RHS: Infection Prevention and Control practice questions

Answer: A) Uncovered charts or keyboards

• ACorrect. Use barriers or overgloves.
• BIncorrect. That's expected during exposure.
• CIncorrect. That's barrier-protected.
• DIncorrect. That's barrier-protected.

Answer: A) Remove the gloves and perform hand hygiene before typing on the keyboard

Computer equipment in the operatory is a clinical contact surface. It must be covered with a barrier that is changed between patients, or touched only after contaminated gloves are removed.

• ACorrect. Chairside computer equipment is a clinical contact surface. If it has no barrier, it should not be touched with contaminated gloves. Removing gloves and performing hand hygiene before touching it prevents cross-contamination.
• BIncorrect. CDC advises against washing or disinfecting gloves. Wiping them does not reliably decontaminate them and can damage the glove material.
• CIncorrect. The keyboard is already contaminated once it is touched with contaminated gloves. Putting a barrier on afterward covers the contamination rather than preventing it.
• DIncorrect. Clinical contact surfaces must be barrier-protected or disinfected between patients. Waiting until the end of the day allows cross-contamination.

Answer: A) The tubehead, PID, and exposure control panel or button

Any surface touched with contaminated gloves during exposures, such as the tubehead, PID, and control panel, should be covered with a barrier, or cleaned and disinfected after each patient.

• ACorrect. Gloved hands touch these surfaces during exposures. CDC advises covering radiography equipment such as the tubehead and control panel with barriers, or cleaning and disinfecting it after each patient.
• BIncorrect. The apron is cleaned and disinfected after use, but the surfaces most touched during exposures are the tubehead, PID, and controls. Protecting only the apron leaves them contaminated.
• CIncorrect. The tubehead is a noncritical item, but contaminated gloves still touch it, so it needs a barrier or cleaning and disinfection between patients. The sensor also needs its own FDA-cleared barrier.
• DIncorrect. The processing area also needs aseptic handling, but this does not protect operatory equipment that contaminated gloves touch during exposures.

Answer: A) The controls are hard to clean and are touched with saliva-contaminated gloves

During imaging, gloved hands contaminated with saliva touch the chair controls, which are hard to clean. CDC recommends covering such surfaces with barriers, changing them between patients, and cleaning and disinfecting the surface if it is soiled underneath.

• ACorrect. CDC names switches on dental chairs as clinical contact surfaces that are hard to clean. These surfaces should be covered with an FDA-cleared barrier, and the barrier changed between patients.
• BIncorrect. A thin plastic barrier gives no radiation shielding. Its purpose is infection control: it keeps contamination off a surface that is hard to clean.
• CIncorrect. Gloves must be worn when taking radiographs and handling contaminated film packets or sensors. A barrier on the controls does not replace hand protection.
• DIncorrect. CDC says to look at the surface after removing the barrier. If it is soiled, clean and disinfect it before the next patient.

Answer: A) Clean it and disinfect it with an EPA-registered intermediate-level (tuberculocidal) hospital disinfectant

Digital sensors are semicritical. If one cannot be heat-sterilized or high-level disinfected, CDC calls at minimum for an FDA-cleared barrier plus cleaning and intermediate-level (tuberculocidal) disinfection between patients.

• ACorrect. For sensors that cannot be heat-sterilized or high-level disinfected, CDC's minimum is barrier protection plus an EPA-registered hospital disinfectant with intermediate-level (tuberculocidal) activity between patients.
• BIncorrect. Barriers reduce contamination but can fail. CDC still calls for cleaning and disinfecting the sensor between patients.
• CIncorrect. Sensors are semicritical. The CDC minimum is intermediate-level (tuberculocidal) disinfection, not low-level.
• DIncorrect. Dry wiping is not disinfection. The sensor must be cleaned and then disinfected with an EPA-registered intermediate-level disinfectant.

Answer: A) Perform hand hygiene right away, before touching the computer or anything else

CDC directs dental personnel to perform hand hygiene immediately after removing gloves, because hands can be contaminated through glove defects or during removal. Whether hands are visibly soiled affects only the method (soap and water vs. alcohol-based rub).

• ACorrect. CDC calls for hand hygiene immediately after removing gloves. Gloves can have small defects, and hands can become contaminated while taking gloves off.
• BIncorrect. Surface disinfectant wipes are not hand hygiene products. CDC calls for soap and water, or an alcohol-based hand rub when hands are not visibly soiled.
• CIncorrect. Hand hygiene has to happen immediately after removing gloves. Putting it off lets contaminated hands spread microorganisms to the keyboard and other surfaces.
• DIncorrect. Hand hygiene is required after glove removal either way. Visible soiling only decides the method: soap and water instead of an alcohol-based hand rub.

Answer: B) Gloves

• AIncorrect. Gloves come off first.
• BCorrect. They're the most contaminated.
• CIncorrect. Gloves come off first.
• DIncorrect. Gloves come off first.

Answer: A) Open the envelope with treatment gloves and drop the plate into a clean cup without touching it, then remove the gloves, perform hand hygiene, and load the scanner

Open the exposed PSP barrier with contaminated gloves and let the plate drop out untouched. Then remove the gloves, perform hand hygiene, and handle the plate and scanner with clean hands or fresh gloves.

• ACorrect. The contaminated barrier is handled only with contaminated gloves and the plate falls out without being touched. The scanner is then loaded with clean hands or fresh gloves, so no saliva reaches the plate or the scanner.
• BIncorrect. Wiping the envelope doesn't make the treatment gloves clean. Loading the scanner with gloves worn in the patient's mouth transfers contamination to the plate and the scanner.
• CIncorrect. The outside of the envelope is contaminated with saliva. Opening it with clean bare hands contaminates the hands, and they then carry that contamination to the plate and the scanner.
• DIncorrect. Spraying the plate doesn't fix the contaminated gloves, which still touch the scanner. Unapproved chemicals on the plate's phosphor surface can also damage it; follow the manufacturer's instructions.

Answer: C) Remove the used barriers, clean and disinfect any touched surfaces that were not covered, then put on fresh barriers

The panoramic unit's contact surfaces are clinical contact surfaces. Between patients, the barriers are replaced, and any touched surfaces that were left uncovered are cleaned and disinfected.

• AIncorrect. The chin rest, head guides, hand grips and controls are also touched by the patient or by the operator's gloves, so they need barriers or disinfection too.
• BIncorrect. CDC says barriers on clinical contact surfaces must be changed between patients, whether or not they look soiled.
• CCorrect. Clinical contact surfaces are barrier-protected or cleaned and disinfected between patients. Used barriers are discarded, uncovered contaminated areas are disinfected, and new barriers go on. A new disposable or reprocessed bite block is used.
• DIncorrect. These are noncritical surfaces that touch only intact skin. A barrier or an EPA-registered hospital disinfectant is enough, so immersion high-level disinfection isn't needed.

Answer: C) Noncritical

• AIncorrect. It doesn't contact mucosa.
• BIncorrect. It doesn't penetrate tissue.
• CCorrect. It contacts only intact skin.
• DIncorrect. It's reusable and noncritical.