ICE: Process Instruments and Devices practice questions

Answer: A) The wrap keeps the instruments sterile after the cycle until the package is opened for use

Sterilization packaging must let the sterilant reach the instruments and then keep them sterile until the package is opened. Wrapping does not replace cleaning or internal chemical indicators.

• ACorrect. CDC says packaging materials must let the sterilizing agent penetrate and must keep items sterile after sterilization until the point of use.
• BIncorrect. Sterilization wraps must let steam or another sterilant reach the instruments. If the wrap blocked steam, the instruments would not be sterilized.
• CIncorrect. CDC calls for an internal chemical indicator in every package. Wrapping does not replace it.
• DIncorrect. Instruments must be cleaned before packaging and sterilization. Leftover debris can shield microorganisms from the sterilant, and wrapping does not make up for poor cleaning.

Answer: A) Crowded instruments can keep the solution's cavitation from reaching every surface

Ultrasonic cleaners remove debris through cavitation in the solution. Overloading keeps the solution from reaching all instrument surfaces and reduces cleaning.

• ACorrect. Ultrasonic cleaning removes debris through cavitation in an aqueous solution. Instruments packed tightly together shield one another, so some surfaces are not cleaned.
• BIncorrect. An ultrasonic cleaner cleans instruments; it does not sterilize them. Sterilization happens later in the process.
• CIncorrect. Overloading reduces cleaning effectiveness. It does not intensify cavitation.
• DIncorrect. Debris is removed mainly by cavitation. CDC notes that typical ultrasonic solutions often carry no antibacterial label claims.

Answer: C) Before sterilization, as the manufacturer directs

• AIncorrect. Lubricate routinely.
• BIncorrect. Many need lubrication.
• CCorrect. Some need lubrication after as well.
• DIncorrect. Lubricate before sterilizing.

Answer: B) After they dry

• AIncorrect. Let them dry first.
• BCorrect. Wet packs can wick in contamination.
• CIncorrect. Let the cycle and drying finish.
• DIncorrect. Remove them after drying.

Answer: D) Placed loosely, not overloaded

• AIncorrect. Package per protocol.
• BIncorrect. That blocks circulation.
• CIncorrect. That blocks circulation.
• DCorrect. So sterilant can circulate.

Answer: A) Keep them in covered or closed cabinets in an area where they cannot become wet

CDC recommends storing sterile packages in covered or closed cabinets away from water. Packages that become wet, torn, or punctured must be reprocessed before use.

• ACorrect. CDC says sterile instruments and supplies should be stored in covered or closed cabinets and not where they might become wet.
• BIncorrect. Storing packages near a sink exposes them to splashes. Wet packages are considered contaminated and must be reprocessed.
• CIncorrect. An uncovered operatory counter exposes packages to spatter and handling. CDC recommends covered or closed cabinets.
• DIncorrect. Packages must be inspected before use, and any that are wet, torn, or punctured must be reprocessed no matter what date is on them.

Answer: A) The package is torn, gets wet, or has its seal broken

Event-related shelf life means a sterile package stays usable until an event compromises it, such as tearing, moisture or a broken seal, rather than until a set date. Packages should be inspected for damage before use.

• ACorrect. Under event-related practice, an item stays sterile until something contaminates it, such as a tear, moisture or a broken seal. The package must be inspected before use.
• BIncorrect. A fixed expiration date describes time-related shelf life, not event-related shelf life.
• CIncorrect. Spore testing checks how the sterilizer is performing. It does not set how long an already-processed package stays sterile.
• DIncorrect. A chemical indicator shows that the package was exposed to sterilization conditions. Its appearance during storage is not what ends sterility under event-related practice.

Answer: B) Allow them to dry thoroughly, then inspect them before packaging

CDC directs that cleaned instruments be dried thoroughly before packaging, because moisture compromises the wrap or pouch and its ability to keep the contents sterile.

• AIncorrect. CDC says instruments should dry thoroughly before packaging. Moisture can compromise the packaging and its ability to keep the contents sterile.
• BCorrect. CDC directs that cleaned instruments be allowed to dry thoroughly before they are packaged, wrapped, or otherwise contained, and that they be inspected first.
• CIncorrect. Leftover water does not help steam reach the instruments. Wet instruments can damage the integrity of the packaging material.
• DIncorrect. A holding solution is used before cleaning to keep debris from drying on. Instruments that have been cleaned and rinsed should be dried and packaged, not soaked again.

Answer: A) About 270°F (132°C) for about 4 minutes

• ACorrect. Air is removed before steam enters.
• BIncorrect. That's too low.
• CIncorrect. That's too high for steam.
• DIncorrect. That's far too low.

Answer: D) 250°F (121°C)

• AIncorrect. That's far too hot for steam.
• BIncorrect. That's too cool to sterilize.
• CIncorrect. That's boiling, not sterilization.
• DCorrect. For about 30 minutes, or hotter for shorter cycles.