Saudi Prometric Nursing Infection Control and Saudi MOH Regulations 1 — Questions and Answers
Question 1: According to WHO hand hygiene guidelines, which of the 'Five Moments for Hand Hygiene' requires hand hygiene BEFORE the moment?
- Before touching a patient and before aseptic procedures (Correct answer)
- After touching a patient
- After touching patient surroundings
- After body fluid exposure
Correct answer: Before touching a patient and before aseptic procedures
The WHO Five Moments are: (1) before touching a patient, (2) before aseptic/clean procedures, (3) after body fluid exposure, (4) after touching a patient, (5) after touching patient surroundings. Moments 1 and 2 are 'before' moments that protect the patient.
Question 2: A patient admitted with suspected Ebola hemorrhagic fever requires which level of transmission-based precautions?
- Contact + Droplet + Airborne (full PPE including PAPR) (Correct answer)
- Standard precautions only
- Contact precautions with N95 mask
- Droplet precautions with surgical mask
Correct answer: Contact + Droplet + Airborne (full PPE including PAPR)
Ebola requires all three levels of transmission-based precautions plus enhanced PPE including a powered air-purifying respirator (PAPR) or equivalent, due to high lethality, contact with body fluids, and potential aerosol generation during procedures. Saudi MOH and CDC recommend this approach.
Question 3: A hospital in Saudi Arabia wants to implement a central line-associated bloodstream infection (CLABSI) prevention bundle. Which element is most critical?
- Maximum sterile barrier precautions during insertion (cap, gown, mask, sterile gloves, drape) (Correct answer)
- Changing central lines every 72 hours
- Using antibiotic-impregnated catheters for all patients
- Flushing lines with heparin twice daily
Correct answer: Maximum sterile barrier precautions during insertion (cap, gown, mask, sterile gloves, drape)
The CLABSI prevention bundle includes: hand hygiene, chlorhexidine skin antisepsis, maximum sterile barriers during insertion, avoiding femoral access, and daily review of line necessity (remove ASAP). Maximum sterile barrier precautions during insertion are the cornerstone of prevention.
Question 4: The Saudi Ministry of Health requires hospitals to report healthcare-associated infections (HAIs). Which agency is responsible for national HAI surveillance in Saudi Arabia?
- Saudi CDC (SCDC) / MOH Infection Prevention and Control Program (Correct answer)
- The Joint Commission International (JCI)
- WHO Regional Office for the Eastern Mediterranean (EMRO)
- Saudi Commission for Health Specialties (SCFHS)
Correct answer: Saudi CDC (SCDC) / MOH Infection Prevention and Control Program
Saudi Arabia's Ministry of Health oversees the national infection prevention and control program through the Saudi CDC (SCDC). Hospitals are required to report HAIs including CLABSI, CAUTI, SSI, and VAP through the national surveillance system.
Question 5: The nurse is changing a patient's wound dressing and notes increasing purulent exudate, erythema, and warmth. What is the most appropriate next step?
- Obtain a wound swab culture and notify the physician before applying a new dressing (Correct answer)
- Apply an antimicrobial dressing without further assessment
- Increase the frequency of dressing changes to three times daily
- Apply hydrogen peroxide to clean the wound
Correct answer: Obtain a wound swab culture and notify the physician before applying a new dressing
Signs of wound infection (purulence, erythema, warmth, pain, edema) require wound culture to identify the causative organism and guide antibiotic therapy. The physician must be notified. Hydrogen peroxide is cytotoxic to healing tissue and should not be used.
Question 6: Which sterilization method is most appropriate for heat-sensitive medical instruments such as endoscopes?
- Low-temperature hydrogen peroxide gas plasma sterilization (e.g., STERRAD) (Correct answer)
- Steam autoclave at 134°C
- Dry heat oven
- Ethylene oxide (EO) gas
Correct answer: Low-temperature hydrogen peroxide gas plasma sterilization (e.g., STERRAD)
Heat-sensitive instruments (endoscopes, optical instruments, certain plastics) cannot withstand autoclave temperatures. Low-temperature hydrogen peroxide gas plasma (STERRAD) or ethylene oxide are the options; STERRAD is preferred because it is faster (30–75 min), safer for staff, and has no toxic residues. EO requires lengthy aeration.
Saudi Prometric Nursing Infection Control and Saudi MOH Regulations 1
According to WHO hand hygiene guidelines, which of the 'Five Moments for Hand Hygiene' requires hand hygiene BEFORE the moment?