IAHCSMM (CRCST) 3 — Questions and Answers
Question 1: What is the minimum recommended water quality for use in the final rinse cycle of automated washers in sterile processing?
- Tap water treated with chlorine
- Softened water only
- Deionized or purified water (Correct answer)
- Distilled water mixed with detergent
Correct answer: Deionized or purified water
Deionized or purified water is recommended for final rinse cycles to prevent mineral deposits and residue that could interfere with sterilization or cause patient harm.
Question 2: A sterile package is found with a small tear in the outer wrap. What is the correct action?
- Re-wrap with an additional layer of the same material
- Mark the package as 'use first' and distribute immediately
- Consider the package non-sterile and reprocess the item (Correct answer)
- Apply tape over the tear and continue normal distribution
Correct answer: Consider the package non-sterile and reprocess the item
Any compromise to packaging integrity renders the item non-sterile; the item must be removed from service and reprocessed.
Question 3: Which sterilization method is most appropriate for heat-sensitive, moisture-sensitive devices such as certain flexible endoscopes?
- Steam autoclave at 270°F
- Ethylene oxide (EO) gas sterilization (Correct answer)
- Dry heat oven sterilization
- Flash steam sterilization
Correct answer: Ethylene oxide (EO) gas sterilization
Ethylene oxide sterilization is performed at low temperatures and is suitable for heat- and moisture-sensitive items like flexible endoscopes.
Question 4: What does 'event-related sterility' mean?
- Sterility expires based solely on the calendar date printed on the package
- Sterility is maintained until the package is opened or its integrity is compromised (Correct answer)
- Sterility is guaranteed for exactly one year from sterilization date
- Sterility depends on the type of organism the device was exposed to
Correct answer: Sterility is maintained until the package is opened or its integrity is compromised
Event-related sterility means that a properly packaged, intact item remains sterile until an event occurs that compromises the package, not simply based on a date.
Question 5: What is the purpose of a chemical integrator (Class 5) used inside a sterilization tray?
- To indicate the sterilant type used in the cycle
- To react to all critical sterilization parameters and provide a pass/fail result (Correct answer)
- To measure the exact time elapsed during the sterilization cycle
- To serve as a replacement for biological indicators
Correct answer: To react to all critical sterilization parameters and provide a pass/fail result
Class 5 chemical integrators respond to all critical parameters (time, temperature, steam) and provide a reliable internal indicator of sterilization conditions within the load.
Question 6: Which organization publishes sterilization standards most commonly referenced by US sterile processing departments?
- OSHA
- AAMI (Association for the Advancement of Medical Instrumentation) (Correct answer)
- FDA Center for Drug Evaluation
- American Hospital Association
Correct answer: AAMI (Association for the Advancement of Medical Instrumentation)
AAMI publishes the ST series of standards (e.g., AAMI ST79) that are the primary references for steam sterilization practices in US healthcare facilities.
Question 7: During ultrasonic cleaning, what process removes soil from instrument surfaces?
- High-pressure water jets breaking down biofilm
- Cavitation — formation and collapse of microscopic bubbles (Correct answer)
- Chemical oxidation of organic matter
- Thermal denaturation of proteins at elevated temperatures
Correct answer: Cavitation — formation and collapse of microscopic bubbles
Ultrasonic cleaners use cavitation — the rapid formation and implosion of tiny bubbles — to dislodge soil from instrument surfaces, including hard-to-reach areas.
IAHCSMM (CRCST) 3
What is the minimum recommended water quality for use in the final rinse cycle of automated washers in sterile processing?