Infection Control: New York State Mandatory Training

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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 patient’s 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?

  a. Mr. B could be charged with unprofessional conduct for failing to adhere to scientifically accepted principles and practices of infection control.

  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.

  c. Both A and B.

  d. None of the above.


2. According to the CDC, there were an estimated 722,000 HAIs in acute care hospitals in the US in 2011. About 75,000 hospital patients with HAIs died during their hospitalizations

  a. True.

  b. False.


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

  a. Utilizing personal protective equipment (PPE) and Standard Precautions while providing care and treatment to patients in an acute care hospital.

  b. Insuring that healthcare staff, who serve patients in a home care agency, are in good health and are current with recommended adult immunizations.

  c. Cleaning and disinfecting equipment for a free-standing surgery center while adhering to manufacturers’ and CDC guidelines.

  d. All of the above.


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:

  a. Contact with mucous membranes of the eyes, nose or mouth.

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

  c. Human bites.

  d. Exposure though broken or abraded skin.


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

  a. True.

  b. False.


6. The CDC’s 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.

  b. False.


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.

  b. False.


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.

  b. False.


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

  a. Gloves when touching body blood, body fluids, secretions, excretions, contaminated items, for touching mucous membranes and non-intact skin.

  b. Gowns during procedures and patient care activities when contact of clothing/exposed skin with blood/body fluids, secretions, or excretions is anticipated.

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

  d. Masks and goggles or a face shield during patient care activities likely to generate splashes or sprays of blood, body fluids, secretions and excretions.


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.

  b. False.


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

  a. Types of microorganisms.

  b. Number of microorganisms.

  c. Potential for cross-contamination.

  d. All of the above.


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.

  a. True

  b. False


13. The incidence of occupational transmission of the hepatitis B virus has decreased by 96% since 1987. This is largely due to the practice of Universal Precautions and the 1992 Bloodborne Pathogen Standard in which hepatitis B vaccination has been required to be provided to healthcare workers.

  a. True

  b. False


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

  a. 0.8%

  b. 30%

  c. 0.3%

  d. 6%


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.

      b. False.


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

      a. True

      b. False


    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?

      a. Critical items are enter sterile tissue or the vascular system must be sterile. Critical items have a high risk for infection if they are contaminated with any microorganism.

      b. Non-critical items are those that come in contact with intact skin but not mucous membranes.

      c. Semicritical items contact mucous membranes or nonintact skin.

      d. All of the above.


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

      a. Use a sharps container capable of maintaining its impermeability after waste treatment to avoid subsequent physical injuries during final disposal.

      b. Place disposable syringes with needles, including sterile sharps that are being discarded, scalpel blades, and other sharp items into puncture-resistant containers located as close as practical to the point of use.

      c. Do not bend, recap, or break used syringe needles before discarding them into a container.

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


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

      a. It does not harm the recipient, does not expose the provider to any avoidable risks and does not result in waste that is dangerous for the community.

      b. It includes practices intended to prevent transmission of bloodborne pathogens between one patient and another, or between a healthcare worker and a patient, and also to prevent harms such as needlestick injuries.

      c. Both A and B.

      d. Neither A or B.


    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:

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

      a. All of the above.

      b. None of the above.

      c. 1 and 3.

      d. 1, 2 and 3.



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