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Cleaning, Decontamination, and Disinfection (Questions 1-25)
1. Question: What is the first step in manual cleaning of soiled instruments? Answer: Rinse
with lukewarm water to remove gross soil. Rationale: Prevents drying of bioburden;
AAMI ST79 (2017) recommends immediate rinse at point-of-use to avoid biofilm
formation (CBSPD 2025 Cleaning Module).
2. Question: Enzymatic detergents are used because they? Answer: Break down proteins,
starches, and fats. Rationale: Proteases for blood, amylases for starches; neutral pH
avoids corrosion (IAHCSMM CST manual, Ch. 4; 2025 update on eco-friendly
enzymes).
3. Question: What is the recommended water temperature for manual cleaning? Answer:
90-110°F (32-43°C). Rationale: Hotter water coagulates proteins; AAMI TIR34
guidelines for effective soil removal without damage.
4. Question: Ultrasonic cleaners should run for how long per load? Answer: 5-10 minutes.
Rationale: Allows cavitation to dislodge debris; over 10 min risks pitting (CBSPD
Ultrasonic Standards, 2025).
5. Question: High-level disinfection is required for? Answer: Semi-critical items like
endoscopes. Rationale: Kills all microbes except high numbers of spores (Spalding
classification; CDC HLD guidelines).
, 6. Question: What is the contact time for glutaraldehyde in HLD? Answer: 20 minutes at
20-25°C. Rationale: EPA label; temperature affects efficacy (AAMI ST91, flexible
endoscopes).
7. Question: PPE during decontamination includes? (Select all) Answer: Gloves, gown,
face shield, shoe covers. Rationale: OSHA BBP standard 1910.1030; protects against
splashes (2025 CBSPD PPE update).
8. Question: What causes biofilm in washers? Answer: Inadequate rinsing and drying.
Rationale: Mineral deposits harbor bacteria; weekly acid flush recommended (AAMI
ST79).
9. Question: Manual brushing should use? Answer: Nylon bristles and neutral detergent.
Rationale: Avoids scratches; soft metal tools for lumens (CBSPD Decon 2025).
10. Question: Pre-cleaning at point-of-use prevents? Answer: Soil drying and transport
contamination. Rationale: Within 30 min; reduces bioburden by 90% (AORN
Perioperative Standards).
11. Question: What is the purpose of a lumen brush? Answer: Remove debris from
channels. Rationale: Single-use preferred; size matches ID (AAMI ST91).
12. Question: Flash sterilization is for? Answer: Emergency unwrapped items only.
Rationale: Not routine; 3-min cycle at 132°C (AAMI ST79; 2025 caution on overuse).
13. Question: Disinfectant efficacy testing? Answer: Weekly ATP bioluminescence.
Rationale: Measures organic residue; <100 RLU clean (CBSPD QA).
14. Question: What is neutral pH? Answer: 7. Rationale: Safe for instruments; alkaline >8
corrodes (IAHCSMM manual).