sterilization
- Steam autoclave (moist heat) sterilization (Correct answer)
- Hydrogen peroxide plasma sterilization
- Dry heat sterilization
Correct answer: Steam autoclave (moist heat) sterilization
Steam autoclave (moist heat) sterilization is the gold standard for heat-stable instruments due to its reliability, speed, and non-toxic nature.
Question 2: What does the Spaulding Classification system categorize?
- Surgical wound contamination levels
- Medical devices by infection risk to determine required reprocessing level (Correct answer)
- Anesthesia risk levels for patients
- Sterilization cycle types by temperature
Correct answer: Medical devices by infection risk to determine required reprocessing level
The Spaulding Classification categorizes medical devices into critical, semi-critical, and non-critical items based on their infection risk and the required level of disinfection or sterilization.
Question 3: In the perioperative setting, the 'scrub' role is responsible for:
- Managing the sterile field and passing instruments to the surgeon (Correct answer)
- Circulating outside the sterile field and documenting care
- Administering anesthesia to the patient
- Positioning and transporting the patient
Correct answer: Managing the sterile field and passing instruments to the surgeon
The scrub person works within the sterile field, maintaining sterility and passing instruments, sutures, and supplies to the surgeon.
Question 4: Malignant hyperthermia (MH) is triggered by which class of agents?
- Opioid analgesics and benzodiazepines
- Volatile inhalation anesthetics and succinylcholine (Correct answer)
- Non-depolarizing neuromuscular blockers
- Local anesthetics and vasopressors
Correct answer: Volatile inhalation anesthetics and succinylcholine
Malignant hyperthermia is triggered by volatile halogenated inhalation anesthetics (e.g., sevoflurane, desflurane) and the depolarizing muscle relaxant succinylcholine.
Question 5: The first-line pharmacologic treatment for malignant hyperthermia crisis is:
- Propofol
- Sodium bicarbonate
- Dantrolene sodium (Correct answer)
- Epinephrine
Correct answer: Dantrolene sodium
Dantrolene sodium is the specific antidote for malignant hyperthermia, acting by inhibiting calcium release from the sarcoplasmic reticulum in muscle cells.
Question 6: Which principle of surgical asepsis states that sterile items placed below the patient's waist level are considered contaminated?
- The sterile field must remain in constant view
- Items of questionable sterility are considered contaminated
- Sterile persons and items contact only sterile areas
- Sterile tables are sterile only at table level (Correct answer)
Correct answer: Sterile tables are sterile only at table level
A fundamental aseptic principle is that the sterile drape is only considered sterile at table level; anything that falls or is lowered below this level is contaminated.
Question 7: What is the recommended OR temperature range to reduce surgical site infections and prevent patient hypothermia?
- 60–65°F (15–18°C)
- 68–75°F (20–24°C) (Correct answer)
- 78–82°F (25–28°C)
- 85–90°F (29–32°C)
Correct answer: 68–75°F (20–24°C)
AORN guidelines recommend OR temperatures of 68–75°F (20–24°C) to balance infection control and normothermia maintenance for most adult procedures.
CNOR Trivia 3
Which sterilization method is considered the gold standard for heat-stable surgical instruments?