Mosbys Respiratory Care Equipment 9th Edition By J.M. Cairo Test Bank

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Mosbys Respiratory Care Equipment 9th Edition By J.M. Cairo Test Bank

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Mosbys Respiratory Care Equipment 9th Edition By J.M. Cairo Test Bank

Chapter 02: Principles of Infection Control

MULTIPLE CHOICE

A 78-year-old man is going to be discharged today after having abdominal surgery several days ago. The nurse notices that the patient has a temperature of 101.5 F and has some tan secretions in his suture area. A specimen is sent to the laboratory. The results show the presence of gram-positive cocci. The statement that might explain this condition is which of the following?

a.	The antibiotic was ineffective.
b.	The patient was not compliant with therapy.
c.	It is normal to have secretions at the suture site.
d.	A health care-associated infection should be considered.

ANS: D

No antibiotic was mentioned in the scenario. There is no history of the patient receiving any medication for this problem, so compliance is not an issue with this situation. It is not normal to have secretions at a suture site.

PTS: 1 REF: Page 41

A nosocomial infection is best defined as a:

a.	respiratory systemborne pathogen.	c.	bacterial or viral organism.
b.	hospital-acquired pathogen.	d.	blood-borne pathogen.

ANS: B

A nosocomial infection is one that is acquired in a hospital setting. Respiratory systemborne pathogens and blood-borne pathogens can be acquired in the community.

PTS: 1 REF: Page 28

Infectious diseases are not usually caused by:

a.	ticks.	c.	viruses.
b.	bacteria.	d.	algae.

ANS: D

Algae do not cause infectious diseases. Infectious diseases can be caused by ticks, bacteria, and viruses.

PTS: 1 REF: Page 32, Table 2-3

Clinical microbiology is concerned with _____ the organism.
identifying
controlling
isolating
eradication of

a.	1 and 4	c.	1, 2, and 4
b.	2 and 3	d.	1, 2, and 3

ANS: D

Clinical microbiology addresses the identification, isolation, and control of pathogens, not their eradication.

PTS: 1 REF: Page 28

A prokaryotic, one-celled organism that ranges in size from 0.5 m to 50 m is usually classified as which of the following?

a.	Virus	c.	Bacterium
b.	Protozoan	d.	Retrovirus

ANS: C

This is the definition of a bacterium.

PTS: 1 REF: Page 28

When speaking about the morphology of bacteria, one is referring to its:

a.	size.	c.	function.
b.	shape.	d.	movement.

ANS: B

There are three ways to classify bacteria: by its shape, by staining, and by its metabolic characteristics. Size, function, and movement are not characteristics used to classify bacteria.

PTS: 1 REF: Page 28

Which of the following is a bacterium?

a.	Herpes simplex	c.	Pseudomonas aeruginosa
b.	Pneumocystis carinii	d.	Candida albicans

ANS: C

Pneumocystis carinii is a protozoan, herpes is a virus, and Candida albicans is a fungus.

PTS: 1 REF: Page 29

A sputum specimen is received in the microbiology laboratory. Gram staining and a microscopic examination reveal a paired, spherical, purple-stained organism. It can be reasonably assumed that this organism is which of the following?

a.	Gram-negative bacilli	c.	Gram-positive diplococci
b.	Gram-negative staphylococci	d.	Gram-positive bacilli

ANS: C

Diplococci are spherically shaped bacteria that occur in pairs; gram-positive organisms appear blue or violet. Gram-negative organisms have a red appearance from the counterstain. Staphylococci are cocci that occur in irregular clusters. Bacilli are rodlike organisms.

PTS: 1 REF: Pages 28-29

The word vibrio refers to:

a.	The many shapes bacteria can assume
b.	The erratic movement of bacteria
c.	Comma-shaped morphology
d.	Spirochete helical shape

ANS: C

Vibrio refers to comma-shaped bacteria.

PTS: 1 REF: Page 28, Figure 2-1

An organism that appears reddish-pink after Gram staining is usually called:

a.	gram-negative.	c.	nonacid-fast.
b.	gram-positive.	d.	acid-fast.

ANS: A

Gram-positive organisms stain blue or violet, whereas gram-negative organisms appear red from a counterstain of red dye safranin. Acid-fast is a different test.

PTS: 1 REF: Pages 28-29

Which of the following is a gram-negative pathogen?

a.	Bacillus anthracis	c.	Pseudomonas aeruginosa
b.	Staphylococcus aureus	d.	Clostridium botulinum

ANS: C

Bacillus anthracis, Staphylococcus aureus, and Clostridium botulinum are gram-positive pathogens.

PTS: 1 REF: Page 29

Which of the following is spread by direct contact?

a.	Measles	c.	Staphylococcus
b.	Hepatitis B	d.	Histoplasmosis

ANS: C

Staphylococcus is spread by direct contact. Measles are spread by droplets; hepatitis B, by indirect contact; and histoplasmosis, by airborne dust.

PTS: 1 REF: Page 32, Table 2-3

The Ziehl-Neelsen stain is useful in identifying which family of microorganisms?

a.	Streptococci	c.	Staphylococci
b.	Mycobacterium	d.	Pseudomonas

ANS: B

The Ziehl-Neelsen stain is also called the acid-fast stain and is used to identify Mycobacterium species such as Mycobacterium tuberculosis. This stain is not used to identify streptococci, staphylococci, or Pseudomonas.

PTS: 1 REF: Page 29

Which of the following is typically associated with tuberculosis?

a.	Mycobacterium	c.	Clostridium
b.	Pseudomonas	d.	Bordetella

ANS: A

Mycobacterium tuberculosis is the organism responsible for pulmonary, spinal, and miliary tuberculosis.

PTS: 1 REF: Page 29

Bacteria that require oxygen for growth are typically known as:

a.	aerobes.	c.	anaerobes.
b.	airborne.	d.	autotrophs.

ANS: A

Aerobes require oxygen for life. Airborne refers to the method of transmission of infectious diseases. Anaerobes can grow and live without oxygen, and autotrophs require simple inorganic nutrients to sustain themselves.

PTS: 1 REF: Page 29

Which of the following is true concerning facultative anaerobes?

a.	They have limited oxygen tolerance.
b.	They require complex nutrients to exist.
c.	They cannot live in oxygen environments.
d.	They require simple inorganic nutrients to exist.

ANS: A

Facultative anaerobes have limited oxygen tolerance. Heterotrophs require complex nutrients to exist. Autotrophs require simple inorganic nutrients to exist. Only anaerobes cannot live in oxygen environments.

PTS: 1 REF: Page 29

To survive adverse conditions, such as excessive heat and dryness, bacteria might do which of the following?

a.	Store excess water in special sporelike structures
b.	Form large colonies in a short period of time
c.	Speed up their enzymatic processes
d.	Form endospores

ANS: D

Certain bacteria form endospores under adverse conditions such as dryness, heat, and poor nutrition. Bacteria do not undergo any of the other processes mentioned.

PTS: 1 REF: Page 29

Ventilator-associated pneumonia is commonly caused by which of the following?

a.	Escherichia coli	c.	Enterobacteriaceae
b.	Bacillus anthracis	d.	Corynebacterium diphtheriae

ANS: C

Ventilator-associated pneumonia is most commonly caused by Pseudomonas aeruginosa, Staphylococcus aureus, Enterobacteriaceae, Haemophilus influenzae, and Streptococcus spp.

PTS: 1 REF: Page 32, Box 2-1

A virus can be described as a parasite with which of the following traits?

a.	Nucleic acid core	c.	Size of less than 20 nm
b.	Carbohydrate sheath	d.	Ability to produce spores

ANS: A

Viruses have a nucleic acid core surrounded by a protein sheath; viruses range from 20 nm to 200 nm. They do not produce spores.

PTS: 1 REF: Page 29

Viruses are usually described as nonliving because they:

a.	do not have a cell wall.
b.	are unable to self-replicate.
c.	must create endospores to survive.
d.	cannot live without another living organism.

ANS: B

Viruses must invade a living organism to replicate. This is the reason that they are described as nonliving. They do have a wall-like structure that is made of protein. They do not create endospores and are able to live outside a host; however, they cannot replicate outside of a host.

PTS: 1 REF: Page 29

Which of the following is a virus that has a respiratory route of transmission?

a.	Polio	c.	Coronavirus
b.	Hepatitis	d.	Herpes simplex

ANS: C

Coronavirus has a respiratory route of transmission; for polio, the route of transmission is through the gut. Hepatitis is transmitted through body fluids and blood, and herpes simplex has several routes of transmission, including oral, genital, and ocular.

PTS: 1 REF: Page 31, Table 2-2

Chlamydia species are classified as:

a.	viruses.	c.	protozoa.
b.	bacteria.	d.	intracellular parasites.

ANS: D

Chlamydia species have complex structures that resemble those of bacteria and they act like viruses in that they require a living host to replicate, but they are actually intracellular parasites. Protozoa are unicellular eukaryotes.

PTS: 1 REF: Page 29

Which of the following is the type of organism that causes malaria and trypanosomiasis?

a.	Virus	c.	Protozoa
b.	Parasite	d.	Bacteria

ANS: C

Protozoan infections include amebiasis, malaria, trypanosomiasis, and Pneumocystis pneumonia.

PTS: 1 REF: Page 29

Which of the following is the protozoan organism that is associated with pneumonia in immune-compromised patients?

a.	Schistosoma	c.	Pneumocystis
b.	Shigella	d.	Rickettsiae

ANS: C

Pneumocystis pneumonia is common in immunocompromised patientsparticularly those infected with human immunodeficiency virus. Pneumocystis is a protozoan. Schistosoma is a blood fluke. Shigella is a gram-negative, nonspore-forming, rod-shaped bacteria. Rickettsiae are intracellular parasites that resemble bacteria.

PTS: 1 REF: Page 31

Airborne droplet nuclei are responsible for the transmission of:

a.	legionellosis.	c.	staphylococcus.
b.	histoplasmosis.	d.	tuberculosis.

ANS: D

Tuberculosis is transmitted by droplet nuclei. Legionellosis is transmitted by airborne aerosols; histoplasmosis, by airborne dust; and staphylococcus, by direct contact.

PTS: 1 REF: Page 32, Table 2-3

A budding unicellular organism revealed in the microscopic examination of sputum is most likely:

a.	yeast.	c.	Rickettsia.
b.	Bacillus.	d.	Clostridium.

ANS: A

Yeast reproduces by budding. Bacteria reproduce either by binary fission or conjugation. Rickettsia reproduces by binary fission.

PTS: 1 REF: Page 30

All of the following organisms can be transmitted via the respiratory tract, except:

a.	hepatitis.	c.	varicella.
b.	influenza.	d.	parainfluenza.

ANS: A

Hepatitis is transmitted through blood and body fluids.

PTS: 1 REF: Page 32, Table 2-3

Which of the following is the least likely mode of transmission for a nosocomial infection?

a.	Airborne	c.	Vector-borne
b.	Through fomites	d.	Direct contact

ANS: C

The transmission of infections by vectors is rarely associated with nosocomial infections. In the hospital, instruments and equipment (through fomites) are common sources of hospital-acquired infections. Direct contact is also a common way to transmit nosocomial infections.

PTS: 1 REF: Page 31

The spread of diseases requires all of the following, except:

a.	pathogen source.	c.	mode of transmission.
b.	immunosuppression.	d.	susceptible host.

ANS: B

Immunosuppression is not a requirement for the transmission of an infectious disease. However, a pathogen source, mode of transmission, and susceptible host must be present. A susceptible host does not have to be immunosuppressed to be considered susceptible. The host could have had surgery, be intubated, or have an indwelling catheter to be susceptible.

PTS: 1 REF: Page 28

You are visiting a country that has been plagued by heavy rains and flooding. The population is suffering from widespread disease. Which of the following is the most likely cause of the disease?

a.	Cholera	c.	Legionella
b.	Influenza	d.	Salmonellosis

ANS: A

Cholera is a waterborne infectious disease. With excessive rains and flooding, this waterborne bacterium might flourish. Legionella is spread by aerosols. Salmonellosis is a food-borne infectious disease. Influenza is spread through the respiratory tract.

PTS: 1 REF: Page 32, Table 2-3

The skin and mucosal tissue can prevent the spread of infectious agents by acting as _____ barriers.

a.	immunologic	c.	epidermal
b.	mechanical	d.	soft

ANS: B

The skin and mucous membranes are mechanical barriers to infection, meaning that they physically prohibit the transfer of infectious organisms into a host.

PTS: 1 REF: Page 32

Which of the following is a common pathogen that could cause a disruption of normal flora in a patient receiving antibiotic therapy?

a.	Clostridium difficile	c.	Enterobacteriaceae spp.
b.	Pneumocystis carinii	d.	Pseudomonas aeruginosa

ANS: A

Clostridium difficile are the bacteria that cause the disruption of normal flora in the gastrointestinal tract caused by antibiotic therapy. Pneumocystis carinii are the protozoa that cause pneumonia in immunocompromised patients with human immunodeficiency virus. Enterobacteriaceae spp. are the bacteria that can cause hypogammaglobulinemia in patients with multiple myeloma.

PTS: 1 REF: Page 33, Table 2-4

Transmission of an infectious agent by flies would fall into which mode of disease transfer?

a.	Vector-borne	c.	Contact
b.	Airborne	d.	Indirect

ANS: A

Insects are the transmission agents in vector-borne infectious diseases. Airborne, indirect, and contact transmission are not accomplished via insects.

PTS: 1 REF: Page 29

Which of the following are the two primary human barriers to infection in the health care setting?

a.	Disinfection and sterilization
b.	Immunologic and mechanical
c.	Disinfection and pasteurization
d.	Hand-washing and personal protective equipment

ANS: B

Human barriers to infection include the mechanical barriers of the skin and mucous membranes and the persons immune system. The others are preventative measures that reduce the spread of infection in health care settings.

PTS: 1 REF: Page 32

An agent that destroys pathogenic microorganisms on inanimate objects only is best described as a:

a.	virucide.	c.	bactericide.
b.	germicide.	d.	disinfectant.

ANS: D

A disinfectant describes agents that destroy pathogenic microorganisms on inanimate objects only. Germicide is a general term used to describe agents that destroy pathogenic microorganisms on living tissue and inanimate objects. A bactericide destroys all pathogenic bacteria. A virucide destroys viruses only.

PTS: 1 REF: Pages 32-33

Sterilization differs from pasteurization in that sterilization destroys:

a.	bacteria and fungi only.	c.	all microbes.
b.	only bacteria.	d.	only viruses.

ANS: C

Bactericides destroy only pathogenic bacteria. Fungicides kill fungi, and virucides kill viruses. Sterilization kills all microbes including spores, whereas pasteurization is a disinfection process that removes most pathogenic microorganisms except bacterial endospores.

PTS: 1 REF: Page 32

All of the following are factors that affect disinfection and sterilization, except:

a.	shape of the pathogen.	c.	resistance of the pathogen.
b.	number of organisms.	d.	strength of the germicide.

ANS: A

The shape of the organism does not make a difference in how disinfection and sterilization work. The number, location, and innate resistance of the microorganisms; the concentration and potency of the germicide; the duration of exposure; and the physical and chemical environment in which the germicide is used are all factors that affect disinfection and sterilization.

PTS: 1 REF: Page 32

Which of the following are true about the amount of time required to kill microbes?
Time decreases as the strength of the germicide decreases.
Time is directly proportional to the number of pathogens.
Time increases as the microbial population increases.
Time varies with the resistance of the organism.

a.	2, 3, and 4	c.	1 and 3
b.	3 and 4	d.	2 and 3

ANS: A

The number of pathogens and their resistance affect the amount of time it takes to kill microbes. Increased strength of a germicide will decrease the amount of time to kill the microbes.

PTS: 1 REF: Page 33

Which of the following medical states increase patient susceptibility to nosocomial infection?

a.	Hypoglycemia	c.	Hyperbilirubinemia
b.	Altered B cells	d.	Hypogammaglobulinemia

ANS: D

Hypogammaglobulinemia is the only answer that describes a condition that increases susceptibility to nosocomial infections.

PTS: 1 REF: Page 33, Table 2-4

A patients susceptibility to Pseudomonas aeruginosa is increased by:

a.	organ transplantation.	c.	antibiotic therapy.
b.	multiple myeloma.	d.	oncochemotherapy.

ANS: D

Organ transplantation increases a patients susceptibility to toxoplasmosis. Multiple myeloma increases a patients susceptibility to Haemophilus influenzae. Antibiotic therapy increases a patients susceptibility to Clostridium difficile. Oncochemotherapy increases a patients susceptibility to Pseudomonas aeruginosa and Candida.

PTS: 1 REF: Page 33, Table 2-4

After a ventilator is cleaned and ready for use, it should be stored in:

a.	the hallway near the freight elevators.
b.	the back of the preparation area.
c.	the back of the clean-up area.
d.	a separate clean room.

ANS: D

A separate clean room is necessary so that dirty and clean equipment remain separate. Hallways, prep areas, and clean-up areas are not ideal places to store clean equipment.

PTS: 1 REF: Page 34

In general, germicides are most effective in which of the following environments?

a.	Lower acidity	c.	Lower temperatures
b.	Lower alkalinity	d.	Higher temperatures

ANS: D

Higher temperatures increase the activity of most germicides. Higher alkalinity also improves the antimicrobial activity of some disinfectants. Lower temperatures and acidity do not improve the action of germicides.

PTS: 1 REF: Page 33

Under normal conditions, high-level disinfectants can kill all of the following organisms, except:

a.	fungal buds.	c.	gram-positive bacteria.
b.	bacterial spores.	d.	gram-negative bacteria.

ANS: B

Bacterial spores are not killed by high-level disinfectants unless they are exposed to the disinfectant for an extended time. Fungi and all bacteria are killed by high-level disinfectants.

PTS: 1 REF: Page 33

Flash pasteurization exposes equipment to which of the following?

a.	Water bath at 72 C for 15 minutes	c.	Moist heat at 72 C for 15 minutes
b.	Water bath at 63 C for 30 minutes	d.	Moist heat at 72 C for 15 seconds

ANS: D

There are only two methods for pasteurization: the flash process and the batch process. The flash process requires moist heat at 72 C for 15 seconds, and the batch process requires a water bath at 63 C for 30 minutes.

PTS: 1 REF: Page 36

Quaternary ammonium salts are routinely used to sanitize:

a.	ventilator tubing.	c.	walls and furniture.
b.	ventilator surfaces.	d.	critical respiratory care equipment.

ANS: C

Quats are bactericidal, fungicidal, and virucidal toward lipophilic viruses. They are not sporicidal, tuberculocidal, or virucidal toward hydrophilic viruses. They are used to sanitize noncritical surfaces like walls and furniture. Most ventilator tubing is disposable and is therefore not cleaned and disinfected.

PTS: 1 REF: Page 36

Alcohols such as ethyl and isopropyl are unable to kill:

a.	fungi.	c.	bacteria.
b.	viruses.	d.	bacterial spores.

ANS: D

Ethyl and isopropyl alcohols are bactericides, fungicides, and virucides, but they do not kill bacterial spores.

PTS: 1 REF: Page 36

The ability of alcohols to act as an effective disinfectant decreases significantly when their concentration drops below:

a.	30%.	c.	70%.
b.	50%.	d.	90%.

ANS: B

Below 50% concentration, the ability of alcohols to disinfect decreases significantly.

PTS: 1 REF: Page 36

The respiratory therapist is in a contact isolation room with a patient. The stethoscope for use with this patient is located within the patients room. Which of the following is the most appropriate solution for disinfecting this stethoscope?

a.	Acetic acid	c.	Glutaraldehyde
b.	Ethylene oxide	d.	Isopropyl alcohol

ANS: D

Alcohols are used to disinfect equipment such as thermometers, stethoscopes, and fiberoptic endoscopes; in addition, they are used to clean the surfaces of mechanical ventilators and preparation areas. Acetic acid is the disinfectant of choice with home respiratory care equipment and is not often used in the hospital setting. Glutaraldehyde is a respiratory irritant and would not be appropriate for use in patient care areas. Ethylene oxide cannot be used at the bedside because it requires specialized equipment and takes several steps to prepare it for disinfectant use.

PTS: 1 REF: Page 36

Phenolic compounds are generally diluted to what concentration?

a.	0.04% to 0.05%	c.	40% to 50%
b.	0.4% to 5.0%	d.	4% to 5%

ANS: B

Phenolic compounds are diluted to a 0.4% to 5% solution to provide a low to intermediate level of disinfection.

PTS: 1 REF: Page 35, Table 2-5

Bacterial spores can be inactivated by exposure to:

a.	10 hours of iodophors.
b.	8 hours of glutaraldehyde.
c.	30 minutes of isopropyl alcohol.
d.	6 hours of quaternary ammonium compounds.

ANS: B

Glutaraldehyde is sporicidal and has an exposure time of 6 to 8 hours. Iodophors are bactericidal, tuberculocidal, fungicidal, and virucidal, but they are not effective against bacterial spores. Alcohols are bactericidal, fungicidal, and virucidal, but they do not kill bacterial spores. Quaternary ammonium compounds are not sporicidal.

PTS: 1 REF: Page 35

A residue will remain on equipment exposed to:

a.	formaldehyde.	c.	hydrogen peroxide.
b.	isopropyl alcohol.	d.	quaternary ammonium compounds.

ANS: A

Formaldehyde will leave a residue on equipment. The other agents listed in these choices will not.

PTS: 1 REF: Page 35, Table 2-5

Which of the following disinfectants/sterilizing agents is a respiratory irritant?

a.	Phenolic	c.	Formaldehyde
b.	Iodophors	d.	Isopropyl alcohol

ANS: C

Formaldehyde is a respiratory irritant. The other agents listed are not.

PTS: 1 REF: Page 35, Table 2-5

A typical high-level disinfectant can kill organismsbut not sporesin what time period?

a.	24 hours	c.	12 to 18 hours
b.	1 to 2 hours	d.	Less than 45 minutes

ANS: D

High-level disinfectant agents are typically chemical sterilants that are used at reduced exposure times, usually less than 45 minutes. They kill bacteria, fungi, and viruses in this period of time. However, spores are not killed unless the chemical is used for an extended period of time.

PTS: 1 REF: Page 35

In batch pasteurization, equipment is placed in a water bath heated to ____ for 30 minutes.

a.	63 C	c.	163 C
b.	72 C	d.	175 C

ANS: A

Batch pasteurization requires the equipment to be exposed to a water bath at 63 C for 30 minutes. Flash pasteurization requires equipment to be exposed to moist heat at 72 C for 15 seconds.

PTS: 1 REF: Page 36

Acid glutaraldehyde is tuberculocidal with a minimum exposure time of _____ minutes.

a.	10	c.	30
b.	20	d.	40

ANS: B

Acid glutaraldehyde is bactericidal, fungicidal, and virucidal with a 10-minute exposure time. However, exposure time must be extended to 20 minutes for it to become tuberculocidal.

PTS: 1 REF: Page 37

The statement A disinfectants potency increases as its concentration increases is not true for:

a.	phenols.	c.	iodophors.
b.	alcohols.	d.	glutaraldehydes.

ANS: C

Iodophors are the only exception to this statement.

PTS: 1 REF: Page 37

During a home care visit, the respiratory therapist is instructing the patient and family member on the use of the patients equipment. Which of the following household items should the respiratory therapist inform the patient to use to decontaminate the equipment?

a.	Alcohol	c.	Bleach
b.	Vinegar	d.	Lye

ANS: B

White household vinegar is used extensively as a method for decontaminating home care respiratory equipment. One part 5% white household vinegar and three parts water should be used. Bleach and lye are too dangerous for the patient to use and are respiratory irritants. Prolonged and repeated use of alcohol can cause swelling and hardening of rubber and plastic tubes.

PTS: 1 REF: Page 36

An oxygen atom can be added to acetic acid to form an excellent disinfectant with sterilization capabilities. This disinfecting agent is:

a.	peroxide.	c.	peracetic acid.
b.	peroxidic acid.	d.	acetic peroxide.

ANS: C

Peracetic acid is an excellent disinfectant with sterilization capabilities. It kills microbes by denaturing proteins, disrupting cell wall permeability, and oxidizing cellular metabolites. Its shortcoming is that it can corrode brass, iron, copper, and steel.

PTS: 1 REF: Page 35

Carbolic acid is:

a.	an acetic acid derivative.	c.	the basis for phenol derivatives.
b.	a common disinfectant.	d.	the only form of acid glutaraldehyde.

ANS: C

Carbolic acid is the prototype 6-carbon aromatic compound. It was first used as a germicide by Lister in his pioneering work on antiseptic surgery.

PTS: 1 REF: Page 36

The Centers for Disease Control and Prevention recommends that blood spills be cleaned with:

a.	ethanol.	c.	sodium hypochlorite.
b.	peracetic acid.	d.	alkaline glutaraldehyde.

ANS: C

The Centers for Disease Control and Prevention recommends that a 1:10 dilution of sodium hypochlorite be used to clean blood spills.

PTS: 1 REF: Page 37

A 1.25% solution of acetic acid has been shown to be an effective bactericidal agent against:

a.	Staphylococcus aureus	c.	Micobacterium tuberculosis
b.	Pseudomonas aeruginosa	d.	Streptococcus pneumoniae

ANS: B

Pseudomonas aeruginosa is killed by 1.25% acetic acid or one part 5% white household vinegar and three parts water. Pseudomonas aeruginosa transmission is through indirect contact via fomites, such as those on clothing, surgical bandages, and especially equipment. It is the most common respiratory pathogen in patients with cystic fibrosis and is encountered in patients with chronic obstructive pulmonary disease.

PTS: 1 REF: Page 36

Which of the following indicates the minimum time a tracheostomy inner cannula should be soaked in 3% hydrogen peroxide to be an effective disinfectant during a patients tracheostomy care?

a.	1 minute	c.	10 minutes
b.	5 minutes	d.	15 minutes

ANS: C

Commercially available 3% solutions of hydrogen peroxide are effective disinfectants of bacteria (including Mycobacteria sp.), fungi, and viruses and are active within 10 minutes at room temperature. To be effective against spores, the solution would need to be at 50 C and the equipment would need to be soaked for at least 20 minutes.

PTS: 1 REF: Page 37

The Centers for Disease Control and Prevention recommends a _____ dilution of bleach to water to clean up blood spills.

a.	1:1	c.	1:10
b.	1:2	d.	1:100

ANS: C

The Centers for Disease Control and Prevention recommends that a 1:10 dilution of sodium hypochlorite be used to clean up blood spills.

PTS: 1 REF: Page 37

Which type of germicide requires activation with bicarbonate?

a.	5% acetic acid	c.	3% hydrogen peroxide
b.	2% alkaline glutaraldehyde	d.	10% sodium hypochlorite

ANS: B

Only alkaline glutaraldehyde requires activation with a bicarbonate solution. This yields a solution with a pH of 7.5 to 8.5.

PTS: 1 REF: Page 37

Commercial-grade hydrogen peroxide is an effective disinfectant at room temperature after how many minutes?

a.	5	c.	30
b.	10	d.	60

ANS: B

Commercially available 3% solutions of hydrogen peroxide are effective disinfectants of bacteria (including Mycobacteria sp.), fungi, and viruses and are active within 10 minutes at room temperature.

PTS: 1 REF: Page 37

Which of the following physical properties are required for an autoclave to sterilize biohazardous material?
Dry heat
A vacuum
100% humidity
Increased air pressure

a.	2 and 3	c.	1, 2, and 4
b.	1 and 3	d.	2, 3, and 4

ANS: D

Air is evacuated, moisture is added (100% humidity), and the pressure inside the autoclave is raised to 15 to 20 lb-force per square inch gauge (psig). Air is evacuated from the chamber because residual air prolongs the penetration time of steam, thus increasing the total autoclave cycle time. Pressure is used to raise the temperature of the steam, which is critical because the amount of time required to achieve sterilization depends on the temperature inside of the autoclave. Dry heat is not used during autoclaving.

PTS: 1 REF: Page 38

Dry-heat sterilization involves a 1-hour to 2-hour exposure at approximately:

a.	100 C.	c.	170 C.
b.	132 C.	d.	200 C.

ANS: C

Dry heat is another effective method of heat sterilization. Its use is limited to items that are not heat-sensitive. Temperatures must be maintained between 160 C and 180 C for 1 to 2 hours for sterilization.

PTS: 1 REF: Page 38

At high altitudes, sterilization by boiling must be prolonged primarily because of which of the following?

a.	Increased oxygen content	c.	Increased normal boiling point
b.	Reduced oxygen content	d.	Reduced normal boiling point

ANS: D

Because water boils at a lower temperature at high altitudes, exposure time must be prolonged during this form of sterilization at high elevations.

PTS: 1 REF: Page 38

Which of the following should routinely be used to ensure proper function and quality control of an autoclave?
Pressure-sensitive tape
Biologic indicators
Chemical indicators
Heat-sensitive tape

a.	2	c.	1, 2, and 3
b.	2 and 4	d.	1, 2, and 4

ANS: B

Because the process of autoclaving depends on several factors, heat-sensitive tape and biologic indicators are routinely used to ensure quality control during the process. Heat-sensitive tape that is used for packaging materials for autoclaving changes color when it is exposed to a given temperature for a prescribed amount of time. The most common biologic indicators for autoclaving are strips of paper that are impregnated with Bacillus stearothermophilus spores. These strips should be used weekly (at a minimum) to ensure that the autoclave is working properly. Biologic indicators are also used for ethylene oxide sterilization.

PTS: 1 REF: Page 38

According to the classification of infection-risk devices described by Spaulding, ventilator tubing is considered:

a.	critical.	c.	semicritical.
b.	noncritical.	d.	highly critical.

ANS: C

Ventilator tubing comes in contact with intact mucous membranes and is considered semicritical. Critical items are those that are introduced into sterile tissue or the vascular system. Noncritical items come in contact with intact skin. Noncritical items include face masks, ventilators, stethoscopes, and blood pressure cuffs. Highly critical is not a descriptor that Spaulding used.

PTS: 1 REF: Page 39

According to the classification described by Spaulding, which of the following items of medical equipment fall into the category of noncritical infection risk?

a.	Scalpels	c.	Ventilator tubing
b.	Ventilators	d.	Manual resuscitators

ANS: B

Noncritical items come in contact with intact skin. These items include face masks, ventilators, stethoscopes, and blood pressure cuffs. Scalpels are introduced into sterile tissue and are considered critical items. Ventilator tubing and manual resuscitators come in contact with intact mucous membranes and are considered semicritical.

PTS: 1 REF: Page 40