Question 1

What is the first step in the decontamination process?

Accepted Answer

Decontamination begins at the point-of-use (in the OR) to prevent blood/soil from drying on instruments. This makes subsequent cleaning steps effective.

Question 2

The ideal temperature for enzymatic cleaners is typically:

Accepted Answer

Enzymes are proteins that work best at specific warm temperatures. Too hot (>140°F) kills the enzymes; too cold renders them sluggish. Always check manufacturer IFUs.

Question 3

Cavitation is the cleaning mechanism used in:

Accepted Answer

Ultrasonic cleaners use sound waves to create microscopic bubbles that implode (cavitation), pulling soil off surfaces and crevices.

Question 4

Which type of water is recommended for the final rinse of critical medical devices?

Accepted Answer

Final rinses require water free of minerals and impurities (Critical Water) to prevent staining, corrosion, and pyrogen contamination.

Question 5

When manually cleaning a device, the brushing motion should be performed:

Accepted Answer

Brushing under the water surface prevents aerosols containing pathogens from becoming airborne and contaminating the technician.

Question 6

A washer-disinfector uses which process to achieve thermal disinfection?

Accepted Answer

Thermal disinfection in automated washers relies on sustaining a high temperature rinse for a specific time to kill vegetative microorganisms.

Question 7

Items with lumens (channels) must be:

Accepted Answer

Soaking isn't enough. Friction (brushing) is required to remove soil inside the lumen, followed by flushing to clear debris.

Question 8

The pH of a detergent used for anodized aluminum containers (rigid containers) should be:

Accepted Answer

Anodized aluminum is damaged by high/low pH. Neutral pH detergents are required to prevent corrosion/pitting of the protective layer.

Question 9

Proper airflow in the decontamination area should be:

Accepted Answer

Negative pressure ensures that air flows *into* the decon area from clean areas and is exhausted outside, preventing contaminants from drifting into clean prep areas.

Question 10

TASS (Toxic Anterior Segment Syndrome) is an acute inflammation of the eye caused by:

Accepted Answer

TASS is a sterile inflammatory reaction caused by toxic residues (like detergents, endotoxins, or enzymes) left on eye instruments. Thorough rinsing with critical water is essential.

Question 11

Before placing instruments into an ultrasonic cleaner, they must be:

Accepted Answer

Ultrasonic cleaners are for fine cleaning. Gross soil inhibits cavitation and contaminates the bath quickly. Pre-cleaning is mandatory.

Question 12

Descaling is the process of:

Accepted Answer

Hard water leaves chalky mineral deposits (scale) on equipment walls. Descaling agents (acidic) remove this buildup to maintain efficiency.

Question 13

Which agency regulates disinfectants and sterilants used on non-living surfaces?

Accepted Answer

The EPA regulates surface disinfectants and liquid chemical sterilants (as pesticides). The FDA regulates high-level disinfectants used on medical devices.

Question 14

Personal Protective Equipment (PPE) for the decontamination area includes:

Accepted Answer

Full PPE is required to protect against splashes and biohazards. Heavy-duty utility gloves are preferred over exam gloves.

Question 15

A 'High-Level Disinfectant' (HLD) kills:

Accepted Answer

HLD kills almost everything (TB, viruses, fungi) but cannot guarantee the kill of high numbers of spores (that requires sterilization).

Question 16

The minimum effective concentration (MEC) of a high-level disinfectant must be tested:

Accepted Answer

HLD solutions (like Glutaraldehyde or OPA) degrade over time. You must dip a test strip before *every* use to ensure potency.

Question 17

According to the Spaulding Classification, 'Semi-critical' items require at least:

Accepted Answer

Semi-critical items touch mucous membranes (e.g., endoscopes, anesthesia blades) and require High-Level Disinfection. Critical items (enter sterile tissue) require sterilization.

Question 18

Why must instruments be disassembled before cleaning?

Accepted Answer

Bioburden hides under movable parts. Disassembly ensures detergent and water reach every surface.

Question 19

Ortho-phthalaldehyde (OPA) is a common:

Accepted Answer

OPA is a widely used liquid high-level disinfectant for flexible endoscopes. It is a safer alternative to glutaraldehyde.

Question 20

If a rigid container is returned to decontamination with the filter still in place:

Accepted Answer

Disposable filters are single-use. They must be removed in decon to allow proper cleaning of the lid and retention plate.

Question 21

When loading a mechanical washer, instruments should be placed:

Accepted Answer

Box locks and ratchets must be open to allow spray action to reach the hinge areas and jaws.

Question 22

The 'hollow' cavitation test used for ultrasonic cleaners involves:

Accepted Answer

The aluminum foil test detects uneven cavitation. (Note: Newer commercial tests like SonoCheck are also used, but foil is the classic textbook answer for verifying cavitation energy distribution).

Question 23

Prions (which cause CJD) are uniquely resistant to:

Accepted Answer

Prions are misfolded proteins that are incredibly resistant. They require extended sterilization cycles (e.g., 18 min at 273°F or 1 hour at 250°F) and specific cleaning protocols.

Question 24

Which detergent is best for removing stubborn organic soils like dried blood?

Accepted Answer

Protease enzymes specifically break down proteins (blood/tissue). Lipase breaks down fats.

Question 25

Transporting contaminated items to the decontamination area requires:

Accepted Answer

OSHA requires biohazardous materials to be contained in leak-proof, labeled containers to protect staff and the environment during transport.

Question 26

Power equipment (drills, saws) should generally be:

Accepted Answer

Immersion allows water to enter the motor housing, destroying the mechanism. Follow IFU carefully—usually manual wipe-down.

Question 27

Biofilms are:

Accepted Answer

Biofilms form when bacteria attach to a surface and secrete a matrix (slime). They are very hard to remove and shield bacteria from chemicals.

Question 28

Robotic instruments (like DaVinci) typically require:

Accepted Answer

Robotic arms have complex cables and pulleys. They require very specific, time-intensive manual and automated cleaning steps.

Question 29

The temperature of the decontamination area should be maintained between:

Accepted Answer

Decon should be cooler (60-65°F) to inhibit bacterial growth and keep staff comfortable while wearing hot PPE.

Question 30

If instruments arrive from the OR with saline on them, what will likely happen?

Accepted Answer

Saline is salt water. Salt causes rapid corrosion (rust/pitting) on stainless steel. OR staff should use sterile water, not saline, to keep items moist.

Question 31

Degassing an ultrasonic cleaner is done to:

Accepted Answer

Excess gas bubbles cushion the cavitation implosions, reducing cleaning power. Running the unit empty for a cycle degasses the water.

Question 32

Glutaraldehyde usually requires a soak time of ____ for high-level disinfection at 20°C.

Accepted Answer

For HLD, Glutaraldehyde typically requires 45-90 mins (depending on formulation). For Sterilization, it requires 10 hours.

Question 33

Phenolics are environmental disinfectants that should generally NOT be used on:

Accepted Answer

Phenolics leave a residue that can irritate skin and is toxic to infants (depigmentation). They are for environmental surfaces only.

Question 34

The final step in manual cleaning is:

Accepted Answer

Rinsing removes the detergent and loosened soil. Critical water prevents recontamination/staining. (Drying follows, but rinsing is the final 'cleaning' step action).

Question 35

Loaner instruments should be:

Accepted Answer

You cannot trust outside processing. Loaners must be treated as contaminated and go through the full decontamination cycle at the receiving facility.

Question 36

When cleaning a Kerrison Rongeur, the most critical step often missed is:

Accepted Answer

Kerrisons have a sliding mechanism that traps bone and tissue. If not disassembled or opened fully during cleaning, bioburden remains trapped inside, leading to sterilization failure.

Question 37

A Loaner Set arrives at 2:00 PM for a 3:00 PM case. The manufacturer IFU requires an 8-minute steam cycle. The hospital's policy allows IUSS. What is the BEST decision?

Accepted Answer

Patient safety comes first. Loaner trays must be fully decontaminated and sterilized. 1 hour is insufficient for proper processing (soak, clean, pack, sterilize, cool). Pressure to flash sterilize due to late delivery should be resisted.

Question 38

Which water quality issue creates a 'rainbow' effect or stain on stainless steel instruments?

Accepted Answer

Excessive silicates in the water supply typically cause blue/rainbow discoloration on instruments.

Question 39

A 'TASS' outbreak in the ophthalmology department would trigger an audit of:

Accepted Answer

Toxic Anterior Segment Syndrome (TASS) is caused by residues (detergents, endotoxins) left on eye instruments. The audit would focus on water quality (critical water) and rinsing steps.

Decontamination Practice Questions

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