CDC INFECTION CONTROL EXAM WITH GUARANTEED ACCURATE ANSWERS |VERIFIED, Exams of Nursing

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CDC INFECTION CONTROL EXAM CDC INFECTION CONTROL EXAM WITH GUARANTEED ACCURATE ANSWERS |VERIFIED In the text the acronym DHCP is used - what does it reference? - ACCURATE ANSWERS✔✔ refers to all paid and unpaid personnel in the dental health-care setting who might be occupationally exposed to infectious materials ie dentist, dental hygienest, dental assistant, front desk How are pathogenic microorganisms like HBV transmitted in the dental setting? - ACCURATE ANSWERS✔✔ 1) direct contact with blood, oral fluids, or other patient materials; 2) indirect contact with contaminated objects (e.g., instruments, equipment, or environmental surfaces); 3) contact of conjunctival, nasal, or oral mucosa with droplets (e.g., spatter) containing microorganisms generated from an infected person and propelled a short distance (e.g., by coughing, sneezing, or talking); and 4) inhalation of air- borne microorganisms that can remain suspended in the air for long periods

What is the difference between universal precautions and standard precautions in the clinical dental practice? - ACCURATE ANSWERS✔✔ Standard precautions apply to contact with 1) blood; 2) all body fluids, secretions, and excretions (except sweat), regard- less of whether they contain blood; 3) nonintact skin; and 4) mucous membranes. Saliva has always been considered a potentially infectious material in dental infection control; thus, no operational difference exists in clinical dental practice between universal precautions and standard precautions. In the text the acronym OPIM is used - what does it reference? - ACCURATE ANSWERS✔✔ Other potentially infectious materials. OSHA term that refers to 1) body fluids including semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures; any body fluid visibly contaminated with blood; and all body fluids in situations where differentiating between body fluids is difficult or impossible; 2) any unfixed tissue or organ (other than intact skin) from a human (living or dead); and 3) HIV-containing cell or tissue cultures, organ cultures; HIV- or HBV-containing culture medium or other solutions; and blood, organs, or other tissues from experimen- tal animals infected with HIV or HBV. Can an individual that is a carrier of Hepatitis B work as a dental receptionist? Why or why not? - ACCURATE ANSWERS✔✔ Yes, as that position does not perform exposure-prone procedures. Can an individual with Hepatitis C work as a dental hygienist?Why or why not? - ACCURATE ANSWERS✔✔ No restrictions on professional

activity.HCV-positive health-care personnel should follow aseptic technique and standard precautions. Given the scenario that you have chicken pox, when can you return to work as a dental hygienist? - ACCURATE ANSWERS✔✔ From tenth day after first exposure through twenty-first day (twenty-eighth day if varicella-zoster immune globulin [VZIG] administered) after last exposure. How long is your dentist-employer required to keep your confidential medically related information? - ACCURATE ANSWERS✔✔ at least the duration of employment plus 30 years What body fluid contains the greatest proportion of HBV infectious particle titers and is the most critical vehicle of transmission in the health-care setting? - ACCURATE ANSWERS✔✔ bloodand blood- contaminated saliva How long can HBV survive in dried blood at room temperature on an environmental surface? - ACCURATE ANSWERS✔✔ less than or equal to 1 week Given the scenario that you received the primary vaccine series for HBV, what should you do if you did not develop an adequate antibody response? - ACCURATE ANSWERS✔✔ complete a second 3-dose vaccine series or be evaluated to determine if they are HBsAg-positive. If no antibody response occurs after the second series, testing for HBsAg should be performed

Given the scenario that you received the primary vaccine series for HBV, what should you do if you are a nonresponder to the vaccination? - ACCURATE ANSWERS✔✔ Nonresponders to vaccination who are HBsAg-negative should be considered susceptible to HBV infection and should be counseled regard- ing precautions to prevent HBV infection and the need to obtain HBIG prophylaxis for any known or probable parenteral exposure to HBsAg-positive blood. Given the scenario that you received the primary vaccine series for HBV and you responded accordingly with antibodies, how often should you receive a booster does of the vaccine? - ACCURATE ANSWERS✔✔ Vaccine-induced antibodies decline gradually over time, and 60% of persons who initially respond to vaccination will lose detectable antibodies over 12 years. Even so, immunity continues to prevent clinical disease or detectable viral infection. Booster doses of vaccine and periodic serologic testing to monitor antibody concentrations after completion of the vaccine series are not necessary for vaccine responders What is the cause of occupational exposures to blood in dentistry that poses the greatest risk of disease transmission? - ACCURATE ANSWERS✔✔ Exposures occur through percutaneous injury (e.g., a needle-stick or cut with a sharp object), as well as through contact between potentially infectious blood, tissues, or other body fluids and mucous membranes of the eye, nose, mouth, or non-intact skin (e.g., exposed skin that is chapped, abraded, or shows signs of dermatitis)

Dr. Pearce just provided a local anesthesia injection and turned over the used syringe to you, how are you going to recap the contaminated needle? - ACCURATE ANSWERS✔✔ the practitioner should recap the needle between injections by using a one-handed technique or use a device with a needle-resheathing mechanism. Passing a syringe with an unsheathed needle should be avoided because of the potential for injury. What is the single most critical measure for reducing the risk of transmitting disease? - ACCURATE ANSWERS✔✔ Hand hygiene (e.g., handwashing, hand antisepsis, or surgi- cal hand antisepsis) substantially reduces potential pathogens on the hands and is considered the single most critical mea- sure for reducing the risk of transmitting If your hands are visibly soiled, is it acceptable to use an alcohol-based hand rub? - ACCURATE ANSWERS✔✔ No Why should hand antiseptic products have a persistent effect? - ACCURATE ANSWERS✔✔ Persistence is critical because microorganisms can colonize on hands in the moist environment underneath gloves Is our liquid soap dispensing system the ideal? Why or why not? - ACCURATE ANSWERS✔✔ Yes, because pathogenic organisms have been found on or around bar soap during and after use What types of hand lotions are acceptable to use in the dental care setting? - ACCURATE ANSWERS✔✔ lotions that do not contain petroleum or other oil emollients

Why should you keep your fingernails short? - ACCURATE ANSWERS✔✔ to thoroughly clean underneath them and prevent glove tears Why should you not wear artificial nails, even if kept short? - ACCURATE ANSWERS✔✔ Hand carriage of gramnegative organisms has been determined to be greater among wearers of artificial nails than among non-wearers When is nail polish okay? - ACCURATE ANSWERS✔✔ Freshly applied nail polish on natural nails does not increase the microbial load from periungual skin if fingernails are short; however, chipped nail polish can harbor added bac- teria Why is it frugal to restrict the wearing of rings? - ACCURATE ANSWERS✔✔ Whether wearing rings increases the likelihood of transmitting a pathogen is unknown; further studies are needed to establish whether rings result in higher transmission of pathogens in health-care settings. However, rings and decorative nail jewelry can make donning gloves more difficult and cause gloves to tear more readily What does PPE stand for and entail? - ACCURATE ANSWERS✔✔ Personal protective Equipment is designed to protect the skin and the mucous membranes of the eyes, nose, and mouth of DHCP from exposure to blood or OPIM. Primary PPE used in oral health-care

settings includes gloves, surgical masks, protective eyewear, face shields, and protective clothing (e.g., gowns and jackets). How are you to manage your face shields/protective eyewear - ACCURATE ANSWERS✔✔ Reusable PPE (e.g., clinician or patient protective eyewear and face shields) should be cleaned with soap and water, and when visibly soiled, dis-infected between patients, according to the manufacturer's directions. Why should you change your mask once it becomes wet? - ACCURATE ANSWERS✔✔ when a mask becomes wet from exhaled moist air, the resistance to airflow through the mask increases, causing more airflow to pass around edges of the mask. When do you need to change your overgown? - ACCURATE ANSWERS✔✔ DHCP should change protective clothing when it becomes visibly soiled and as soon as feasible if penetrated by blood or other potentially infectious fluids When do you need to wash your hands in terms of glove use? What water temp? - ACCURATE ANSWERS✔✔ Hand hygiene should be performed immediately before donning gloves. In addition, bacteria can multiply rapidly in the moist environments underneath gloves, and thus, the hands should be dried thoroughly before donning gloves and washed again immediately after glove removal. cool or tepid water is recommended

Why should you not wash your gloves? - ACCURATE ANSWERS✔✔ Washing latex gloves with plain soap, chlorhexidine, or alcohol can lead to the formation of glove micropunctures (177,212,213) and subsequent hand contamination When is it appropriate to "double-glove"? - ACCURATE ANSWERS✔✔ during longer procedures (i.e., >45 minutes) and during oral surgery procedures What is the difference between irritant contact dermatitis and allergic contact dermatitis - ACCURATE ANSWERS✔✔ Irritant contact dermatitis is com- mon, nonallergic, and develops as dry, itchy, irritated areas on the skin around the area of contact. By comparison, allergic contact dermatitis (type IV hypersensitivity) can result from exposure to accelerators and other chemicals used in the manu- facture of rubber gloves (e.g., natural rubber latex, nitrile, and neoprene), as well as from other chemicals found in the dental practice setting (e.g., methacrylates and glutaraldehyde). Why do we use powder-free gloves in the clinic? - ACCURATE ANSWERS✔✔ When powdered latex gloves are worn, more latex protein reaches the skin. In addition, when powdered latex gloves are donned or removed, latex protein/powder particles become aerosolized and can be inhaled, contacting mucous membranes. As a result, allergic patients and DHCP can experience cutaneous, respiratory, and conjunctival symptoms related to latex protein exposure What are the predisposing factors/conditions to alert us that a patient may have a latex sensitivity/allergy? - ACCURATE ANSWERS✔✔

Certain common predisposing conditions for latex allergy include previous history of allergies, a history of spina bifida, urogenital anomalies, or allergies to avocados, kiwis, nuts, or bananas. What is the receiving, cleaning, & decontaminated procedure for managing contaminated dental instruments? - ACCURATE ANSWERS✔✔ Cleaning should precede all disinfection and sterilization processes; it should involve removal of debris as well as organic and inorganic contamination. Removal of debris and contamination is achieved either by scrubbing with a surfactant, detergent, and water, or by an automated process (e.g., ultrasonic cleaner or washer-disinfector) using chemical agents. If visible debris, whether inorganic or organic matter, is not removed, it will interfere with microbial inactivation and can compromise the disinfection or sterilization process. After cleaning, instruments should be rinsed with water to remove chemical or detergent residue. Splashing should be minimized during cleaning and rinsing. Before final disinfection or sterilization, instruments should be handled as though contaminated. Why should you allow the instrument packs to dry in the sterilizer before removing them? - ACCURATE ANSWERS✔✔ Instrument packs should be allowed to dry inside the sterilizer chamber before remov- ing and handling. Packs should not be touched until they are cool and dry because hot packs act as wicks, absorbing moisture, and hence, bacteria from hands. Why is it important not to over-pack the sterilizer (specifically what happens)? - ACCURATE ANSWERS✔✔ overloading the sterilizer chamber can result in cool air pockets and items not being sterilized.

When is it appropriate to use unwrapped sterilization methods and what conditions must occur? - ACCURATE ANSWERS✔✔ An unwrapped cycle (sometimes called flash sterilization) is a method for sterilizing unwrapped patient-care items for immediate use. Unwrapped sterilization should be used only under certain conditions: 1) thorough cleaning and drying of instruments precedes the unwrapped sterilization cycle; 2) mechanical monitors are checked and chemical indicators used for each cycle; 3) care is taken to avoid thermal injury to DHCP or patients; and 4) items are transported aseptically to the point of use to maintain sterility. Is it okay to store your scaling instruments unwrapped? Why? - ACCURATE ANSWERS✔✔ Critical instruments sterilized unwrapped should be transferred immediately by using aseptic technique, from the sterilizer to the actual point of use. Critical instruments should not be stored unwrapped. Semicritical instruments that are sterilized unwrapped on a tray or in a container system should be used immediately or within a short time. When sterile items are open to the air, they will eventually become contaminated. Storage, even temporary, of unwrapped semi- critical instruments is discouraged because it permits exposure to dust, airborne organisms, and other unnecessary contamination before use on a patient Is it okay to use a "bead sterilizer" in dentistry? Why? - ACCURATE ANSWERS✔✔ FDA has determined that a risk of infection exists with these devices because of their potential failure to sterilize dental instruments and has required their commercial distribution cease unless the manu- facturer files a premarket approval application.

What are the various ways to assess if your sterilizer is working properly and what is the most accepted method? - ACCURATE ANSWERS✔✔ Physical and chemical indicators. Biological indicators (BIs) (i.e., spore tests) are the most accepted method for monitoring the sterilization process (278,279) because they assess it directly by killing known highly resistant microorganisms (e.g., Geobacillus or Bacillus species), rather than merely testing the physical and chemical condi- tions necessary for sterilization. Why do we date and initial the sterilization packages? - ACCURATE ANSWERS✔✔ This approach recognizes that the product should remain sterile indefinitely, unless an event causes it to become contaminated What should you do if you are working the sterilization center and you notice that a "sterilized" instrument packet is torn? - ACCURATE ANSWERS✔✔ If packaging is compromised, the instruments should be cleaned, packaged in new wrap, and sterilized again. What is the difference between a clinical contact surface and a housekeeping surface? - ACCURATE ANSWERS✔✔ Environmental surfaces can be divided into clinical contact surfaces and housekeeping surfaces (249). Because housekeep- ing surfaces (e.g., floors, walls, and sinks) have limited risk of disease transmission, they can be decontaminated with less rig- orous methods than those used on dental patient-care items and clinical contact surfaces (244). Strategies for cleaning and disinfecting surfaces in patient-care areas should consider the 1) potential for direct patient contact; 2) degree and frequency of hand contact; and 3) potential contamination of the sur- face with body

substances or environmental sources of micro- organisms (e.g., soil, dust, or water). Why do we use barriers? - ACCURATE ANSWERS✔✔ Barrier protection of surfaces and equipment can prevent contamination of clinical contact surfaces, but is particularly effective for those that are difficult to clean. How do you manage barriers between patients? - ACCURATE ANSWERS✔✔ Because such coverings can become contaminated, they should be removed and discarded between patients, while DHCP are still gloved. After removing the barrier, examine the surface to make sure it did not become soiled inadvertently. The surface needs to be cleaned and disinfected only if contamination is evident. Otherwise, after removing gloves and performing hand hygiene, DHCP should place clean barriers on these surfaces before the next patient. Why are you to wear a mask and nitrile gloves when disinfecting your operatory? - ACCURATE ANSWERS✔✔ Because of the risks associated with exposure to chemical disinfectants and contaminated sur- faces, DHCP who perform environmental cleaning and disinfection should wear gloves and other PPE to prevent occupational exposure to infectious agents and hazardous chemicals. Do you need to clean the wall in your operatory? Do you need to clean the cabinet surfaces (vertical surfaces)? - ACCURATE ANSWERS✔✔ Unless contamination is reasonably anticipated or apparent, cleaning or disinfecting walls, window drapes, and other vertical surfaces is unnecessary.

What is regulated waste and have you experienced it in Clinic I? - ACCURATE ANSWERS✔✔ Examples of regulated waste found in dental-practice settings are solid waste soaked or saturated with blood or saliva (e.g., gauze saturated with blood after surgery), extracted teeth, surgically removed hard and soft tissues, and contaminated sharp items (e.g., needles, scalpel blades, and wires) and No Why is there a concern over biofilm in the dental unit water lines? - ACCURATE ANSWERS✔✔ These microorganisms colonize and replicate on the interior surfaces of the waterline tubing and form a biofilm, which serves as a reservoir that can amplify the number of free- floating (i.e., planktonic) microorganisms in water used for dental treatment. These exhibit limited patho- genic potential for immunocompetent persons. Why should you run a dental handpiece that uses water 20-30 seconds after the dental procedure has been completed? - ACCURATE ANSWERS✔✔ This procedure is intended to help physically flush out patient material that might have entered the turbine and air and waterlines. Is it acceptable to disinfect your prophy angle handpiece (instead of placing it through a sterilization cycle)? - ACCURATE ANSWERS✔✔ For processing any dental device that can be removed from the dental unit air or waterlines, neither surface disinfection nor immersion in chemical germicides is an acceptable method.

How should you manage the handpiece coupling that remains in your operatory? - ACCURATE ANSWERS✔✔ Such components (e.g., handles or dental unit attachments of saliva ejectors, high-speed air evacuators, and air/water syringes) should be covered with impervious barriers that are changed after each use. Why should you not let your patient close his/her mouth around the saliva ejector "like a straw"? - ACCURATE ANSWERS✔✔ Studies have reported that backflow in low-volume suc- tion lines can occur and microorganisms be present in the lines retracted into the patient's mouth when a seal around the saliva ejector is created. What are the infection control procedures during obtaining and exposing radiographs/digital plates? - ACCURATE ANSWERS✔✔ Gloves should be worn when taking radiographs and handling contaminated film packets. Other PPE (e.g., mask, protective eyewear, and gowns) should be used if spattering of blood or other body fluids is likely. Heat- tolerant versions of intraoral radiograph accessories are available and these semicritical items (e.g., film-holding and positioning devices) should be heatsterilized before patient use. Why and when do we have our patients use an antimicrobial mouthrinse? - ACCURATE ANSWERS✔✔ Antimicrobial mouth rinses used by patients before a dental procedure are intended to reduce the number of microorgan- isms the patient might release in the form of aerosols or spat- ter that subsequently can contaminate DHCP and equipment operatory surfaces.

Is it okay to give your patient their extracted 3rd molar? - ACCURATE ANSWERS✔✔ Extracted teeth can be returned to patients on request, at which time provisions of the standard no longer apply How are you to manage a dental impression before taking it to the materials lab to pour up your model? - ACCURATE ANSWERS✔✔ disinfected with an EPA-registered hospital disin- fectant with a tuberculocidal claim, and thoroughly rinsed How should we handle a patient suspected infected with TB? - ACCURATE ANSWERS✔✔ Patients with a medical history or symptoms indicative of undiagnosed active TB should be referred promptly for medical evaluation to determine possible infectiousness. What is Creutzfeldt-Jacob disease and why is of concern to dentistry? - ACCURATE ANSWERS✔✔ Creutzfeldt-Jakob disease (CJD) belongs to a group of rap- idly progressive, invariably fatal, degenerative neurological dis- orders, transmissible spongiform encephalopathies (TSEs) that affect both humans and animals and are thought to be caused by infection with an unusual pathogen called a prion. Prions are isoforms of a normal protein, capable of self-propagation although they lack nucleic acid. Prion diseases have an incu- bation period of years and are usually fatal within 1 year of diagnosis.