CSFA Aseptic Technique and Sterilization Questions and Answers — Questions and Answers
Question 1: During a procedure, the CSFA observes a circulating nurse, who is not gowned and gloved, reach over the sterile back table to retrieve an item from the far side. What is the most appropriate immediate action for the CSFA to take?
- Immediately state that the field has been contaminated and request that all potentially affected items be removed and replaced. (Correct answer)
- Ask the surgeon if they believe the field is still sterile.
- Wait until the end of the procedure to report the incident to the charge nurse.
- Say nothing to avoid conflict and continue with the procedure.
Correct answer: Immediately state that the field has been contaminated and request that all potentially affected items be removed and replaced.
A core principle of aseptic technique is that non-sterile individuals or items must never cross over the sterile field. When this occurs, the field is considered contaminated. The CSFA has a duty to advocate for patient safety by immediately identifying the breach so the team can take corrective action, which includes removing and replacing any compromised supplies or drapes.
Question 2: A critical, non-porous, non-lumened surgical instrument is accidentally dropped on the floor mid-procedure. The surgeon states it is urgently needed to complete the case. According to AORN and AAMI guidelines, what is the most appropriate course of action?
- Wipe the instrument with an alcohol-based wipe and return it to the sterile field.
- Process the instrument using an Immediate-Use Steam Sterilization (IUSS) cycle, ensuring it is first cleaned, placed in a validated rigid container, and transported aseptically. (Correct answer)
- Submerge the instrument in glutaraldehyde for 10 minutes before returning it to the field.
- Process the instrument using the shortest available IUSS cycle without a container to save time.
Correct answer: Process the instrument using an Immediate-Use Steam Sterilization (IUSS) cycle, ensuring it is first cleaned, placed in a validated rigid container, and transported aseptically.
Immediate-Use Steam Sterilization (IUSS), formerly known as 'flash sterilization,' should be kept to a minimum and used only in urgent situations. The complete, proper procedure must be followed, which includes thorough cleaning and decontamination, placement in a closed, rigid sterilization container validated for IUSS, running the manufacturer-specified cycle, and aseptic transfer to the sterile field.
Question 3: A wrapped set of heavy orthopedic instruments needs to be sterilized for a case later in the day. Which of the following represents the minimum exposure time and temperature for a gravity displacement steam sterilization cycle?
- 4 minutes at 270°F (132°C)
- 15 minutes at 250°F (121°C)
- 30 minutes at 250°F (121°C) (Correct answer)
- 10 minutes at 270°F (132°C)
Correct answer: 30 minutes at 250°F (121°C)
For wrapped instruments in a gravity displacement sterilizer, the steam must adequately penetrate the packaging and the dense instrument load. The recognized minimum exposure time to achieve sterilization under these conditions is 30 minutes at 121°C (250°F).
Question 4: A biologic indicator (BI) used to monitor the efficacy of a steam sterilization cycle contains spores from which microorganism?
- Bacillus atrophaeus
- Mycobacterium tuberculosis
- Clostridium difficile
- Geobacillus stearothermophilus (Correct answer)
Correct answer: Geobacillus stearothermophilus
Biological indicators are the most reliable method for monitoring sterilization efficacy because they directly test the lethality of the process. For steam sterilization, BIs contain spores of Geobacillus stearothermophilus, a thermophilic bacterium that is highly resistant to moist heat, ensuring that if it is killed, less resistant organisms have also been eliminated.
Question 5: Which of the following is a fundamental principle of surgical asepsis regarding movement and positioning within the sterile field?
- The back of a sterile gown is considered sterile and may face the field.
- A sterile field may be set up and left unattended if the room is secured.
- Scrubbed personnel should pass each other back-to-back or face-to-face. (Correct answer)
- The edges of a sterile container are considered sterile once the package is opened.
Correct answer: Scrubbed personnel should pass each other back-to-back or face-to-face.
To maintain sterility, scrubbed surgical team members must pass one another in a way that prevents contact between a sterile front and a non-sterile back. Therefore, they should pass either by turning back-to-back or by facing each other at a safe distance. The front of a sterile gown is considered sterile from chest to the level of the sterile field; the back is always considered non-sterile.
Question 6: When performing a traditional surgical hand scrub using an antimicrobial soap and brush, the CSFA must ensure they scrub their hands and arms to what anatomical level?
- To the midpoint of the forearm.
- Four inches above the wrist.
- To the level of the elbow.
- Two inches above the elbow. (Correct answer)
Correct answer: Two inches above the elbow.
The surgical hand scrub is performed to reduce the number of resident and transient microorganisms on the hands and forearms. The scrub must extend from the fingertips to two inches above the elbow. This ensures that the entire area that will be enclosed within the sterile gown sleeves is surgically clean, preventing potential contamination should water drip down from a less clean area.
CSFA Aseptic Technique and Sterilization Questions and Answers
During a procedure, the CSFA observes a circulating nurse, who is not gowned and gloved, reach over the sterile back table to retrieve an item from the far side.
What is the most appropriate immediate action for the CSFA to take?