Saudi Prometric Nursing Infection Control and Saudi MOH Regulations 2 — Questions and Answers
Question 1: The nurse discovers that a patient who died in the ICU tested positive for Creutzfeldt-Jakob disease (CJD). Which decontamination method is required for instruments used on this patient?
- Extended autoclave at 134°C for 18 minutes (porous load) — standard disinfection is ineffective (Correct answer)
- Standard steam autoclave at 121°C for 15 minutes
- Glutaraldehyde immersion for 30 minutes
- Hydrogen peroxide gas plasma sterilization
Correct answer: Extended autoclave at 134°C for 18 minutes (porous load) — standard disinfection is ineffective
Prions (CJD causative agents) are extremely resistant to standard sterilization. The WHO recommends extended steam autoclaving (134°C, 18 min) in a porous load autoclave, combined with sodium hydroxide pre-treatment. Standard disinfectants do not inactivate prions.
Question 2: A nurse sustains a needlestick injury while caring for an HIV-positive patient. What is the most important immediate action?
- Wash the wound with soap and water and report immediately for post-exposure prophylaxis (PEP) assessment (Correct answer)
- Apply a tourniquet to prevent spread
- Squeeze the wound to promote bleeding
- Wait 24 hours to see if symptoms develop
Correct answer: Wash the wound with soap and water and report immediately for post-exposure prophylaxis (PEP) assessment
Immediate washing with soap and water reduces transmission risk, followed by immediate reporting for PEP eligibility assessment. PEP (antiretroviral therapy) must ideally begin within 2 hours and no later than 72 hours post-exposure to be effective in reducing HIV transmission risk.
Question 3: Which antiseptic agent is recommended for skin antisepsis before central line insertion according to Saudi MOH/CDC guidelines?
- Chlorhexidine gluconate 2% in 70% isopropyl alcohol (Correct answer)
- Povidone-iodine 10%
- Isopropyl alcohol 70% alone
- Normal saline with chlorhexidine
Correct answer: Chlorhexidine gluconate 2% in 70% isopropyl alcohol
Current guidelines (CDC, Saudi MOH IPC) recommend chlorhexidine gluconate 2% in 70% isopropyl alcohol for central line insertion site antisepsis. It provides both rapid (alcohol) and sustained (chlorhexidine) antimicrobial activity, reducing CLABSI more effectively than povidone-iodine alone.
Question 4: A patient in the hospital develops diarrhea and is positive for Clostridioides difficile (C. diff). Which type of gloves should the nurse wear?
- Non-sterile gloves — but alcohol-based hand rub is NOT sufficient; soap and water required (Correct answer)
- Sterile gloves with double-gloving
- No gloves if using alcohol hand rub
- Standard exam gloves; alcohol hand rub is sufficient
Correct answer: Non-sterile gloves — but alcohol-based hand rub is NOT sufficient; soap and water required
C. difficile spores are not killed by alcohol-based hand sanitizers. Soap and water must be used for hand hygiene when caring for C. diff patients, as the physical scrubbing action removes spores. Contact precautions (gloves and gown) are required.
Question 5: The Saudi MOH has established infection control standards for healthcare facilities. Which document outlines the minimum requirements for IPC programs in Saudi hospitals?
- Saudi MOH Infection Prevention and Control Manual (Correct answer)
- The Joint Commission International Accreditation Standards
- ISO 15189 Laboratory Standards
- Saudi Board of Health Specialties Guidelines
Correct answer: Saudi MOH Infection Prevention and Control Manual
The Saudi MOH Infection Prevention and Control Manual establishes mandatory IPC standards for all Saudi healthcare facilities, including program structure, surveillance requirements, isolation precautions, hand hygiene, and sterilization protocols.
Question 6: The nurse is applying personal protective equipment (PPE) before entering an airborne isolation room. What is the correct sequence for donning PPE?
- Gown, mask/respirator, eye protection, gloves (Correct answer)
- Gloves, gown, mask, eye protection
- Mask, gloves, gown, eye protection
- Eye protection, gloves, mask, gown
Correct answer: Gown, mask/respirator, eye protection, gloves
The correct donning sequence is: (1) gown — protects clothing, (2) mask/N95 respirator — fit-tested, (3) eye protection/face shield, (4) gloves — last because hands are the most common contamination vector. Doffing is in reverse, with gloves removed first.
Saudi Prometric Nursing Infection Control and Saudi MOH Regulations 2
The nurse discovers that a patient who died in the ICU tested positive for Creutzfeldt-Jakob disease (CJD).
Which decontamination method is required for instruments used on this patient?