1. Ms.

A, a registered nurse, has supervisory responsibility for a licensed practical

nurse, Mr. B. Ms. A observed Mr. B change a dressing on a patient and then go to
another patients room without changing gloves, or washing his hands. Ms. A has
noticed that this has occurred at other times as well. She made a mental note of it
and planned to speak to Mr. B about this. Unfortunately, Ms. A was distracted by
other priorities on the unit and neglected to follow up with Mr. B. What could be the
outcome of this situation?


b. Ms. A could be charged with unprofessional conduct for failing to insure that Mr.
B, for whom Ms. A has administrative and clinical oversight, adheres to scientifically
accepted principles and practices of infection control.


Correct: Both A and B.


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2. According to the CDC, there are approximately 2 million healthcare acquired
infections (HAIs) annually. Of these infections almost 99,000 people die annually.


a. True.




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3. Infections can be prevented by interrupting one or more of the links in the
Chain of Infection. This can be achieved through:


d. All of the above.




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4. According to the National Institute for Occupational Safety and Health (NIOSH),
the most common route of exposure of US hospital healthcare workers to blood or
other body fluids is through:


b. Percutaneous injuries with contaminated sharp instruments such as needles and
scalpels.




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5. According to the CDC healthcare personnel only practice hand hygiene about half
the time.


a. True.




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6. The CDCs Hand Hygiene Guidelines (2002) covered in this course recommend
that if hands are not visibly soiled, use an alcohol-based hand rub for routinely
decontaminating hands in clinical situations. Alternatively, wash hands with an
antimicrobial soap and water in clinical situations.


a. True.




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7. A hierarchy of controls are used to minimize the risk of infection in healthcare
facilities.
These controls include:

Legal and regulatory controls.
Administrative and training controls.
Engineering controls.
Work practice controls.




a. True.




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8. Standard precautions are based on the concept that blood and body fluids must
be treated as if infectious, therefore personal protective equipment (PPE) is needed
as a barrier to transmission of infectious agents. The choice of PPE is determined by
the type of interaction the healthcare worker has with the patient.


a. True.




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9. Personal Protective Equipment (PPE) for standard precautions include all the
following EXCEPT:


c. Gloves, gowns and masks for all routine care.




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10. The procedure for removing gloves is:

Grab outside edge near wrist;
Peel away from hand, turning glove inside out;
Hold in opposite gloved hand;
Slide ungloved finger under the wrist of the remaining glove;
Peel off from inside, creating a bag for both gloves;
Discard.



a. True.




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11. The level of contamination on healthcare equipment and environmental
surfaces is dependent upon:


d. All of the above.




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12. Healthcare workers do not need to immediately attend to an occupational
exposure to blood or body fluids, since prophylactic treatment is most effective if
administered as soon as possible after antibodies form.


b. False




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13. Since the 1992 Bloodborne Pathogens Standard in which hepatitis B
vaccination has been required to be provided to healthcare workers, as well as
Universal Precautions, the incidence of occupational transmission of the hepatitis B
virus has decreased by 96%.


a. True




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14. After percutaneous injury with a contaminated sharp instrument, the average
risk of HIV infection is:


c. 0.3%




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15. For professionals who practice in settings where handling, cleaning, and
reprocessing equipment, instruments or medical devices is performed in a
dedicated Sterile Processing Department, it is important to understand core
concepts and principles of infection control, including:

Standard and Universal Precautions including PPE;
Cleaning, disinfection, and sterilization;
Appropriate application of safe practices for handling instruments, medical devices
and equipment;
Designation and physical separation of patient care areas from cleaning and
reprocessing areas;
Verify with those responsible for reprocessing what steps are necessary prior to
submission regarding pre-cleaning, soaking, etc.



a. True.




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16. Cleaning involves the removal or destruction of all microorganisms and their
spores.


b. False




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17. The CDC Guidelines utilize the Spaulding classification, which divides
instruments and items for patient care into critical, semicritical or non-critical
items. Depending on the category, planning for disinfection or sterilization can be
determined for the most part. Which of the following are correct?


d. All of the above.




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18. All the following are related to proper sharps disposal strategies EXCEPT:


d. Make thorough use of a sharps container by over filling the container, even if the
contents are not well contained; just be careful.




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19. Which of the following is true about Safe Injection?


c. Both A and B.




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20. Recent headlines in New York State and in other states have identified incidents
of unsafe injection practices in some healthcare facilities which resulted in
outbreaks of bloodborne pathogens. According to the CDC, the two (2) main
breaches of infection control practices were:

Reinsertion of used needles into a multiple-dose vial or solution container such as a
saline bag.
Use of a sterile, single-use, disposable needle and syringe for each injection given.
Use of a single needle or syringe to administer intravenous medication to multiple
patients.
Failure to use a 1:100 dilution (500--615 ppm available chlorine) to decontaminate
nonporous surfaces.



c. 1 and 3.