Exam 3: Infection Prevention and Control in the Perioperative Setting

Which of the following lists the correct order of the proper steps in the removal of soiled sterile attire when breaking scrub?

Both sterilization and disinfection describe the elimination of microbial contamination and the achievement of a state suitable for patient care in select situations.However,disinfection differs from sterilization in that the process for disinfection uses:

Which glove lubricant,used to facilitate easy donning,is considered a best practice?

The Centers for Disease Control and Prevention (CDC)has identified pathogens that could pose a threat to national and world security and safety through bioterrorism.Select the four most probable agents that could be used to cause mass transmission,mortality,panic,and social disruption.

While antibiotics have been credited with saving lives,misuse of antibiotics has contributed to the evolution of multidrug-resistant organisms (MDROs).Antibiotic use is prolific in the perioperative setting.Select the antibiotic application has evidence to support it as a best practice and not,potentially,a misuse of antibiotics.

The transplant team received the liver from the procurement team moments after it arrived by medical air lift.The OR was ready with a scrubbed team of a circulating nurse,scrub person,transplant surgeon,and surgical resident and with a sterile back table set up and counted to prepare the liver for transplant.As the surgeon began to dissect out the liver vessels,he realized that the liver could reasonably serve two recipient patients and he had another suitable donor candidate.The surgeon was aware that all of the available OR rooms were blocked and running until midnight,and the second patient could not be scheduled until this case was finished.As he carefully segmented and split the liver,the second patient was contacted to come to the medical center.The anesthesia provider transported the original intended recipient patient into the room and proceeded to prepare and induce the patient with a general anesthetic.The circulating nurse suddenly realized the sterile technique violation dilemma after the patient was asleep.Which option best reflects appropriate sterile technique and the best care for both patients?

A swab of a fluid collection from an edematous,red,and separating postoperative wound is sent to the microbiology lab for culture,sensitivity,and Gram stain.The surgeon expects that the result will show a gram-positive coccus.This Gram stain designation is based on the:

If a sterile glove becomes contaminated during the procedure,the best practice for corrective action is:

To protect the forearms,hands,and clothing from contacting bacteria on the outside of the used gown and gloves,members of the scrubbed surgical team should use the following procedure to remove soiled gowns and gloves.Which choice lists the appropriate first 3 steps in the removal of the sterile gown?

With the production of more steam in the sterilizer chamber,the pressure increases as well.The steam should contain little or no entrapped liquid water.Steam quality is the term that describes the amount of water mixed with the steam.The constitution of high-quality steam would be measured by:

An integrator is a multiparameter indicator designed to measure:

All surgical patients present with the risk for hypothermia from a variety of factors inherent in the surgical experience.Hypothermia has been shown to be a factor that may place the surgical patient at risk for infection and delayed healing.Select the intervention that is an engineered control factor to protect the patient from hypothermia.

Sterile surgical drapes are used to create the sterile field,protecting the patient from endogenous and exogenous sources of contamination.Of the characteristics listed,which are essential to maintaining the sterile field?

Willard Braun was admitted to the ICU 3 weeks ago for heart failure and intractable atrial fibrillation.He has had diarrhea for 4 days that has cultured C.difficile.The transmission-based precautions sign on the door to his room alerts the staff to employ:

The evening before the procedure was scheduled,the central sterile processing department received two complete sets of an orthopedic spine fusion system that contained titanium-implantable instrumentation,four flexible coated retractor blades,and a sterilized internal paper inventory form.The sterilization instructions provided by the vendor representative recommended steam sterilization for the implants,but stated that the flexible coated blade retractors could not be exposed to temperatures higher than 220° F.The appropriate sterilization option for these instruments and devices would be:

In several studies,it was determined that the risk of contamination and subsequent infection to the wearer can be reduced by wearing two pairs of sterile surgical gloves,as opposed to wearing one pair.Select the correct statement that refers to double gloving in terms of a best practice.

Surgical site infections (SSIs)are most often caused by gram-positive cocci and may arise from the patient's own endogenous sources.The most typical causative microorganism cultured from SSIs is:

Ernesto Horn was admitted to the emergency department (ED)with respiratory symptoms,facial and upper body abrasions,burns,and moist lesions after a small package,delivered to his office,exploded and sprayed him with dried powder and glass shards.In response to the reported mechanism of injury,the ED team sequestered him in a secluded area away from the rest of the patients.The team believed that this was highly suspicious of a bioterrorism event.The epidemiologist was called and the patient was transferred to a negative-pressure isolation room and placed on Standard,Contact,Airborne,and Droplet Precautions.Based on these actions,what microorganism agents might be suspected to be involved?

The hospital epidemiologist was alerted when several cultures had recently revealed suspicious similarities.He was concerned about two unrelated patients with similar abscesses in similar body regions.Susan Grant,a 72-year-old diabetic patient taking immunosuppressive medications for chronic Crohn's disease,had an incision and drainage of a perianal fistula.Shawn Ames,a healthy 22-year-old college student and motocross racer,had an incision and drainage plus excision of a pilonidal cyst.Both patients cultured out a new subtype of S.aureus.Susan's specimen results showed a significant colony growth of S.aureus plus differential growth of coagulase-negative S.epidermidis,while Shawn's specimen was a high colony growth coagulase-positive,similar subtype of S.aureus.The epidemiologist charged his department to be alert for this S.aureus subtype and cross-check for trends.He was most concerned about one of these patients in particular and pulled up the medical record for review.Which patient may be at higher risk with the more virulent strain and why?

The circulating nurse prepped the face,neck,and upper chest for a radical neck dissection.After removing the protective towels around the prep site,the surgical fellow applied the head drape and the rest of the patient was draped.During the preincision surgical time-out,the fire risk score was determined to be high.When the surgeon reentered the room,after leaving the room to scrub,and donned her gown and gloves,she noticed an area on the neck that did not look prepped.She asked for prep solution on a sponge and sponge forceps to complete the prep area,taking care not to moisten the head drape.After handing off the used sponge forceps she asked for the scalpel.What step was omitted in this process?