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CAii/CMII practice questions

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Question 1Infection prevention and control principles

A sterile dressing pack has been left open on a trolley in a treatment room while the clinician answers a telephone call. According to aseptic technique principles, what is the correct action?

  1. Cover the pack with a paper towel and continue
  2. Continue if the trolley was wiped with alcohol at the start
  3. Use the pack only for a wound that is already infected
  4. Discard the pack and prepare a new sterile field Correct answer.

Explanation

An open sterile field is considered contaminated once it is left unattended or exposed to the environment, because airborne particles and contact with non-sterile surfaces introduce microorganisms. Aseptic technique requires that a sterile field be prepared immediately before use and never left uncovered and unattended. The safe action is to discard and start again.

Question 2Infection prevention and control principles

Which statement best describes the purpose of standard infection control precautions?

  1. They apply to all patients regardless of known infection status Correct answer.
  2. They replace the need for transmission-based precautions
  3. They are used only when a patient has a diagnosed bloodborne virus
  4. They apply only to staff working in operating theatres

Explanation

Standard precautions are the minimum level of infection prevention applied to every patient, on the assumption that any blood or body fluid may be infectious. They include hand hygiene, appropriate personal protective equipment, safe sharps handling and environmental cleaning. Because they are universal, they do not depend on a known diagnosis.

Question 3Infection prevention and control principles

A nurse's hands are visibly soiled with blood after removing a dressing. Which hand hygiene method is required?

  1. Alcohol gel followed by a water rinse
  2. A wipe with an alcohol impregnated cloth
  3. Soap and water hand wash Correct answer.
  4. Alcohol-based hand rub only

Explanation

When hands are visibly soiled or contaminated with blood or body fluids, they must be washed with soap and water, because alcohol-based products do not remove organic material effectively. Alcohol rubs are suitable only for visibly clean hands. Washing physically removes the contamination before any further action.

Question 4Infection prevention and control principles

Under the World Health Organization's five moments for hand hygiene, at which point is hand hygiene required immediately before a patient contact?

  1. Before putting on gloves only
  2. Before touching the patient Correct answer.
  3. After touching the patient's surroundings
  4. After documenting the care given

Explanation

The WHO five moments include hand hygiene before touching a patient, before a clean or aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings. The moment before patient contact protects the patient from organisms carried on the hands. It is distinct from the moment after contact.

Question 5Infection prevention and control principles

Which item of personal protective equipment should be removed first when leaving a patient's room after providing care involving body fluids?

  1. Face mask
  2. Gown
  3. Eye protection
  4. Gloves Correct answer.

Explanation

Gloves are the most contaminated item and are removed first, followed by eye protection, gown and finally the mask or respirator. Removal order is designed to avoid contaminating the face or clean clothing. Hand hygiene follows immediately after all PPE is removed.

Question 6Infection prevention and control principles

A used hollow-bore needle must be disposed of after a blood test. What is the safest immediate action?

  1. Recap it carefully using one hand before disposal
  2. Place it in a clinical waste bag and seal the bag
  3. Hand it to a colleague to carry to the sharps bin
  4. Drop it directly into a sharps container at the point of use Correct answer.

Explanation

Sharps must be disposed of immediately into a designated sharps container at the point of use, without recapping, to prevent needlestick injury. Recapping and passing sharps between people are recognised causes of injury. Sharps containers should be close to the point of use and not overfilled.

Question 7Infection prevention and control principles

Which of the following is a correct description of the chain of infection?

  1. A causative organism, a reservoir, a portal of exit, a mode of transmission, a portal of entry and a susceptible host Correct answer.
  2. A portal of entry, a portal of exit and a hand hygiene product
  3. A reservoir, a disinfectant, a sterile field and a wound
  4. A causative organism, a vaccine, an antibiotic and an immune host

Explanation

The chain of infection describes the sequence required for infection to spread: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry and susceptible host. Breaking any link prevents transmission. Infection control measures target different links in this chain.

Question 8Infection prevention and control principles

Which action best illustrates the principle of source isolation for a patient with suspected infectious diarrhoea?

  1. Cohorting the patient with other patients who have the same symptoms
  2. Keeping the patient's door open to allow airflow
  3. Placing the patient in a single room with dedicated toilet facilities Correct answer.
  4. Moving the patient to a bay near the nurses' station for observation

Explanation

Source isolation aims to contain the infectious agent by placing the patient in a single room with dedicated facilities, reducing contact with other patients. Cohorting is used only when single rooms are unavailable and must involve patients with the same confirmed organism. An open door increases environmental contamination risk.

Question 9Infection prevention and control principles

A patient is known to be colonised with meticillin-resistant Staphylococcus aureus (MRSA) on the skin. What does colonisation mean in infection prevention terms?

  1. The organism has been eliminated by antibiotics
  2. The organism is present and multiplying without causing signs of infection Correct answer.
  3. The organism is present and always causes invasive disease
  4. The organism is only detectable in blood cultures

Explanation

Colonisation means microorganisms are present and multiplying on or in the body without producing clinical signs of infection. Colonised patients can act as a reservoir and transmit organisms to others. This is why screening and contact precautions may be used even when the patient is well.

Question 10Infection prevention and control principles

A clinician is about to insert a peripheral intravenous cannula. Which combination best reflects the aseptic non-touch technique (ANTT) approach?

  1. Using the same antiseptic swab for multiple patients
  2. Protecting key parts and key sites from contact with non-sterile surfaces Correct answer.
  3. Wearing sterile gloves for all cannula insertions regardless of technique
  4. Cleaning the skin with water only before insertion

Explanation

ANTT focuses on identifying and protecting key parts and key sites from contamination, using non-touch technique where possible. Sterile gloves are used for sterile ANTT procedures but not universally for all cannulation. Skin must be cleaned with an appropriate antiseptic and allowed to dry.

Question 11Infection prevention and control principles

Which statement about alcohol-based hand rub is correct?

  1. It must be rinsed off with water after use
  2. It is effective against many organisms but not against bacterial spores Correct answer.
  3. It is effective against all organisms including Clostridioides difficile spores
  4. It should be used when hands are visibly soiled

Explanation

Alcohol-based hand rub rapidly reduces many vegetative bacteria, enveloped viruses and some fungi, but it is not reliably sporicidal. For organisms such as Clostridioides difficile, soap and water washing is preferred because it physically removes spores. Alcohol rub is applied to dry hands and not rinsed off.

Question 12Infection prevention and control principles

A spill of blood occurs on a hard floor. Which sequence best reflects safe management?

  1. Cover the spill with a dry cloth and leave it to dry
  2. Contain the spill, clean with detergent and water, then disinfect with a chlorine-releasing agent Correct answer.
  3. Disinfect first with alcohol and then mop with detergent
  4. Mop the spill into a drain and rinse with water

Explanation

Blood spills are managed by containing the area, cleaning to remove organic material with detergent and water, and then applying a disinfectant such as a chlorine-releasing agent at the correct concentration and contact time. Cleaning before disinfection is essential because organic matter inactivates many disinfectants.

Question 13Infection prevention and control principles

Which practice reduces the risk of catheter-associated urinary tract infection?

  1. Irrigating the catheter daily with antiseptic
  2. Removing the catheter as soon as it is no longer clinically indicated Correct answer.
  3. Using a catheter with the largest possible diameter
  4. Routine replacement of the catheter every 24 hours

Explanation

The most effective measure is to avoid unnecessary catheterisation and remove the device promptly when no longer indicated. Each day a catheter remains in place increases the risk of infection. Routine daily replacement and antiseptic irrigation are not recommended.

Question 14Infection prevention and control principles

A healthcare worker develops a needlestick injury from a contaminated needle. What is the recommended first action?

  1. Wait for 48 hours to see whether symptoms develop
  2. Apply alcohol gel to the puncture site and continue working
  3. Squeeze the wound firmly to express blood and then apply a tight bandage
  4. Wash the wound with soap and water and report it immediately through the exposure protocol Correct answer.

Explanation

After a needlestick injury the wound should be washed with soap and water (not scrubbed or squeezed), and the incident reported immediately so that risk assessment and post-exposure prophylaxis can be considered. Prompt reporting is essential because prophylaxis for bloodborne viruses is time-sensitive.

Question 15Infection prevention and control principles

Which statement correctly distinguishes cleaning, disinfection and sterilisation?

  1. Cleaning destroys all microorganisms, disinfection removes soil, and sterilisation reduces pathogen numbers
  2. Sterilisation is the same as disinfection when alcohol is used
  3. Cleaning removes organic matter, disinfection reduces pathogens, and sterilisation destroys all microorganisms including spores Correct answer.
  4. Disinfection destroys all spores, sterilisation removes soil, and cleaning reduces pathogen numbers

Explanation

Cleaning physically removes soil and organic matter, disinfection reduces or eliminates many pathogenic organisms on inanimate surfaces, and sterilisation destroys all microorganisms including bacterial spores. These are distinct processes and are chosen according to the intended use of the item.

Question 16Infection prevention and control principles

A patient with pulmonary tuberculosis is being cared for on a ward. Which additional precaution is most appropriate?

  1. Standard precautions with no additional measures
  2. Contact precautions with gloves and gown only
  3. Droplet precautions with a surgical mask and a single room only
  4. Airborne precautions in a negative-pressure room with a fit-tested respirator Correct answer.

Explanation

Pulmonary tuberculosis is transmitted by airborne droplet nuclei, so airborne precautions are required. This includes a negative-pressure room with high air exchange and a fit-tested FFP3 respirator for staff entering. A surgical mask and single room alone do not provide adequate protection.

Question 17Infection prevention and control principles

Which factor most directly increases a patient's susceptibility to healthcare-associated infection?

  1. Being nursed in a bay with a window
  2. Daily bed linen changes
  3. Presence of an invasive device such as a central venous catheter Correct answer.
  4. Use of a single room during admission

Explanation

Invasive devices breach natural defences and provide a surface for biofilm formation, making them a major risk factor for healthcare-associated infection. Environmental factors such as single rooms or windows may influence transmission but are not the most direct host susceptibility factor. Device use is a modifiable risk that should be reviewed daily.

Question 18Infection prevention and control principles

A ward is experiencing an outbreak of norovirus. Which control measure is most important in addition to standard precautions?

  1. Airborne precautions with a negative-pressure room
  2. Contact precautions with enhanced environmental cleaning using a chlorine-based product Correct answer.
  3. Restricting all antibiotic use on the ward
  4. Closing the ward to all visitors indefinitely

Explanation

Norovirus spreads readily by contact and environmental contamination, so contact precautions with rigorous cleaning using a chlorine-based product are central to outbreak control. Hand washing with soap and water is preferred because alcohol is less effective against norovirus. Airborne precautions are not indicated.

Question 19Infection prevention and control principles

Which statement about the use of gloves in clinical practice is correct?

  1. Gloves do not replace hand hygiene and should be removed immediately after the task Correct answer.
  2. Gloves may be worn for several patients if they remain visibly clean
  3. Gloves should be washed with alcohol gel between patients
  4. Gloves should be worn for every patient contact regardless of risk

Explanation

Gloves are a single-use barrier and must be removed and hands decontaminated immediately after the task and before touching anything else. They do not substitute for hand hygiene and must be changed between patients. Washing gloves with alcohol is unsafe and ineffective.

Question 20Infection prevention and control principles

A linen skip is overflowing and soiled linen is on the floor of a sluice room. Which principle of infection prevention is most directly breached?

  1. Correct technique for venepuncture
  2. Immunisation of healthcare workers
  3. Safe management of the environment and waste Correct answer.
  4. Appropriate use of antibiotics

Explanation

Overflowing waste and soiled linen on the floor breach safe environmental management, which is a core standard precaution. Correct waste segregation and containment prevent environmental contamination and exposure of staff and patients. The other options relate to different control measures.

Question 21Infection prevention and control principles

Which statement about surgical site infection prevention is supported by current evidence?

  1. Continuing prophylactic antibiotics for seven days after surgery is standard practice
  2. Shaving the surgical site the night before surgery reduces infection risk
  3. Wound dressings should be changed daily regardless of exudate
  4. Appropriate prophylactic antibiotics given within the recommended time before incision reduce risk Correct answer.

Explanation

Timely prophylactic antibiotics, usually within 60 minutes before incision (or according to the specific agent's pharmacokinetics), reduce surgical site infection risk. Hair removal, if needed, should be done immediately before surgery with clippers rather than razors. Prolonged postoperative antibiotics are not routinely recommended.

Question 22Infection prevention and control principles

A hospital wants to reduce transmission of carbapenemase-producing Enterobacterales (CPE). Which combination of measures is most consistent with a robust screening and isolation strategy?

  1. Using standard precautions alone for all colonised patients
  2. Screening only patients who are already symptomatic
  3. Risk-based screening on admission, contact precautions for colonised patients, and cohorting with dedicated staff where single rooms are unavailable Correct answer.
  4. Relying on environmental cleaning without any patient screening

Explanation

Controlling CPE relies on identifying colonised patients through risk-based screening, applying contact precautions, and using cohorting with dedicated staff when single rooms are limited. Colonised patients may be asymptomatic yet act as a reservoir. Standard precautions alone are insufficient for a multidrug-resistant organism with high clinical impact.

Question 23Infection prevention and control principles

A new decontamination policy proposes using a disinfectant at half the manufacturer's recommended contact time to speed up turnover. What is the main infection control concern?

  1. Reduced contact time may prevent the required level of microbial kill Correct answer.
  2. The disinfectant will become sterile more quickly
  3. Contact time has no effect on disinfectant performance
  4. Shorter contact time improves efficacy against spores

Explanation

Disinfectants require the manufacturer's specified contact time to achieve the claimed level of microbial kill. Shortening contact time can leave viable organisms on the surface, undermining decontamination. Manufacturer instructions must be followed to ensure efficacy and safety.

Question 24Infection prevention and control principles

Which statement best explains why antibiotic stewardship is considered an infection prevention measure?

  1. Stewardship eliminates the need for hand hygiene
  2. Stewardship guarantees that no patient will develop a healthcare-associated infection
  3. Reducing unnecessary antibiotic use limits selection pressure that drives antimicrobial resistance Correct answer.
  4. Antibiotics are used to sterilise the environment

Explanation

Antimicrobial resistance is driven largely by selective pressure from unnecessary or inappropriate antibiotic use. Stewardship programmes aim to optimise prescribing, which preserves the effectiveness of antibiotics and reduces the emergence of resistant organisms. It complements, but does not replace, other infection control measures.

Question 25Infection prevention and control principles

During an audit, staff are observed removing aprons and gloves but not performing hand hygiene before leaving a patient bay. Which link in the chain of infection is most directly left unbroken?

  1. Infectious agent
  2. Susceptible host
  3. Portal of entry
  4. Mode of transmission Correct answer.

Explanation

Hands contaminated after patient care act as a vehicle that transfers organisms to other patients and surfaces, which is the mode of transmission link. Hand hygiene breaks this link. The portal of entry and susceptible host relate to the receiving patient rather than the transfer pathway itself.

Question 26Infection prevention and control principles

Which statement best describes the purpose of standard infection control precautions in a healthcare setting?

  1. They are required only during invasive procedures that breach skin or mucous membranes
  2. They apply to all patients regardless of known infection status, because any patient may be a source of transmissible organisms Correct answer.
  3. They are applied only to patients with a confirmed laboratory diagnosis of an infectious disease
  4. They replace transmission-based precautions once a patient is placed in a single room

Explanation

Standard precautions are the baseline level of infection control applied to every patient at every contact, because colonisation and subclinical infection are common and status is often unknown. Transmission-based precautions are added on top of standard precautions when a specific route of spread is suspected or confirmed, not used instead of them.

Question 27Infection prevention and control principles

A healthcare worker's hands are visibly soiled with blood after assisting a patient. Which action is the correct first step?

  1. Wipe hands on a paper towel and continue the procedure before cleaning
  2. Wash with soap and water, then dry thoroughly before any further activity Correct answer.
  3. Apply alcohol gel over the visible blood and then rinse with water
  4. Apply alcohol-based hand rub and rub until dry without pre-washing

Explanation

When hands are visibly soiled or contaminated with blood or body fluids, soap and water washing is required because alcohol-based hand rub is impaired by organic material and does not physically remove it. Hand rub is reserved for hands that are not visibly soiled.

Question 28Infection prevention and control principles

Which statement about the correct sequence for donning personal protective equipment before a procedure is accurate?

  1. Hand hygiene is performed after all PPE is in place to avoid contaminating the equipment
  2. Gloves are put on first so that the gown can be fastened over them securely
  3. The gown and gloves are applied simultaneously to save time during a busy shift
  4. Hand hygiene is performed before donning, and the gown is put on before gloves so that glove cuffs cover the gown cuffs Correct answer.

Explanation

Hand hygiene precedes PPE donning, and the order gown then mask then eye protection then gloves ensures gloves are the outermost layer and cover the gown cuffs. Putting gloves on first would leave the gown cuffs exposed and contaminate the gloves during fastening.

Question 29Infection prevention and control principles

Which of the following is the most appropriate action when a single-use tourniquet becomes contaminated with blood during venepuncture?

  1. Store it in a pocket and reuse it later in the shift after it dries
  2. Discard it as clinical waste and use a new tourniquet for the next patient Correct answer.
  3. Rinse it under running water in the clinical hand-wash sink and reuse
  4. Wipe it with an alcohol swab and return it to the shared phlebotomy tray

Explanation

A single-use item that becomes contaminated with blood cannot be reliably decontaminated and must be discarded as clinical waste. Reusing or merely wiping a blood-contaminated single-use device risks cross-transmission between patients.

Question 30Infection prevention and control principles

A patient is admitted with suspected Clostridioides difficile infection and has diarrhoea. Which combination of measures is most appropriate?

  1. Cohorting with other diarrhoeal patients and alcohol gel as the sole hand hygiene measure
  2. Open bay placement with curtains drawn and alcohol rub before and after contact
  3. Single room with dedicated toilet, gloves and apron for contact, and soap and water hand washing by staff Correct answer.
  4. Standard precautions only, because C. difficile is spread solely by the airborne route

Explanation

C. difficile spores are not reliably killed by alcohol, so soap and water hand washing is essential, along with contact precautions and a single room with dedicated facilities where possible. Cohorting with other diarrhoeal patients risks cross-infection and alcohol alone is inadequate against spores.

Question 31Infection prevention and control principles

Which statement best explains why a 'bare below the elbows' policy contributes to infection prevention?

  1. It removes the need to perform hand hygiene before every patient contact
  2. It allows effective hand and wrist washing and avoids clothing and jewellery that harbour organisms and interfere with PPE Correct answer.
  3. It sterilises the skin of the forearms so that organisms cannot be carried
  4. It is required only for staff working in operating theatres and critical care

Explanation

Bare below the elbows allows thorough washing of hands and wrists and prevents cuffs, wristwatches, rings and bracelets from acting as reservoirs or interfering with correct PPE use. It supports hand hygiene but does not replace it.

Question 32Infection prevention and control principles

A patient is being cared for with contact precautions for a multidrug-resistant organism. Which action best reflects correct removal of PPE on leaving the bed space?

  1. Remove gloves, perform hand hygiene, then remove the apron and leave without further hand hygiene
  2. Remove gloves and apron, then leave the area and perform hand hygiene at the ward entrance
  3. Remove the mask first, then gloves, then apron, then perform hand hygiene
  4. Remove gloves and apron together, then perform hand hygiene before removing the mask if one was worn Correct answer.

Explanation

Gloves and apron are the most contaminated items and are removed first, followed by hand hygiene, then facial protection if worn, with hand hygiene again afterwards. Removing facial protection first or leaving before hand hygiene risks contaminating the environment and the worker.

Question 33Infection prevention and control principles

Which statement about the use of a disinfectant on a contaminated environmental surface is correct?

  1. The product must be used at the manufacturer's stated concentration and contact time to achieve the claimed effect Correct answer.
  2. Any disinfectant may be substituted for another regardless of the organism targeted
  3. Doubling the concentration compensates for a shorter contact time
  4. Contact time is irrelevant provided the surface looks visibly clean afterwards

Explanation

Disinfectant efficacy depends on using the correct concentration and allowing the stated contact time; shortening either reduces or abolishes the claimed microbicidal effect. Manufacturer instructions are based on standardised testing against specific organisms.

Question 34Infection prevention and control principles

A healthcare worker has a small area of broken skin on the hand and is about to perform a procedure likely to involve contact with blood. What is the most appropriate action?

  1. Proceed without a dressing because gloves alone are sufficient protection
  2. Cover the lesion with a waterproof dressing and wear gloves, considering whether the task should be delegated Correct answer.
  3. Apply a fabric plaster and continue, as fabric plasters are waterproof
  4. Exclude the worker from all patient contact until the skin has fully healed

Explanation

Broken skin should be covered with a waterproof dressing and gloves worn, and the worker should assess whether the task is appropriate to delegate to reduce exposure risk. Gloves alone do not reliably cover a lesion, and total exclusion is disproportionate for a small lesion.

Question 35Infection prevention and control principles

Which statement best explains the role of surveillance in an infection prevention and control programme?

  1. It replaces the need for standard precautions once rates are low
  2. It focuses solely on counting infections and does not inform action
  3. It systematically collects and analyses infection data to detect trends, outbreaks and the effect of interventions Correct answer.
  4. It is used only to report mandatory figures to external agencies, not to change practice

Explanation

Surveillance is the ongoing systematic collection, analysis and feedback of infection data, enabling early detection of outbreaks, monitoring of trends and evaluation of control measures. Its value lies in prompting action and measuring the effect of interventions, not merely reporting figures.

Question 36Infection prevention and control principles

A patient with an indwelling central venous catheter develops fever and rigors during a dressing change. Which action best reflects the principle of preventing catheter-related bloodstream infection?

  1. Clean the site with tap water and apply a non-sterile dressing
  2. Change the dressing only when it becomes visibly soiled
  3. Reuse the same dressing pack for several patients to reduce waste
  4. Use a sterile dressing technique with an appropriate skin antiseptic and review whether the catheter is still needed Correct answer.

Explanation

Central line care requires an aseptic non-touch technique with a suitable skin antiseptic, and regular review of ongoing need for the device to minimise dwell time. Non-sterile technique, infrequent changes and shared dressing packs all increase contamination risk.

Question 37Infection prevention and control principles

Which statement about the management of a patient with suspected viral haemorrhagic fever in a receiving hospital is most appropriate?

  1. Place the patient in an open bay and use alcohol gel as the only barrier measure
  2. Apply standard and contact precautions immediately and involve infection specialists before further invasive procedures Correct answer.
  3. Continue routine care with standard precautions until laboratory confirmation is available
  4. Delay any risk assessment until the patient has been reviewed by a senior clinician the next day

Explanation

Suspected high-consequence infections require prompt risk assessment and escalation, with standard and contact precautions applied immediately while specialist advice is sought. Waiting for laboratory confirmation or deferring assessment delays essential precautions.

Question 38Infection prevention and control principles

A hospital kitchen and a clinical ward share a sluice facility. Which principle best addresses the risk this arrangement poses?

  1. Increased use of air fresheners to mask odours in the sluice
  2. Storage of clean linen in the sluice to keep it close to the ward
  3. Separation of clean and dirty flows, so that clean items and food never pass through or near the dirty sluice Correct answer.
  4. Reliance on staff memory rather than defined zoning to prevent cross-flow

Explanation

Separation of clean and dirty flows prevents clean items, food and linen from being contaminated by waste and soiled materials. Zoning and defined routes should be built into the environment and workflow rather than left to memory.

Question 39Infection prevention and control principles

A clinician argues that a disinfectant with a broad-spectrum label can be used to reprocess a reusable flexible endoscope without the specified automated process. Which statement best explains why this is unsafe?

  1. Reusable endoscopes require validated reprocessing including cleaning, disinfection or sterilisation with monitoring of each stage Correct answer.
  2. Broad-spectrum labels mean any method is acceptable provided the item looks clean
  3. Monitoring of the reprocessing cycle is unnecessary if the disinfectant is new
  4. Manual soaking alone is always sufficient because the label says broad-spectrum

Explanation

Reusable endoscopes demand validated reprocessing with documented cleaning, disinfection or sterilisation and monitoring, because their complex channels are difficult to clean and disinfect. A broad-spectrum label does not substitute for the validated process and cycle monitoring.

Question 40Infection prevention and control principles

A ward's hand hygiene audit shows high compliance but rising rates of a multidrug-resistant organism. Which explanation is most consistent with this finding?

  1. Compliance was measured at moments that do not capture all transmission opportunities, and environmental or device reservoirs may be contributing Correct answer.
  2. Multidrug-resistant organisms are spread only by direct contact and never by the environment
  3. Alcohol rub is effective against all organisms including spores, so reservoirs cannot exist
  4. High hand hygiene compliance always prevents all transmission, so the audit must be wrong

Explanation

Audits measure observed moments and may miss transmission opportunities, and multidrug-resistant organisms can persist in environmental and device reservoirs that hand hygiene alone does not address. Effective control combines hand hygiene with environmental cleaning, device care and antimicrobial stewardship.

Question 41Medical device reprocessing and sterilization

Which document type provides validated, device-specific instructions for cleaning, disinfection, and sterilization that a reprocessing department must follow?

  1. The manufacturer's validated reprocessing instructions for the device Correct answer.
  2. The sterilizer manufacturer's operator manual
  3. The national standard for biological indicator incubation
  4. The facility's general infection-control policy manual

Explanation

Reprocessing must follow the device manufacturer's validated instructions, because those instructions are the only ones proven to render that specific device safe for reuse. Generic facility policies and sterilizer manuals do not contain device-specific validated parameters.

Question 42Medical device reprocessing and sterilization

A rigid endoscope is received with visible blood and tissue. What is the correct first step before manual cleaning?

  1. Transport it in a closed container to the reprocessing area for immediate cleaning Correct answer.
  2. Soak it in high-level disinfectant to fix the soil
  3. Store it dry overnight to allow soil to loosen
  4. Place it directly into the automated washer-disinfector

Explanation

Soiled devices must be contained and transported promptly to the reprocessing area so bioburden does not dry and become difficult to remove. Cleaning must precede any disinfection or sterilization step for the device to be reliably reprocessed.

Question 43Medical device reprocessing and sterilization

Which class of chemical indicator responds to all critical sterilization parameters and is placed inside each package?

  1. Class 1 process indicator
  2. Class 5 integrating indicator Correct answer.
  3. Class 3 single-variable indicator
  4. Class 6 emulating indicator

Explanation

A Class 5 integrating indicator is designed to react to all critical parameters and can be used inside packs to monitor whether conditions were met. Class 1 external indicators only distinguish processed from unprocessed items.

Question 44Medical device reprocessing and sterilization

What is the primary purpose of a biological indicator in steam sterilization monitoring?

  1. To demonstrate that the sterilization process killed highly resistant spores Correct answer.
  2. To measure the humidity inside the chamber
  3. To confirm that the packaging material remained intact
  4. To verify that the correct temperature was printed on the cycle record

Explanation

A biological indicator contains highly resistant spores and provides direct evidence that the process was lethal to microorganisms. Physical records and packaging checks are separate verification activities.

Question 45Medical device reprocessing and sterilization

Which sterilization process is the standard choice for heat- and moisture-tolerant surgical instruments?

  1. Moist heat steam sterilization Correct answer.
  2. Hydrogen peroxide gas plasma
  3. Ethylene oxide sterilization
  4. Radiation sterilization

Explanation

Saturated steam under pressure is the preferred method for items that tolerate heat and moisture because it is rapid, reliable, and leaves no toxic residue. The other methods are reserved for heat- or moisture-sensitive devices.

Question 46Medical device reprocessing and sterilization

A washer-disinfector is used to reprocess respiratory therapy equipment. Which parameter must be verified to confirm the thermal disinfection stage is effective?

  1. The detergent concentration only
  2. The chamber door seal pressure
  3. The rinse-water conductivity only
  4. The A0 value achieved during the disinfection hold Correct answer.

Explanation

The A0 concept expresses lethality as equivalent time at a reference temperature, allowing the disinfection stage to be validated across the actual time-temperature profile. Detergent and rinse parameters support cleaning but do not by themselves prove disinfection.

Question 47Medical device reprocessing and sterilization

Which item should be excluded from a low-temperature hydrogen peroxide gas plasma cycle?

  1. Cellulose-based packaging materials Correct answer.
  2. Rigid aluminum instruments
  3. Devices with long narrow lumens approved by the manufacturer
  4. Stainless steel retractors

Explanation

Cellulose-based materials such as paper and linen absorb the hydrogen peroxide vapor and can block sterilization and leave residue. Only packaging validated for that specific process may be used.

Question 48Medical device reprocessing and sterilization

How should a sterile package be inspected before being placed on the sterile field?

  1. Open the package to inspect the instrument inside
  2. Check only the expiration date printed on the label
  3. Check the external indicator and confirm the package is dry and intact Correct answer.
  4. Rely on the cycle printout alone

Explanation

Before use, the package must be dry, intact, and show that it has been exposed to the sterilization process. Opening a package before it reaches the field compromises sterility.

Question 49Medical device reprocessing and sterilization

During a steam sterilization cycle, the Bowie-Dick test is used to evaluate which performance characteristic?

  1. Air removal and steam penetration in the chamber Correct answer.
  2. The accuracy of the chamber pressure gauge
  3. The moisture content of the packaging material
  4. Spore lethality in each individual pack

Explanation

The Bowie-Dick test is a diagnostic test of air removal and uniform steam penetration in a pre-vacuum sterilizer. It does not prove sterilization of individual loads, which requires biological and chemical monitoring.

Question 50Medical device reprocessing and sterilization

A pre-vacuum steam sterilizer fails its daily Bowie-Dick test. What is the most appropriate immediate action?

  1. Remove the sterilizer from service until the fault is corrected and the test passes Correct answer.
  2. Continue processing loads and repeat the test the next day
  3. Increase the exposure time for the next load
  4. Switch to a gravity displacement cycle for the day

Explanation

A failed Bowie-Dick test indicates air removal or steam penetration is inadequate, so the sterilizer must be taken out of service until repaired and retested. Loads processed under failed conditions may need to be recalled and reprocessed.