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WorksheetsRevision Infection control and cssd , sterilization
Total questions: 100
Worksheet time: 50mins
Which of the following is the best single action to prevent health care- associated infections?
Wearing gloves at all times
Hand hygiene at appropriate moments
Using masks for all patients
Using antibiotics prophylactically
Standard precautions apply to:
Patients with known infections only.
All patients regardless of diagnosis
Only ICU patients
Only surgical patients
The "chain of infection" link that refers to how an agent leaves the reservoir is:
Mode of transmission
Portal of exit
Susceptible host
Infectious agent
A "fomite" is:
An insect vector
A person with infection.
An inanimate object capable of transmitting microbes
A reservoir animal
Airborne transmission usually involves particles:
> 5 microns
< 5 microns
> 10 microns
5-10 microns
Droplet precautions are required for infections spread by:
Dust particles
Large respiratory droplets from cough/sneeze
Contaminated food
Blood contamination
Which is NOT a correct step for breaking the chain of infection?
Isolation of infectious patients
Adequate sterilization of instruments.
Overprescribing antibiotics routinely
Effective hand hygiene
A sepsis patient's blood culture is positive. The blood acts as:
Portal of exit
Route of transmission
Reservoir
Susceptible host
The best indicator of autoclave effectiveness is:
Autoclave tape only
Chemical indicator only
Biological indicator (spore test)
Visual dryness of load
Color-change indicators on sterilization packs are:
Absolute proof of sterility
Indicators of exposure to sterilization parameters
Indicators of microbial death
Not used in hospitals
The color code for infectious (clinical) waste in many Indian hospitals under BMW rules is:
Yellow
Blue
Red
Green
Sharps should be disposed of in:
Yellow bag
Blue bag
Puncture-proof sharps container (red/white)
Black bag
Which of the following is a common biological indicator organism used to test steam sterilizers?
Bacillus subtilis spores
Staphylococcus aureus
Pseudomonas aeruginosa
E. coli
The recommended alcohol concentration for hand rubs is:
20-30%
40-50%
60-80%
90-95%
If hands are visibly soiled, the recommended action is:
Alcohol-based hand rub
Soap and water washing
Only gloves use
Dry wiping
Which PPE is essential for airborne precautions?
Surgical mask
N95 respirator or equivalent
Face shield only
Gloves only
Proper sequence of donning PPE (general) is:
Gloves →Gown→ Mask → Eye protection
Gown→ Mask/Respirator→ Eye protection →Gloves
Mask → Gloves→ Gown →Eye protection
Eye protection →Gloves→ Gown→ Mask
Proper sequence of doffing PPE to minimize contamination is:
Gloves → Eye protection → Gown → Mask
Mask → Gloves → Gown → Eye protection
Gown → Mask → Gloves → Eye protection
Eye protection → Gown → Gloves → Mask
Which waste treatment is suitable for pharmaceutical waste containing cytotoxic drugs?
Incineration at high temperature
Autoclaving
Landfill without treatment
Chemical neutralization in drainage
The "5 moments for hand hygiene" by WHO does NOT include:
Before touching a patient
Before aseptic procedure
After body fluid exposure risk
After administrative paperwork
An outbreak in the OT caused by contaminated surgical instruments most likely results from failure in:
Hand hygiene only
Sterilization process or packaging integrity
PPE selection
Patient pre-op fasting
Which of the following disinfectants is sporicidal?
Phenolics
Quaternary ammonium compounds
Chlorine compounds (sodium hypochlorite) at appropriate concentration
Plain soap
Biohazard symbol on a bag indicates:
Radioactive content
Infectious material
Chemical hazard
Non-hazardous waste
Which agency or guideline is most commonly referenced for infection control standards in hospitals globally?
WHO (World Health Organization)
FIFA
OECD
WIPO
The purpose of an infection control committee in hospitals is to:
Manage hospital finances
Oversee and implement infection prevention policies and audits
Hire nurses
Purchase drugs
Which is the most heat-resistant microbial form commonly considered in sterilization validation?
Vegetative bacteria
Enveloped viruses
Bacterial spores
Fungi
Which of these is an example of engineering control for infection prevention?
Use of gloves
Installation of negative-pressure isolation rooms
Hand hygiene reminders
Education sessions
Pre-operative antibiotic prophylaxis should ideally be administered:
After incision
Within 60 minutes before incision (depending on agent)
12 hours before surgery
After wound closure
Which is TRUE about reprocessing single-use medical devices (SUDs)?
Always allowed without restrictions
Never allowed anywhere
May be allowed under strict regulation and validation in some settings otherwise discard
Can be reprocessed by boiling at home
What is the correct immediate action after a needlestick injury?
Ignore it if the skin looks fine
Squeeze and suck the wound
Wash wound with soap and water, report incident and seek evaluation for PEP if indicated
Apply bleach directly to wound
Which of the following is NOT classified as biomedical waste?
Non-infectious general office paper
Blood-soaked dressings
Cultures and stocks of infectious agents
Used syringes and needles
For effective segregation at source, items should be:
Mixed in any bag for disposal convenience
Separated into appropriate color-coded bins as per BMW rules
Burned in open pits
Sent to municipal garbage
Ethylene oxide sterilization is especially used for:
Heat-stable metal instruments
Heat-sensitive items like some plastics, electronics
Food utensils
Textile linen only
Which of these acts as a reservoir for hospital-acquired MRSA colonization?
Soil
Hospital surfaces and healthcare workers' hands/nasal carriage
Running water
Ozone
"Contact precautions" recommend:
Door sealing with tape
Use of gloves and gown on entering patient area.
Use of N95 respirator only
No visitation allowed ever
Which chemical sterilant requires activation and has a long aeration time due to toxicity?
70% isopropyl alcohol
Glutaraldehyde (high-level disinfectant)/ethylene oxide gas- EO requires aeration
Soap solution
Sterile water
The period during which an infection can be transmitted even before symptoms appear is called:
Incubation period
Latent period
Infectious period (can overlap incubation)
Convalescence only
Which of these is true for standard surgical masks?
Provide full protection from airborne particles <5 microns
Mainly protect against large droplets and sprays, not airborne aerosols
Are reusable for multiple days without change
Are equivalent to respirators for tuberculosis protection
The correct concentration of sodium hypochlorite for general disinfection of surfaces in healthcare (example) is commonly around:
0.05% for routine disinfection (500 ppm) depending on guidance
0.0001%
5% only
50%
Which is recommended for cleaning and disinfection of non-critical items (items contacting intact skin)?
Sterilization only
Low- to intermediate-level disinfection (e.g., detergent + disinfectant)
No cleaning required
Incineration
Waste containing cytotoxic or cytostatic drugs should be:
Treated as general waste
Collected separately and disposed by high-temperature incineration where required
Flushed into drains
Recycled
When sterilized instruments are stored, the best practice includes:
Leaving packs on floor to save space
Storing in a clean, dry area away from moisture and contamination
Opening packs only when needed and re-sterilizing daily
Storing next to chemical storage
Which one is NOT a function of hospital infection control nurse?
Conduct surveillance of HAIS
Provide staff training on infection prevention
Prescribe antibiotics to patients
Audit hand hygiene compliance
Vaccination of healthcare workers reduces risk of:
Only bacterial infections
Vaccine-preventable infections like Hepatitis B, Influenza, etc.
COVID-19 only
None of the above
The BMW rule that mandates bar-coding and record keeping for waste movement is mainly intended to:
Obfuscate waste origin
Ensure traceability and accountability of biomedical waste management
Increase paperwork only
Save money
Central Sterile Supply Department (CSSD) is primarily responsible for:
Pharmacy inventory
Sterilization, assembly and distribution of sterile supplies and instruments
Patient admissions
Medical record keeping
The primary goal of disinfection is to:
Remove all organic matter only
Reduce the number of viable microorganisms to a level previously specified as safe
Change color of surfaces
Sterilize implants
Which of the following organisms is hardest to kill and thus used to validate sterilization?
Enveloped virus
Mycobacterium tuberculosis
Bacterial spores (e.g., Geobacillus stearothermophilus)
Gram-negative coccobacilli
Best immediate disposal for contaminated fluid from an isolation room:
Drain through regular sink without treatment
Follow hospital SOP: contain, neutralize if necessary, and dispose as per BMW rules
Mix with other waste.
Store in ward fridge
The final step in risk assessment for infection prevention is:
Identification of hazards only
Implement controls and monitor outcomes (evaluate effectiveness)
Hiring more staff only
Instituting punitive measures only
Sterilization is defined as:
Reduction of microbial load by 90%
Complete elimination or destruction of all forms of microbial life,including spores
Cleaning only
Disinfection only
Autoclave sterilization typically uses:
Dry heat at 160°C
Pressurized saturated steam (moist heat)
Chemical vapor only
Ethylene oxide only
Typical standard parameters for gravity displacement steam autoclave are:
121°C for 15 minutes at 15 psi (for standard unwrapped loads)
100°C for 30 minutes
200°C for 2 minutes
80°C for 60 minutes
Which test evaluates the ability of autoclave to remove air (vacuum efficiency)?
Bowie-Dick test
Sterility test with Bacillus stearothermophilus
Autoclave tape
Visual inspection
Biological indicator for steam sterilization commonly uses spores of:
Geobacillus stearothermophilus (formerly Bacillus stearothermophilus)
Bacillus subtilis var niger
E. coli
Candida albicans
Dry heat sterilization (hot air oven) is best suited for:
Heat-sensitive plastics
Powders and oils and metal instruments that can tolerate high temperature
Moist materials
Powdered sugars only
Which sterilization method is appropriate for heat- and moisture-sensitive instruments with complex lumens?
Steam autoclave
Ethylene oxide gas sterilization
Boiling water
Dry heat
Ethylene oxide sterilization requires post-sterilization aeration because:
It smells nice
It is toxic and residual gas must be removed from items
To dry items
To sterilize further
Chemical indicators monitor:
Microbial kill directly
Exposure to sterilization conditions (e.g., temperature/time)
Package integrity over time
The color of the instrument
Which is NOT a sterilization indicator?
Biological indicator
Chemical indicator
Mechanical indicator
Visual indicator of sterility (assumes sterility)
Cold sterilization commonly refers to high-level disinfection with agents such as:
70% ethanol only
Glutaraldehyde or 2% alkaline glutaraldehyde (e.g., for endoscopes)
Boiling water
Paper towels
Ultrasonic cleaners in CSSD are used to:
Sterilize items completely
Remove gross debris and soils via cavitation prior to sterilization
Dry instruments
Package instruments
Packaging for sterilization should allow:
No penetration by sterilant
Adequate penetration by sterilant and maintain sterility afterward (sterile barrier system)
Be airtight to prevent sterilant entry
Be colorful
Maximum recommended reuse time for sterile pack until re-sterilization depends on
Storage conditions, handling, packaging integrity and policy no fixed time universally
Always 1 day only
Never use more than 2 hours
Forever
Which of the following would be considered a critical item requiring sterilization?
Stethoscope diaphragm
Surgical instruments entering sterile tissue or vascular system
BP cuff
Hospital tray
Which is an advantage of steam sterilization over dry heat?
Faster and more effective at lower temperatures for most items
Cheaper in all cases
No water required
Better for oils
The term "sterility assurance level (SAL)" commonly used in sterilization validation describes :
Probability of survival of viable microorganisms on a sterilized item (e.g., 10^-6)
Color change of indicator
Time of sterilization only
Packaging type
High-level disinfection kills:
All microorganisms including high numbers of bacterial spores
All microorganisms except high numbers of bacterial spores (may not be sporicidal)
Only fungi
Nothing
The most reliable record of autoclave cycles for sterilization monitoring is:
Operator's memory
Mechanical (printout/log), chemical indicators and periodic biological indicators
Visual inspection
Packaging color
A tray with lumened instruments should be:
Sterilized as is without special attention
Disassembled and lumens flushed and cleaned before sterilization
Only wiped with alcohol
Irradiated at all times
CSSD workflow should ideally be:
Dirty zone→ clean zone →sterile storage (unidirectional flow)
Clean →dirty → sterile
Intermixing of dirty and clean is fine
No specific order
Which method is NOT used for terminal sterilization of medical waste?
Incineration
Autoclaving (steam sterilization)
Chemical neutralization for some wastes
Freezing to -20°C
Which is a limitation of ethylene oxide sterilization?
Long cycle time and aeration, potential toxicity and carcinogenicity
Immediate sterilization with no aeration needed
Inexpensive and fast always
No compatibility issues with plastics
The most appropriate sterilization control for heat-sensitive endoscopes is:
Boiling water
High-level disinfection (e.g., glutaraldehyde) or low-temperature sterilization methods per protocol
Dry heat at 180°C
Leaving in sunlight
Which of the following is NOT appropriate to place into an autoclave?
Metal surgical instruments
Some heat-sensitive plastic components (may melt)
Wrapped cloth packs
Glassware (if autoclave rated)
The Bowie-Dick test is performed:
Daily on vacuum autoclaves to test air removal and steam penetration
Once a year only
For ethylene oxide only
On chemical indicators only
Which of the following increases sterilizer load failure risk?
Proper loading per manufacturer's instructions
Overloading and blocking steam penetration
Use of chemical indicators
Performing Bowie-Dick test
Sterilization by radiation (gamma or electron beam) is typically used for:
Hospital reprocessing of instruments daily
Industrial sterilization of single-use medical devices and packaging
Home sterilization of bandages
CSSD routine for instruments
For hydrogen peroxide plasma sterilization, main benefit is:
High temp only
Low temperature sterilization suitable for heat-sensitive devices with relatively short cycles
No compatibility restrictions
Can sterilize liquids
Which physical parameter is least important to monitor in a steam sterilizer cycle?
Temperature
Time
Pressure
Color of room paint
A spore test (biological indicator) for ethylene oxide uses spores of:
Bacillus stearothermophilus
Bacillus subtilis (or other species appropriate for the sterilant)
Candida albicans
Enterococcus faecalis
Which is a true statement about cold sterilants vs. sterilization?
Cold sterilants always achieve SAL of 10^-6
Some chemical sterilants can achieve sterilization under validated conditions; not all high-level disinfectants are sterilants
Cold sterilization means freezing devices
Cold sterilants are always safe for patients without rinsing
Which CSSD practice reduces cross-contamination risk?
Wearing same gloves in all zones
Clear demarcation of dirty/clean zones and staff separation
Storing sterile packs in wet area
Repackaging contaminated instruments only
Most common cause of failed sterilization cycles is:
Faulty biological indicators only
Operator error, improper loading or inadequate sterilizer maintenance
Using autoclave tape
Lack of color indicators
Low-temperature sterilization options include:
Steam only
Ethylene oxide, hydrogen peroxide plasma, peracetic acid immersion depending on device compatibility
Boiling water
Hot air oven
Which of the following is essential before sterilizing surgical instruments?
Packaging only, no cleaning
Thorough cleaning (removal of bioburden) prior to sterilization
Disinfecting with alcohol only
Coating with oil
The "shelf life" of a properly packaged sterile item depends mainly on:
Type of packaging, storage conditions, handling practices
Sterilizer brand only
Time since purchase of instrument only
Color of pack
Which test should be run weekly for steam autoclaves to verify sterilizing conditions?
Bowie-Dick only once at installation
Routine biological indicator testing at appropriate frequency per policy (often weekly or per load risk)
No tests requiredVisual test only
Visual test only
Sterility indicators in CSSD should be:
Ignored by staff
Documented and acted upon if failure is detected
Removed after sterilization never to be checked.
Only used for training
Best practice for reprocessing single-use devices (if allowed by regulation) includes:
No validation required
Strict regulatory, functional testing, material compatibility verification and traceability before re-use
Reuse without cleaning is fine
Only rinsing with tap water
Which of the following is a limitation of autoclaving for waste treatment?
Effective for most infectious wastes but not suitable for chemical or pharmaceutical wastes that require other disposal
Always solves all waste types including hazardous chemical waste
Never used in hospitals
Only for textiles
In CSSD, color-coded areas usually indicate:
Staff seniority
Dirty/contaminated area, clean assembly area, sterile storage area for workflow control
Emergency exits
Fire hazard levels
Which method would you choose to sterilize a heat-sensitive flexible endoscope?
Steam autoclave at 121°C
High-level disinfection with validated chemical (e.g., glutaraldehyde) or low-temp sterilization method as per device instructions
Place under UV light for 1 minute
Dry heat at 180°C
Sterilization validation documentation should include:
Only operator name
Cycle parameters, indicator results, maintenance records and corrective actions
Only date and time
Only purchase invoice
The main hazard to staff when using ethylene oxide is:
Noise
Chemical toxicity and carcinogenicity if not properly controlled and ventilated
Overheating of items
Increased humidity
Which of the following is FALSE regarding ultrasonic cleaning?
It replaces sterilization
It helps remove debris from instrument crevices prior to sterilization
Requires proper detergents and maintenance
Should not be used as sole sterilization method
A sterilizer printout typically records:
Cycle parameters (time, temperature, pressure) for traceability and QA
Only the date in faint ink
Only operator initials with no data
Color of instruments
Which item requires sterilization rather than high-level disinfection?
Endotracheal tube used once and disposed
Implantable surgical instrument entering bloodstream
External stethoscope earpiece
Non-critical BP cuff
Which is TRUE about steam sterilization of wrapped items?
Wrapping prevents steam penetration entirely
Wrapping must be permeable to sterilant; improper wrapping can prevent sterilization
Wrapping color determines sterility
Wrapping is optional for any item
The ideal storage for sterile packs is:
Open to corridor for easy access
Dry, clean, away from floor and moisture, FIFO principles applied
Near septic tanks for convenience
On the sterile table ready for use indefinitely
