IAHCSMM Ultimate IAHCSMM 5 — Questions and Answers
Question 1: What is the proper sequence for manual cleaning of surgical instruments?
- Rinse, scrub with detergent, final rinse, dry
- Disassemble, pre-rinse/soak, scrub with detergent in low-lint brush, rinse, dry (Correct answer)
- Soak in disinfectant, rinse, scrub, dry
- Scrub dry first, then rinse with water and detergent solution
Correct answer: Disassemble, pre-rinse/soak, scrub with detergent in low-lint brush, rinse, dry
Manual cleaning begins with disassembly, pre-rinsing or soaking to loosen soil, scrubbing with a low-lint brush and appropriate detergent, thorough rinsing, and drying.
Question 2: Which of the following best describes 'immediate-use steam sterilization' (IUSS), formerly called flash sterilization?
- A sterilization method approved for routine instrument processing to increase throughput
- An emergency procedure for processing items needed for an immediate patient procedure when no alternative exists (Correct answer)
- A faster version of terminal sterilization that can be used for any instrument
- A low-temperature sterilization method for heat-sensitive items
Correct answer: An emergency procedure for processing items needed for an immediate patient procedure when no alternative exists
IUSS is reserved for situations where there is no suitable alternative when an item is needed immediately for a patient, and items should not be routinely flash-sterilized as a convenience.
Question 3: Instruments with box locks and hinges should be sterilized in which position to ensure steam contact on all surfaces?
- Fully closed to protect delicate hinge mechanisms
- Partially open (ratchet in the first ratchet position) (Correct answer)
- Wrapped tightly closed with rubber bands
- Disassembled and sterilized in separate pouches
Correct answer: Partially open (ratchet in the first ratchet position)
Ring-handled instruments with box locks must be sterilized in the open (or first ratchet) position to allow steam to contact all surfaces, including the interior of the box lock.
Question 4: What is the role of ANSI/AAMI ST79 in central service practice?
- It is a federal law mandating specific sterilization temperatures
- It provides comprehensive guidance recommendations for steam sterilization and sterility assurance in healthcare facilities (Correct answer)
- It is a biological indicator testing protocol specific to ethylene oxide
- It sets minimum wage standards for sterile processing technicians
Correct answer: It provides comprehensive guidance recommendations for steam sterilization and sterility assurance in healthcare facilities
ANSI/AAMI ST79 is the leading consensus document providing guidance on steam sterilization practices, monitoring, and sterility assurance for healthcare facilities.
Question 5: Which condition would cause a steam sterilizer to fail to achieve proper sterilization even when temperature and time parameters appear correct?
- Excess load weight beyond the sterilizer's capacity
- Air pockets or non-condensable gases trapped in the chamber preventing steam contact (Correct answer)
- Using distilled water instead of tap water to generate steam
- Sterilizing items immediately after cleaning without a drying step
Correct answer: Air pockets or non-condensable gases trapped in the chamber preventing steam contact
Air pockets and non-condensable gases act as insulators that block steam from reaching item surfaces, preventing the required temperature from being achieved even when the chamber thermometer reads correctly.
Question 6: What is the correct action when a biological indicator (BI) returns a positive result after a sterilization cycle?
- Re-run the BI to confirm and proceed if the second result is negative
- Immediately quarantine all items from that load, notify the supervisor, and investigate the failure (Correct answer)
- Release the load if chemical indicators within the pack passed
- Accept the load since one positive BI may be a laboratory error
Correct answer: Immediately quarantine all items from that load, notify the supervisor, and investigate the failure
A positive BI is treated as a confirmed sterilization failure: all items from the affected load must be quarantined and recalled if distributed, and a full investigation must be conducted before resuming sterilizer use.
Question 7: Which statement about washer-disinfector (WD) maintenance is correct per IAHCSMM standards?
- WDs are self-cleaning and require no routine maintenance checks
- WD performance should be verified daily and the unit maintained per manufacturer's instructions (Correct answer)
- WDs only need biological indicator testing monthly
- Chemical concentrations in WDs are automatically regulated and never need manual verification
Correct answer: WD performance should be verified daily and the unit maintained per manufacturer's instructions
Washer-disinfectors require daily performance verification and routine maintenance per the manufacturer's instructions to ensure consistent cleaning efficacy.
IAHCSMM Ultimate IAHCSMM 5
What is the proper sequence for manual cleaning of surgical instruments?