Sterile Processing and Distribution

Heparin 20,000 units in 1 ml. You wish to give 15,000 units. How many ml will you administer?

• 0.2ml
• 0.75ml
• 1.5ml

Peracetic acid is a liquid oxidizing agent that effectively kills bacteria at low temps

• True
• False

A filter placed immediately before a solution patients vein is

• Membrane filter
• Depth filter
• Final filter
• None of the above

Low Temperature Gas Plasm is not compatible with?

• Heat sensitive devices
• Items with lumens
• Paper products
• None of the above

The Veterans Administration (VA) hospital system has its own certification program for SPD (CS) Technicians

• True
• False

Which of the following is the MOST efficient and cost-effective method for inventory control in the SPD ordering and data generation?

• Computerized Inventory Control System
• Exchange-Cart Distribution System
• Par-Level Restocking Distribution System
• Stockless/Just-in- Time Distribution System

Without water molecules is called

• Gauge
• Anhydrous
• SQ
• Bevel

The sum of the atomic weights of a molecule

• Valence
• Isotonic
• Molecular weight
• SQ

Due to the fast-paced environment in ambulatory surgery centers basic concepts of cleaning, disinfection and sterilization are adjusted to meet faster timeline requirements.

• True
• False

Which of the following agencies would approve the disinfectants used on floors and walls in the Sterile Processing and Distribution Department?

• Joint Commission for the Accreditation of Healthcare Organization
• Centers for Disease Control
• Occupational Health and Safety Administration
• Enviromental Protection Agency

Occupational Health and Safety Administration has estabilished a general air contaminant standard for which of the following?

• Ethylene Oxide
• Ortho-Pthaldehyde
• Isopropyl Alchol
• Glutaraldehyde

Material Safety Data Sheets provide health and safety hazard and risk information on which of the following?

• Electrical
• Chemical
• MSDS
• Mechanical

An acceptable method of decontaminating an item that has been used on a patient is to?

• Sterilize with ethylen oxide gas before cleaning.
• Wipe thoroughly with bleach solution.
• Clean with a detergent solution and then use an appropriate disinfection agent.
• Steam or gas sterilize and then clean with a dtergent solution.

All blood and other potentially infectious materials are handled with caution. Bloodborne pathogen exposure is regulated by?

• Enviromental Protection Agency
• Occupational Safety and Health Administration
• Centers for Disease Control
• Food and Drug Adminstration

The molecular particles that carry electric charges are

• Ions
• Isotonic
• Hypotonic
• Lyophilized

Simultaneous wrapping means to wrap an instrument set with?

• Tow double-woven textile wrappers applied one at a time.
• A singel-woven textile wrapper around a metal container.
• A single non-woven wrapper, double-ply, bonded at the edges.
• One double-woven wrapper and one non-woven wrapper applied one at a time.

Which of these is not used to ensure high level of disinfection?

• Hydrogen Peroxide Plasma
• Sucrose solution
• Paraceacetic solution
• Glutaldehyde solution

Flexible rubber tubing near the needle adapter of an administration set used to determine if the needle is properly placed in the vein is

• Flash ball
• Piggy back
• Heparin lock
• LVP

Milligrams are weights of drugs, units refers to _________.

• Length
• Liquids
• Activity or potency of natural products

Which of the following is neccessary to attain the high temperature needed in a steam sterilizer?

• Pressure
• Concentration
• Moisture
• Vacuum

What is the act of maintaining sterility during procedures called?

• Septic technique
• Uniform technique
• Aseptic technique
• Packaging technique

When a solution has a greater osmolarity than that of blood, it is called

• Osmotic pressure
• Osmosis
• Hypertonic
• Isotonic

State boards of pharmacy:

• Represent the interest of pharmacists to the state legislature and other state agencies
• Regulate the manufacturing of controlled substances
• Are responsible for protecting their citizens' health and welfare with regard to pharmacy services

Which of the following BEST describes the manual cleaning process of surgical instruments?

• Wiping the instrument with a dry towel.
• Holding the instrument under warm running water.
• Scrubbing the instrument in a detergent solution.
• Soaking the instrument in a detergent solution for 10 minutes.

When processing flexible endoscopes in a liquid chemical sterile processing system you should

• Pressurize the scope before starting the machine
• Use tap water as a pre-rinse
• Connect channels to special connectors that allow liquid to flow through them
• Run the cycle twice to ensure that proper microbial kill has taken place

The technician is asked to remove an arthroscopy set from the aerator four hours prior to the completion of aeration time. The supervisor is not available. Which of the following should the technician do?

• Do nothing until the supervisor returns.
• Remove the set as requested.
• Let the set complete the aeration cycle and borrow a set from another hospital
• Inform the requesting area of the safety hazards and give it the set.

Which of these is not a factor that determines the method of sterilization?

• Operational cost
• Desired level of sterilization
• Efficacy
• Time

Which of the following is the main Disadvantage of using a rigid sterilization container system?

• They are difficult to wrap.
• They have surfaces that are slow to reach sterilzer chamber temperature.
• They have easily damaged outer surfaces.
• They must be disassembled, processed, reassembled, and checked before each use.

Does successful sterilization begin with?

• Cleaning
• Decontaminaion
• Packing
• Sterilization

Labels prepared by the pharmacy for sterile products include all of the following except:

• Diluent name and volume
• Stability expiration date and time
• All of the above

When transporting soiled materials, they should be?

• Contained in a closed cart, covered bin.
• Contained in an open cart, clear plastic bags.
• Contained in a closed cart or mesh pans.
• Contained in a closed cart, covered bin and identified with a biohazard label.

There are many concerns about this matter. Whats a wet pack?

• Is not considered contaminated
• Only occurs with gravity displacement sterilization
• Only ccurs when items are loaded wrong on the autoclave cart
• Is still wet after sterilization and drying

Cavitation is a mechanical action that involves the use of ?

• Exploding oxygen bubbles
• Imploding oxygen bubbles
• Exploding gas bubbles
• Imploding gas bubbles

The appropriate sterilization cycle for an autoclave load containing a basin set, a minor surgery set, and twelve towel packs is?

• 270°F (132°C) for 4 minutes, 30 psi, and 20 minutes drying time
• 250°F (121°C) for 30 minutes and slow exhaust
• 250°F (121°C) for 30 minutes and 25 minutes drying time
• 134°F ( 57°C) for 105 minutes and 12 hours aeration

The detergent best suited for heavy orthopedic soils is?

• Neutral pH detergent
• Proteolytic enzyme detergent
• Lipolytic enyzmatic detergent
• Acid detergent

Which parenteral solution is not required to be sterile?

• Subcutaneous injection
• Vaginal
• Intranasal
• Inhalation

If contents of a container of instruments is not clearly visible, the CS/SPD technician should

• Dump the contents into the ultra sonic
• Carefully remove items with gloved hands
• Return the container to the OR
• Use a spnge stick of forcep to remove items

U-100 Humulin N insulin indicates ________per ______.

• 100 units per milliliter
• 5mg per 5ml
• 100mg per milliliter

A characteristic of a solution determined by the number of dissolved particles in it

• Osmosis
• Osmosis pressure
• Valence
• Sharps

Liquid peracetic acid is difficult to rinse from items

• True
• False

When opening an ampule, snap the ampule neck

• Toward the HEPA filter
• Away from the HEPA filter but toward sterile supplies that have been swabbed with an alcohol pad
• Toward the HEPA filter but away from sterile supplies that have not been swabbed with an alcohol pad
• Away from the HEPA filter or any other sterile supplies

The horizontal laminar flow hoods, air blows

• Down toward the work area
• Away from the operator
• Toward the operator
• Up toward the HEPA filter

Before releasing an item to fill a sterile supply order, all of the following must be checked EXCEPT ?

• The expiration date.
• Cost effectiveness data.
• Whether the package is damaged.
• Verification of chemical indicator.

A filter that can filter solutions being drawn into or out of a syringe, but not both ways in the same procedure is

• Depth filter
• Web filter
• Membrane filter
• Final filter

In a dental office, clinical contact surfaces are defined as surfaces that can be directly contaminated during patient care.

• True
• False

What is the easiest method of sterilization?

• Steam sterilization
• Wet heat
• Dry heat
• Radiation

A Bowie-Dick test should be performed in which of the following types of sterilizers?

• Ethylene oxide
• Dry heat
• Gravity displacement steam
• Pre-vacuum steam

The PH of dtergent solution that has been demonstrated to be the safest for cleaning surgical instruments is

• Highly alkaline
• Moderately alkaline
• Neutral
• Acidic

The water-detergent solution in the ultrasonic cleaner must be degassed before it is uesd to remove?

• The gas
• The solution
• The cavitation
• The air

The transport of flash sterilzed items is difficult because

• They have no protective wrapping
• They are wet
• They are hot
• Contained in heavy trays

You are to use 2.4 ml of diluent to reconstitute a vial of medication. what size of syringe should be used?

• 20 ml
• 10 ml
• 5 ml
• 3 ml

Pyrogens

• Grow in parenteral solutions
• Are not water soluble
• Produce fever
• Can be removed by filtration

When using the sequential wrapping method?

• Use extra packaging material to line the tray inside.
• Apply one wrapper followed by a second one.
• The first fold should not cover the contents of the set.
• Only one wrapper should be used.

When a steam sterilizer load contains a mixture of fabric and metal items, the items should be placed?

• In a way that best utilizes the space
• With the fabric items between the metal items
• With the metal items above the fabric items
• With the metal items below the fabric items

Sterilization involves the use of a physical or chemical procedure to

• Remove visible soil from surgical instruments
• Destroy non-pathogenic organisms
• Destroy all forms of microbial life including highly resistant bacterial spores
• Destroy all forms of microbial life except highly resistant baterial spores

Before an item can be placed in a liquid chemical sterile processing system they must be

• Heated
• Filled with air
• Sterilized
• Cleaned

The agency that supervises the development, testing, purity, safety, and effectiveness of prescription and over-the-counter medications is known as the:

• Board of Pharmacy
• Drug Enforcement Administration
• Food and Drug Administration

Which of the following is the MOST important factor in preventing bacteria from contaminating sterile packages?

• The sterilization method used
• The quantity of packages
• The handling of packages
• The correct use of sterility maintenance covers

Peristaltic, cassette, and elastomeric pumps are examples of

• Auto mixers
• Positives pressure pumps
• Controllers
• Administration sets

Surgical grade instruments, if properly cared for, usually last longer than floor grade instruments because they have a?

• Cavitation layer
• Chromium layer
• Oxidation layer
• Passivation layer

If it is not possible to wash contaminated instruments immediately after use, they should be kept moist by?

• Soaking them in a saline solution.
• Soaking them in a high sudsing detergent.
• Covering them with a saline-moistened towel, and placing them in a plastic bag.
• Spraying with an enzymatic foam, covering them with a towel moistened with water, and placing them in a plastic bag.

The part of the needle which attaches to the syringe is called.

• Hub
• Slip tip
• Plunger
• Ampule

A compounded sterile parenteral dosage form that will be parenterally administered is

• Coring
• Depth filter
• Compounded sterile preparation (CSP)
• Gauge

Internal chemical indicators routinely monitor?

• Packages
• Trays
• Rigid sterilizer containers
• All of the above

An estabilished norm determined by opinion,authority, research, and/or theory is a?

• Recommended practice
• Regulation
• Standard
• Rule

In which distribution system are requistions filled and deliveres as they are received?

• Specialty cart
• Case cart
• Par level
• Demand

Compounded sterile preparations (CSPs) are preparations that are made using sterile or non-sterile ingredients that must not contain bacteria in the final product. The process used to avoid contamination while compounding sterile products is known as:

• Non-sterile compounding
• Aseptic technique
• IV compounding

A broken glass suction bottle is returned to Decontamination.Which of the following should the technician do?

• Discard it in a Biohazard waste bag.
• Place it in a cardboard box for disposal.
• Place it in an appropriate rigid container
• Discard it in the general trash.

Outside shipping cartons should NOT be brought into the SPD because they are often?

• Extremely heavy
• Lint producers
• Biologically contaminated
• Water repellent

If a technician's skin is exposed to liquid ethylene oxide, what should the technician do FIRST?

• Wash the exposed area with large amounts of soap ans water
• Apply a medicated ointment to the exposed area
• Immediatelly report to the emergency room
• Notify a supervisor or department manager

A patient contracts an infection from an improperly sterilized surgical instrument.This is an example of?

• A vector transmission
• An airborne transmission
• An aerobic infection
• A nosocomial infection

When working in the decontamination area, transmission of pathogenic organisms from used surgical instruments can BEST be minimized by?

• Ensuring that the area is damp mopped frequently.
• Ensuring that all work surfaces are kept clean and dry.
• Wearing appropriate personal protective equipment.
• Pre-soaking the instruments in a high-level disinfectant.

Which is not a correct statement regarding clean room

• Must be a designated area of the pharmacy
• Must have restricted air flow
• Must accommodate most of the equipment for aseptic compounding
• Must have proper storage of supplies

Since the types of surgeries performed are smaller, PPE is not required when cleaning instruments used in ambulatory surgery centers.

• True
• False

Cotton gauze cannot be used in which sterilization process?

• Low Temperature Gas Plasma
• Ethylene Oxide Gas
• Peracetic Acid
• Steam

Which of the following solutions is generally considered MOST appropriate for high-level disinfection of instruments?

• 0.5% hypochlorite bleach
• 2% Quaternary ammonium compounds
• 50% aqueous isopropyl
• 2% activated glutaraldehyde

A liver Biopsy would be performed to check for which disease?

• HIV Virus
• Hepatitis C virus
• CJD
• None of the above

Small-volume parenterals are:

• Often delivered as "piggybacks" along witih large volume fluids
• Designed to provide the patient's nutritional needs
• Designed to prevent the patient from dehydrating

Both AORN and the Joint Commission recommend that

• The use of flash sterilization be minimized or decreased
• Flash sterilization be performed in only one sterilizer per facility
• Healthcare facilities get FDA approval for flash sterilization
• Only central service techs operate flash sterilizers

A positive biological indicator test shows that the sterilization process

• Was improperly handled
• Was interrupted before completion
• Did not result in the death of all the test organisms.
• Killed an acceptable number of the test organisms.

The purpose of decontamination is to

• Prevent the transmission of disease
• Eliminate the need for manual cleaning
• Render items safe for handling
• Eliminate need for sterilization

The Rx tells you to add one gram of vancomycin to a 250-ml container of dextrose 5% in water and give intravenously over a 2-hour period, repeated every 12 hours for 10 days. Why would you not prepare the entire 20 doses at the same time?

• 2 hours is all the patient needs
• Vancomycin will not be stable in D5W
• Because of the relatively short shelf life of many IV medications

Eethylene Oxide products require _________ hours of aeration at 140F

• 12
• 10
• 8
• 6

The process by which unwrapped instruments are steam sterilized for immediate use when an emergency situation arises is called

• Emergency sterilization
• Flash sterilization
• Core sterilization
• Rapid reprocessing

When transporting sterile packaged items by hand?

• Place in a plastic bag or tote bin.
• Cradle them in your arms.
• Stack them on top of one another
• Place a linen wrapper over them

All of the following items of personal protective equipment should be worn when manually decontaminating flexible fiber-optic endoscopes EXCEPT?

• A mask with side shields.
• An imprervious gown.
• Wrist-lenght gloves.
• A lead apron

A tray of instruments has been brought to the Decontamination area in a saline solution.Which of the following actions should the technician take?

• Treat them in the same manner as all the other articles brought to Decontamination.
• Soak them in detergent and then clean them in the usual manner.
• Rinse them with water and then clean them in the usual manner.
• Ask the supervisor for directions.

The movement of particles in a solution through permeable membranes is called

• Filter
• Dialysis
• Flow rate
• Anhydrous

Desi drugs not considered to be therapeutically equivalent, and generally pre-date the FDA's testing standards. Examples are:

• Augmentin, Amoxil, and Ampicillin
• Librax, Donnatal, and Phenobarbital
• Paregoric

Am ambulatory surgery center and an urgent care facility are the same thing.

• True
• False

Today, healthcare organizations recognize that package sterility is?

• Time-related
• Process-related
• Event-related
• Inventory related

A positve biological indicator shows that the sterilization process?

• Was properly handled
• Did not kill all the test spores
• Was interrupted before completion
• Was sucessful and killed all test spores

Which of the following use a pump to remove air from the sterilizer's chamber before steam is introduced?

• Gravity air dsplacement sterilizers
• Dynamic air removal sterilizers
• Washer-sterilizer
• Flash sterilizer

Which of the following generally describes the correct sequence for the traffic workflow in areas in which medical devices are processed?

• Decontamination, sterile storage, sterilization, assembly
• Distribution, assembly, packaging, sterile storage
• Decontamination, assembly, packaging, sterilization, sterile storage
• Disinfection, assembly, packaaging, sterilization, sterile storage

Drains in pre-vacuum and gravity-displacement sterilizers are placed at the bottom front of the strilizers?

• To make it easy to service the sterilizers
• To make it easy to monitor the steam pressure in the sterilizer
• Because national plumbing codes dictate placement
• Because the air tends to concentrate at the bottom of the chamber

Which of the following statements about flash sterilization is true

• It is the sterilization method of choice for metal instruments
• It is recommended to be used as a primary sterilization process by AAMI and AORN
• It reduces turnaround time because cleaning is not required
• It should be used only in emergencies

Hydrogen peroxide is an example of an oxidative chemistry

• True
• False

Which of the following sterilization methods would be appropriate for petrolatum gauze dressings?

• Steam
• Ethylene Oxide
• Dry heat
• Peracetic acid

Freeze dried

• Valence
• Irrigation solution
• Lyophilized
• Pyrogen

An angled surface, at the tip of a needle is

• Bevel
• Bevel heel
• Hub
• Shaft

There are two types of aeration.Ambient aeration usually takes at at least?

• At least one day
• At least 6 hours
• At least seven days
• At least 3 days

The acronym used in most facilities to help staff remember what to do during a fire emergency is

• FACE
• PACE
• RACE
• PASS

Implantable devices

• Should be flash sterilized in extended cycles
• Should only be sterilized using ethylene oxide
• Should not be flash sterilized
• Should be discarded if not used

A technician working in Decontamination notices that the maintenance person working on the washer/sterilizer did not remove the barrier attire when the person left the area to get additional tools. The technician should?

• Do nothing,since the maintenance personnel did not come in contact with any contaminated material.
• Ask the maintenance person to remove the barrier attire when leaving the area.
• Report the problem to the maintenance supervisor.
• Document the problem in the shift report.

Irregaton solutions are administered

• Throguh a filter needle
• Through a special administration set
• Orally
• By pouring them out of the bottle

Visual inspection of parenteral solutions can show the presence of ___ and ___.

• Particle contamination, precipitation
• PH, precipitation
• Chemical degradation of a drug, osmolarity
• Pyrogens, precipitation

What would you decribe this ?

• Spherical
• Spirochete
• Protozoa
• Spore

A filter that filters solution as the solution is expelled from the syringe

• Final filter
• Hepa filter
• Deptfilter
• Membrane filter

A laminar flow hood where the ari crosses the work area in a horizontal direction

• Veritical hood
• Laminar hood
• Hepa
• Horizontal flow hood

When a needle damages the rubber closure of a parenteral container causing fragments to fall into the container, it is called

• Coring
• Syringe ability
• Final filter
• Bevel

Who controls emissions into the water (under the Clean Water Act).

• Occupational Health and Safety Administration
• Enviromental Protection Agency
• Food and Drug Adminstration
• All of the above

When arranging plastic/paper peel pouches in the sterilizer they should be positioned standing up right on edge with?

• Plastic to plastic
• Paper to plastic
• Paper to paper
• Paper to phenol

Any object that can puncture or cut the skin of anyone who handles them

• Sharps
• Bevel
• Coring
• Cut

A staff member brings several contaminated trays to the SPD on a cart and requests that replacements trays be put on the same cart. The technician should

• Place the trays on the cars as requested.
• Drape the top of the cart and then place the trays on top of the drape.
• Insert the trays in a plastic bag before giving them to the staff member.
• Clean and dry the transport cart and send it to Dstribution for the trays.

Biological indicator of choice for Low Temperature Gas Plasam is ?

• Geobacillus stearothermophilus
• Bacillus atrophaeus
• Bacillus stearothmophillus
• Geobacillus atrophaeus

Which of these medical equipments is not reusable?

• IV pumps
• Crash cart
• Surgical instrumentation
• Rubber gloves

Which of these does not need to be sterilized?

• Artificial pacemaker
• Syrindge
• Scalpels
• Hypodermic needle

A laminar flow hood where the air crosses the work area in a veritical direction

• Horizontal flow hood
• Vertical flow hood
• Laminar hood
• Biological Safety Cabinet

To remove stubborn stains from instruments it is recommended to use?

• Bon Ami Cleaner
• Teflon cleaning sponges
• Non-Abrasive cleaner
• Wire brush

Loose fitting clothing and jewelry should NOT be worn in SPD because it can?

• Presents a non-professional appearance
• Can Becaome easily contaminated
• Can get caught in moving equipment
• May encorage theft among employees

Which solution is placed in and emptied from the peritoneal cavity to remove toxic substances?

• Irrigation solution
• Peritoneal dialysis solution
• Solutions
• Sterile solution

Before the mid-1970s, virtually all surgeries were performed in hospitals

• True
• False

Which of the following is an ethical responsibility of an individual working in Central Processing Department?

• Reporting to work on time
• Communicating effectively
• Supporting department objectives
• Maintaining patient confidentiality

Generally, the first step in removing blood contamination from the channels of an instrument is to soak it in?

• An enzymatic detergent
• An organic detergent
• A phenolic solution
• An alkaline solution

A drug's molecular weight divided by its valence, a common measure of electrolyte concertation is

• Coring
• Valence
• Flow rate
• Equivalent weight

Alcohol-based hand rinse should not be used?

• Prior to patient contact
• If fingernails are chipped.
• If the patient has a respiratory infection.
• If hands are visibly dirty.

Low-risk CSPs are compounded in a ISO Class 5 environment, such as a laminar air flow hood. Example of a low-risk CSP is:

• A 12-hour or less beyond-use-date
• TPN prepared from 4.5% amino acid solution and 22% dextrose, with four electrolytes, multiple vitamins, trace elements, insulin, and ranitidine
• Rx for a high-potency morphine solution that can only be made by using non-sterile morphine powder

Which concentration term used with parenteral solutions does not use the drugs molecular weight to determine its value

• Molarity
• Osmoles
• Equivalents
• Percentage weight per volume

A high efficiency air filter is

• HEPA filter
• Diluent
• Final filter
• Web filter

If the child's ( 2 yrs to 6 yrs) dose of Diphenhydramine Elixir (12.5mg/5ml strength) is 25mg/day; a dose would be how many milliliters if dosed four times a day? How many teaspoonsful?

• 5ml or one teaspoonful
• 2.5ml or one-half teaspoonful
• 20ml or 4 teaspoonful

Healthcare workers are most likely to be infected by which of the following agents?

• Hepatitis B
• Human immunodeficiency virus
• Pneumococcus
• Rubella

How should fiber-optic light cable be stored?

• Tightly coiled, no less than 8 inches
• Loosely coiled, no less than 6 inches
• Tightly coiled, no less than 7 inches
• Loosely coiled, no less than 8 inches

If a laminar flow hood is turned off between aseptic procession sessions, how long should it run before it is used again?

• Does not matter
• At least 15 minutes
• At least 30 minutes
• It should never be turned off

What method of sterilization is most suitable for fluids that can be destroyed by heat?

• Microfiltration
• Wet heat
• Radiation
• Dry heat

If the Operating room requests instruments for an emergency ruptured aortic aneurysm, the technician should send.

• Laparoscopic instruments.
• Major vascular instruments.
• Stereotaxic instruments.
• Carotid endarterectomy instruments.

The water in the ultrasonic cleaner should be changed when it becomes visibly soiled and at least _______.Instruments should not be placed higher than _____ inside the ultrasonic basket.

• Once each shift, should not be placed higher than 3 inches
• Once a week, should not be placed higher than 4 inches
• Twice each shift, should not be placed higher than 5 inches
• Once a day, should not be placed higher than 6 inches

Procedures for withdrawing fluid from a multiple-dose vial include which three?

• Choose correct syringe size, pull back the plunger of the syringe to the desired volume that you want to extract, place the bevel of the needle facing up, on top of the vial closure, and push needle into the vial at a 45 degree angle with bevel facing up and inject air into the container
• Insert the tip of the needle into the fluid and pull back on the syringe, tip the ampule if needed to remove the desired amount of fluid, and change the needle on the syringe to a filter needle to filter any small glass particles from the fluid as it is added to the final product
• Insert the needle straight into the additive port, but be careful not to puncture the sides of teh injection port and be sure to choose a needle long enough to puncture the inner seal at the injection port, then inject fluid into the container

Which part of an administration set is used to set the flow rate

• Spike
• Volume control chamber
• Flashball
• Needle adapter

Water molecules that attach to drug molecules

• Waters of hydration
• Hyptonic
• Aq
• Solution

A biofilm can form in any?

• Sterile water enviroment
• Non-sterile water enviroment
• Enzyme foam product
• Enzyme gel product

The methods that maintain sterility products is

• Aseptic technique
• Bleaching
• A clean person
• Admixture

Externally purchased sterilized itmes should be moved from receiving to sterile storage areas in?

• Containers in which they are shipped
• Covered carts with perforated bottom shelves
• Covered carts with solid bottom shelves
• Open carts with solid bottom shelves

An instrument tray for a laparotomy procedure must include

• A Hipp retractor
• A Simms retractor
• A thyroid retractor
• An abdominal retractor

Name the action in which a drug in a higher concentration solution passes through a permeable membrane to a lower concentration solution.

• Osmosis
• Membrane filiter
• Isotonic
• Final filter

A Pyrogen is a?

• Fever inducing organism
• Antibiotic resistantorganism
• Virus
• Prion

A drug that is added to a parenteral solution is

• Admixture
• Anhydrous
• Dialysis
• Flash ball

Inspection and verification of adequate cleaning is difficult with instruments?

• Without lumens
• With luminization
• With lumens
• None of the above

The number of ambulatory surgery facilities is decreasing nationwide.

• True
• False

Quarternary ammonium compounds or quats, are used to disinfect the surfaces of which area?

• Decon
• Nursery
• Sterilization
• ICCU

Ambient aeration refers to aeration that takes place in?

• A cabinet at 122°F (50°C)
• A cabinet at 140°F (60°C)
• An open space at room temperature
• An ethylene oxide (EtO) sterilizer/aerator

To eliminate the bioburden on metal surgical instruments within the SPD, the MOST cost-efficient sterilization method is generally considered to be?

• Liquid chemical
• Ethylene oxide gas
• Steam under pressure
• Gamma irradiation

Which of these methods of sterilization does not involve electromagnetic radiation?

• Sterilization by Electron beams
• Sterilization by Subatomic particles
• Sterilization by Gamma ray
• Sterilization by X-ray

Ethylene Oxide is not used for point of use processing because of its long cycle times

• True
• False

Low temperature sterilization processes are not used in ambulatory surgery centers.

• True
• False

When left-to-right storage system is used?

• Newly sterilized packs are placed on the right.
• Older packs move to the left.
• Packs on the far right are the first used.
• Packs on the far left are the first used.

Sterilization documentation is not required for items that are flash sterilized

• True
• False

An injection device used when a primary LVP solution is not a drug available is

• Heparin lock
• Bevel
• Final filter
• Ampules

High level disinfection is appropriate for semi critical devices

• True
• False

Cleaning anodized aluminum containers require the use of detergents that are

• Acid pH
• Neutral pH
• Alkaline pH
• Highly alkaline pH

The purpose of USP/NF 797 is the prevent harm and fatality to patients that can result from

• Nonsterile formulation
• Excessive bacterial endotoxins
• Large errors in the strengtht of correct ingredients
• All of the above

The continuous movement at a uniform rate in one direction is called.

• Horizontal flow
• Vertical flow
• Laminar flow
• BSC

A fluid ounce contains 3 gram of medication. How many mg are in one teaspoonful?

• 100mg
• 1500mg
• 500mg

When a solution has a lesser osmolarity than that of blood, it is called

• Hypotonic
• Hypertonic
• Isotonic
• Tonic

Which of the following items MUST be sterilized with an accompanying biological indicator?

• Endoscopes
• Plants
• Implants
• Steam

Multidose vials

• Can be reused within 48 hours if refrigerated
• Can be reused within 24 yours if refrigerated
• Do not contain preservatives
• Contain preservatives

The stem of the needle that provides the overall lenght of the needle

• Sharps
• Shaft
• Luer-lok
• Gauge

Lot control numbers are used to?

• Help monitor sterilizer use
• Enable recall following sterilization failure
• Assist with inventory control
• Help track SPD/CSP/CPD productivity

All staff should paritcipate in subsequent reviews of new Material Safety Data Sheet information?

• Every 3 Months
• Every 8 Months
• Semi-annual
• Annualy

Which distribution system requires the using department to be responsible for maintaining inventory levels?

• Fixed inventory levels
• Centralized exchange systems
• Demand distribution
• Total inventory

The hollow center of a needle

• Tunnel
• Barrel
• Lumen
• Valence

Sterility maintenance covers should be made out of plastic and be placed on sterile items?

• As soon as the items come out of the sterilizer
• After the items have been aerated
• The day after the items have been sterilized
• When the sterilized items cool to ambient room temperature

Which of the following BEST describes the general environmental conditions of SPD sterile storage?

• Controlled temperature and humidity, limited traffic
• Controlled temperature and high humidity, limited traffic
• High temperature and high humidity, no traffic restrictions
• Controlled temperature and humidity, no traffic restrictions

A solvent that dissolves a lyophilized powder or dilutes a solution is a

• Diluent
• Solvent
• Additive
• Admixture

Supplies contaminated with blood and body fluids that require ethylene oxide gas sterilization should be?

• Processed in a double ethylene oxide sterilizer cycle before handling
• Cleaned and processed in an ethylene oxide sterilzer prior to assembly and packaging.
• Cleaned before being processed in a double ethylene oxide sterilzer cycle.
• Cleaned, dried and passed on to the processing area for assembly, packaging, and sterilization.

The number of positive or negative charges on an ino

• Valence
• Ions
• Molecule weights
• Hypotonic

The inventory of medical and surgical supplies can represents up to what percentage of a facilitys operating budget?

• 30%
• 40%
• 60%
• 90%

You have penicillin 600,000 units in 2ml. You wish to administer 150,000 units. How many ml will you administer?

• 0.5ml
• 0.25ml
• 4ml

Sterile packs should be stored at least ____ away from exterior wall. Sterile packs should be stored at least ____ above the floor and at least ___ from the sprinklers heads.

• One inches,Four inches,Twelve inches
• Two inches,Eight inches,Fourteen inches
• Two inches,Eight inches,Eighteen inches

Heat sensitive items

• Cannot be flash sterilized
• Should be disposable
• Must not be immersed
• Should not be used

Aseptic techniques are methods used to maintain

• PH
• Sterility of sterile products
• Osmotic pressure
• Pyrogens

Used dental instruments pose a very low risk of blood borne pathogenexposure.

• True
• False

The FDA rates generic products on their bioequivalency to the branded product. A-rated drugs are considered by the FDA to be therapeutically equivalent while B-rated drugs are either considered not to be therapeutically equivalent or there is no sufficient information to determine their therapeutic equivalency. Therefore "A" Codes include:

• AA, AB, AN, AO, AP, or AT
• BC
• DESI drugs

Flash sterilization is rarely performed in hospitals

• True
• False

Clamps used for hemostasis are also designed to

• Hold sutures.
• Minimize damage to tissue.
• Separate edges of a wound.
• Hold edges of a wound.

Which of the following statements is the primary reason that items are allowed to cool on sterilizer cart before being placed in storage?

• Items removed too quickly may be hot enough to bum the technician
• Condensation and contamination may result if items are moved to cooler areas when they are still warm
• The packaging material may be damaged if packages are moved when they are still warm
• Tape seals may come loose if packages are moved when they are warm

Filer needles are used when:

• Reconstituting powdered medication in a vial
• The medication being compounded is not sterile
• Medication from an ampule is used

Ambulatorysurgery centers specialize in providing surgeries that do not require hospitalization

• True
• False

Rod-Shaped bacteria is called?

• Flagella
• Cocci
• Bacilli
• Spiral

There are two pressure gauges on a steam sterilizer. These gauges measure the pressure in the

• Jacket and the steam line
• Jacket and the chamber
• Jacket and the boiler/generator
• Chamber and the boiler/generator

When a solution has an osmolarity equivalent to that of blood, it is called

• Hypotonic
• Isotonic
• Hypertonic
• Therapeutic

Bacteria that require oxygen are called?

• Aerobes
• Anaerobes
• Ancaerobes
• None of the above

Endotracheal tubes and anesthesia breathing circuits are examples of

• Critical devices
• Semi-critical devices
• Non-critical devices
• Surgical instruments

The first thing to do when cleaning a device is to?

• Use the correct detergent
• Use the correct disinfectant
• Follow the device manufacturer's instruction
• Follow the Supervisor's instructions

The resulting solution when a drug is added to a parenteral solution

• Admixture
• Solution
• Addtive
• Juice

Which of these is not an aseptic procedure?

• Bandaging
• Wound stitching
• Mastectomy
• Catheterization

A TPN sol. that contains intravenous fat emulsion

• TNA
• TPA
• SAT
• ACT

Currently there are no process monitors available for peracetic acid sterilization processes

• True
• False

Complex solutions with two base solutions (amino acids and dextrose) and additional micro-nutrients

• TNA
• TPA
• Admixture
• Ready-to-mix

Which of the following publications is the official information on generic equivalence?

• USP-NF
• Orange Book
• PDR

Lot control numbers should be placed on each package sterilized, and on the

• Material safety data sheet.
• Sterilization load record.
• Physician's preference card.
• Sterilizer maintenacce record.

Generally, emergency eyewash units should be tested ____ and stations should be located within ____

• At least daily, located within 15 seconds
• At least weekly, located within 10 seconds
• At least once a day,located with 8 seconds
• At least weekly, located with 15 seconds

What is the large volume splash solutions used during surgical or urologic procedures to bathe and moisten body tissues?

• Isotonic
• Osmotic pressure
• Irrigation solution
• Osmosis

Sealed glass containers with an elongated neck is

• Gauge
• Ampules
• CSP
• Vial

Different types of syringe tips

• Piggy backs
• Sharps
• Guage
• Slip-Tip, Luer-Lok, eccentric, oral ____

There are different types of detergents.Enzymatic pre-soaks

• Kill microorganisms
• Break down organic matter
• Speed up drying of organic matter
• Destroys all spores

When the cause of process failure is immediately indentified in sterilization, Majority of the time it involoves?

• Utility problems
• Operator error
• Equipement failure
• Problems with biological indicators

All of the following agencies are involved with the regulation and control of ethylene oxide when it is used as a sterilant EXCEPT the?

• Occupational Safety and Health Administration
• Environmental Protection Agency
• Centers for Disease Control and Prevention
• Food and Drug Administration

The chemicals produced by microorganisms that can cause fever reactions in patients are

• Bacteria
• Viruses
• Pyrogens
• Microorganisms

The rate (in ml/hour or ml/minute) at which the solution is administered to the patient is

• Gauge
• Coring
• Diluent
• Flow rate

After manually cleaning contaminated surgical instruments with a disinfectant solution,the NEXT step in the decontamination process is?

• Lubricating
• Storing
• Sterilizing
• Rinsing

When using the laminar flow hood, a technician should work inside the hood at least

• Two inches
• Four inches
• Six inches
• Eight inches

Containerized packaging systems are Most commonly used to protect which of the following during steam sterilization?

• Surgical instruments
• Basins
• Flexible fiberoptic endoscopes
• Linen packs

All personal electrical devices brought into CS/SPD for use int the department must be?

• Available for all staff to use
• Kept in the supervisors office
• Approved by the safety officer
• Checked and approved by the Bio Med department

When a steam sterilizer is loaded with linen packs only, the packs should be

• Placed on their edges
• Packed tightly together.
• Stacked loosely together.
• Laid flat,anywhere in the chamber.

When heat is added to steam without increasing the moisture content, the steam is called ?

• Wet steam
• Assimilated steam
• Steam under pressure
• Superheated steam

Small volume soltuions connected to an LVP

• Pyrogens
• Piggybacks
• Hypotonic
• SVP

When loading mechanical washers in the decontamination area, which type of personal protective is not required?

• Fluid resistant gown
• Fluid resistant face mask
• Extra protective gloves
• Face shield

What is wrong with this image?

• Textile packs should be placed flat to allow maximum pentration
• Textile packs should be placed on their side to facilitate air removal and steam penetration
• When loading steam sterilizers, instrument sets in mesh-bottom pans or in perforated metal trays should be placed upside down.
• None of the above

While delivering sterile supplies to multiple nursing units, the SPD technician is asked by a unit secretary to take an opened and used tray of instruments back to the SPD Decontamination area. Which of the following is the BEST procedure to use.

• Return for the used tray after completing all deliveries, using the appropriate collection cart.
• Return for the used tray after completing all deliveries, using the sterile delivery cart.
• Takr the used tray to Decontamination on the cart with the remaining sterile supplies.
• Immediately hand-carry the used tray to the Decontamination room and then return to complete the deliveries.

It is recommended that chemotherapy drugs and some antibiotics be compounded in a vertical laminar-flow hood (biological safety cabinet), because

• Horizontal laminar-flow hoods blow a mild current of air directly at the person, resulting in repeated contact with medications
• There are too many ingredients
• HEPA filter should always be aligned in front of the person

A needle used for measurement is called

• Ampules
• Bevel
• Heparin lock
• Gauge

A material that removes electrons from another substance is called

• An oxidizing agent
• A demagnetizer
• An atom
• A molecule

A speicially designed minibag where a drug is put into the SVP fluid just prior to administration

• Ready-to-mix
• Admixture
• TPN
• TNA

"Clean to dirty" is an SPD term used to describe?

• Inventory control methods
• Traffic patterns
• Distribution Control
• Sterilization Control

Instruments must be cleaned before flash sterilization

• True
• False

There are different types of extinguishers what does a Type ABC contain?

• Chromium Oxide
• Carbon dioxide
• Ammonium phosphate
• Soduim hypochlorite

Varying bones reflect different functions, what type of bone is a flat bone?

• An irregular bone
• Rib bone
• Humerus bone
• Smooth bone

Which of the following statement is correct?

• Cleaning and decontamination are the same process.
• You can clean an item without decontaminating it.
• You can decontaminate an item without cleaning it.
• Decontamination should occur before cleaning.

When cleaning an IV pump, it is important to use a germicide on the pump surface in order to?

• Reduce the bioburden present on the equipment.
• Remove stains and tape residues from the equipment.
• Protect patients from toxic reactions due to detergent residues left on the equipment
• Neutralize the corrosive effect that detergents can have on the surface of the equipment.

A diagnostic cycle on the peracetic acid system should be run every day

• True
• False

The effectiveness of any chemical disinfection process depends on all the following EXCEPT?

• Contact time and concentration of the solution
• Concentration of the solution
• Temperature of the solution
• Cost of the chemical

Which system should be used to arrange and maintain sterile packages?

• Last in, first out
• First in, first out
• First out,first in
• Least in, first out

Which of these is not a division of sterility services?

• Decontamination
• Distribution
• Assembly processing
• Sterilization and storage

One of the most important factors in successful cleaning of lumened devices is?

• _Selection of an enzyme detergent
• _Selection of the correct diameter and length cleaning brush
• Use of ultrasonic cleaner
• Use of peroxide