Saudi Prometric Nursing Infection Control and Saudi MOH Regulations 4 — Questions and Answers
Question 1: The nurse is cleaning and disinfecting a blood spill on the floor. What is the correct sequence?
- Put on PPE, remove gross contamination with absorbent material, then disinfect with appropriate agent (e.g., 0.5% sodium hypochlorite) (Correct answer)
- Apply disinfectant first, then remove the blood
- Clean with water first, then apply bleach, then remove residue
- Remove blood with bare hands first, then apply alcohol hand rub
Correct answer: Put on PPE, remove gross contamination with absorbent material, then disinfect with appropriate agent (e.g., 0.5% sodium hypochlorite)
Blood spill management: PPE first (protect self), then remove gross soiling using paper towels/absorbent material (never bare hands), then apply approved disinfectant (0.5% sodium hypochlorite/bleach), allow contact time, and dispose of waste as clinical waste.
Question 2: A hospital is implementing a healthcare-associated infection (HAI) surveillance program. Which calculation is used to measure the CAUTI rate for reporting purposes?
- (CAUTI events / Urinary catheter days) × 1,000 (Correct answer)
- (CAUTI events / Patient days) × 100
- (CAUTI events / Total admissions) × 100
- (CAUTI events / Patients with catheters) × 1,000
Correct answer: (CAUTI events / Urinary catheter days) × 1,000
The CAUTI rate is expressed per 1,000 catheter-days — not per patient or admission — because the risk of infection is proportional to the duration of catheterization. This standardized measure allows benchmarking between facilities and over time.
Question 3: What is the required contact time for a 1,000 ppm sodium hypochlorite (bleach) solution to be effective against HIV, hepatitis B, and standard bacteria?
- At least 1 minute contact time (Correct answer)
- 10 seconds
- 30 minutes
- 5 minutes
Correct answer: At least 1 minute contact time
For blood/body fluid spills, 0.1% (1,000 ppm) sodium hypochlorite requires at least 1 minute of contact time to kill HIV and hepatitis B virus. For C. difficile spores, a higher concentration (5,000 ppm/0.5%) with longer contact time is needed.
Question 4: The nurse is preparing the patient's room after discharge for terminal cleaning. Which surfaces are highest priority?
- High-touch surfaces: bed rails, call button, IV pole, light switches, door handles (Correct answer)
- Window sills and ceiling tiles
- Patient's personal belongings
- Floors and walls in the hallway
Correct answer: High-touch surfaces: bed rails, call button, IV pole, light switches, door handles
High-touch surfaces in the patient environment harbor the most pathogens and are highest priority for terminal (discharge) cleaning. These include bed rails, call buttons, IV poles, light switches, door handles, faucets, and tray tables. Thorough cleaning of these surfaces significantly reduces pathogen transmission.
Question 5: A nurse is caring for a patient with a Vancomycin-Resistant Enterococcus (VRE) infection. When should contact precautions be discontinued?
- After three consecutive negative cultures from relevant sites, per institutional policy (Correct answer)
- After completing the full antibiotic course
- 24 hours after the patient is discharged
- When the patient is asymptomatic for 48 hours
Correct answer: After three consecutive negative cultures from relevant sites, per institutional policy
For VRE, contact precautions are typically continued until three consecutive negative cultures (stool/rectal swabs) are obtained from appropriate sites, at least one week apart, demonstrating decolonization. Institutional policy may specify additional criteria.
Question 6: A nursing student asks why personal protective equipment (PPE) must be removed in a specific order. What is the most important reason?
- To prevent self-contamination — the outside of PPE is contaminated and must not touch the face or mucous membranes (Correct answer)
- To save PPE supplies by careful removal
- To model correct behavior for other staff
- To comply with hospital policy regardless of rationale
Correct answer: To prevent self-contamination — the outside of PPE is contaminated and must not touch the face or mucous membranes
PPE removal (doffing) sequence prevents self-contamination by ensuring the most contaminated surfaces (outside of gloves, outside of gown) are removed first without touching the face. The sequence: gloves off first, then gown, then eye protection, then mask — hands cleaned after each step.
Saudi Prometric Nursing Infection Control and Saudi MOH Regulations 4
The nurse is cleaning and disinfecting a blood spill on the floor.
What is the correct sequence?