IAHCSMM (CRCST) 4 — Questions and Answers
Question 1: What is the correct action when a Bowie-Dick test fails in a pre-vacuum steam sterilizer?
- Run the load anyway if the BI indicator is satisfactory
- Rerun the test once more and use the sterilizer if it passes
- Remove the sterilizer from service, investigate the cause, and notify the appropriate personnel (Correct answer)
- Increase the sterilization temperature and retest
Correct answer: Remove the sterilizer from service, investigate the cause, and notify the appropriate personnel
A failed Bowie-Dick test indicates inadequate air removal in the pre-vacuum sterilizer; the unit must be taken out of service immediately and the cause investigated before returning to use.
Question 2: Which factor is MOST critical in determining the efficacy of manual cleaning of surgical instruments?
- The brand of enzymatic detergent used
- The friction applied during scrubbing and thoroughness of cleaning (Correct answer)
- The temperature of the water
- The length of soaking time before cleaning
Correct answer: The friction applied during scrubbing and thoroughness of cleaning
Manual cleaning relies heavily on mechanical action (friction) to physically remove bioburden, making proper scrubbing technique the most critical factor.
Question 3: What is the recommended relative humidity level in the sterile storage area to protect package integrity?
- 30–60% (Correct answer)
- 70–90%
- 10–20%
- 60–80%
Correct answer: 30–60%
AAMI guidelines recommend maintaining relative humidity between 30–60% in sterile storage to prevent package degradation, condensation, and microbial growth.
Question 4: Which term describes instruments that are used to enter normally sterile tissue or the vascular system and require sterilization?
- Non-critical devices
- Semi-critical devices
- Critical devices (Correct answer)
- Utility-class devices
Correct answer: Critical devices
Critical devices (per the Spaulding Classification) contact sterile tissue or the vascular system and must be sterile before use to prevent serious infection.
Question 5: A surgical instrument with a box-lock joint should be sterilized in what position?
- Fully closed to maintain shape
- Partially open to allow sterilant penetration into the joint (Correct answer)
- Disassembled into individual components
- Wrapped tightly in foam to prevent movement
Correct answer: Partially open to allow sterilant penetration into the joint
Box-lock instruments should be placed in the open or partially open position to allow steam or sterilant to contact all surfaces and penetrate the joint area.
Question 6: What is the main hazard associated with ethylene oxide (EO) residue remaining on a device after sterilization?
- It reduces the effectiveness of disinfectants used afterward
- It can cause chemical burns or toxic reactions in patients or staff (Correct answer)
- It causes rust and corrosion on metal instruments
- It reacts with packaging materials to cause discoloration
Correct answer: It can cause chemical burns or toxic reactions in patients or staff
EO is a toxic, carcinogenic gas; inadequate aeration leaves residue that can cause chemical burns, hemolysis, and other toxic effects in patients and staff.
Question 7: Which sterilization load configuration practice helps ensure adequate steam penetration throughout a wrapped tray?
- Stacking trays tightly to minimize movement
- Placing heavier packs on top and lighter ones on the bottom
- Positioning trays on edge (vertical) or flat with space between items to allow steam circulation (Correct answer)
- Sealing trays with foil before wrapping
Correct answer: Positioning trays on edge (vertical) or flat with space between items to allow steam circulation
Proper loading allows steam to circulate freely; trays should be positioned to facilitate steam penetration and condensate drainage, never packed too tightly.
IAHCSMM (CRCST) 4
What is the correct action when a Bowie-Dick test fails in a pre-vacuum steam sterilizer?