HSPA Sterile Processing (CRCST) — All Questions

The department runs both a foil test and a commercial soil-based test in the ultrasonic. Why are both used?

• a.The foil test checks water quality, and the soil test checks the temperature of the bath
• b.The foil test maps cavitation energy, and the soil test shows soil is actually being removed✓
• c.The foil test is for empty tanks, and the soil test is required whenever a tank is loaded
• d.The foil test is a daily legal requirement, and the soil test is an optional annual audit

The two tests answer different questions: foil demonstrates that cavitation energy is present and evenly distributed in the tank, while a commercial cleaning verification device carries a standardized soil and shows the process actually removes it under real conditions. Neither test measures water hardness or bath temperature, which are monitored separately. Neither is defined by whether the tank happens to be loaded. And neither is a legal requirement with an annual audit schedule; both are quality tests performed at the frequency set by the equipment instructions and department policy, commonly each day of use.AAMI ST79

Which quality practice belongs to an automated endoscope reprocessor program?

• a.Channel cleaning verification testing plus solution concentration and cycle record review✓
• b.A biological indicator with resistant spores is placed in a scope channel for every cycle
• c.Foil strips are suspended in the basin to confirm cavitation before the scopes are loaded
• d.A Bowie-Dick style air removal sheet is run in the chamber at the start of each working day

Endoscope programs verify that manual cleaning worked by testing channels for residual organic markers such as protein or adenosine triphosphate, and they verify the reprocessor by checking the disinfectant concentration, keeping the printed or electronic cycle record, and following the manufacturer's self-disinfection and filter maintenance schedule. A Bowie-Dick sheet tests air removal in a dynamic-air-removal steam sterilizer and has no meaning in a reprocessor. Routine biological indicators belong to sterilization monitoring, not to high-level disinfection cycles. Foil strips test an ultrasonic tank, not a reprocessor basin.AAMI ST91

How is the cleaning performance of a cart washer verified?

• a.The chamber temperature printout is filed, which is accepted in place of any cleaning test
• b.The operator wipes a finished cart with a white towel and records that no soil is visible
• c.A cart washer test device is fixed on a cart and read after the cycle at the set frequency✓
• d.A biological indicator strip is taped to the cart shelf and incubated after the cycle ends

Cart washers are verified with a commercially available cart washer cleaning test device mounted on the cart in a challenging location, run at the frequency stated by the equipment and test manufacturers, with the result documented. A white towel wipe is a useful visual check but is not a validated challenge and misses interior and underside surfaces. The temperature printout is a physical monitor of the cycle and says nothing about whether soil was removed. Biological indicators monitor sterilization, and a cart washer neither claims nor achieves sterilization.AAMI ST79

The daily cleaning verification test in a washer-disinfector fails, and a repeat test with a new device also fails. What is the correct response?

• a.Run the failed loads a second time in the same washer and release them if the trays look clean
• b.Keep the washer running and mark the failed device as inconclusive until service arrives
• c.Take the washer out of service, notify the supervisor, and hold items back to the last pass✓
• d.Switch to a longer cycle on the same washer and continue processing while service is arranged

Two consecutive failures mean the machine cannot be trusted, so it is removed from service, the failure is reported so repair and investigation can begin, and every item processed since the last passing test is identified and reprocessed once a working method is available. Rerunning loads in the same suspect washer repeats an unverified process and visual inspection alone cannot confirm cleaning. Labeling a documented failure as inconclusive is a records problem and leaves patients exposed. A longer cycle on the same machine does not fix a mechanical or chemical fault that the test just identified twice.AAMI ST79

What belongs in the record for a mechanical cleaning efficacy test?

• a.Date, machine and cycle identification, test lot, result, operator, and any action taken✓
• b.The purchase order number for the test devices and the vendor contact who supplied them
• c.The surgeon and procedure the next set is intended for, so a failure can be traced to a case
• d.The room temperature and humidity at the time of the test, plus the water hardness reading

An efficacy record has to let someone later reconstruct which machine was tested, when, with what test lot, by whom, what the result was, and what was done about a failure; those fields are what make a recall or a survey defensible. Surgeon and procedure belong to case records, not to equipment testing. Purchase order data is a purchasing record and does nothing for traceability of the test. Environmental readings are logged separately as part of environmental monitoring and do not identify the machine or the outcome of the test.AAMI ST79

Why are washer-disinfector chamber strainers and drain screens checked and cleaned at the frequency in the operator manual?

• a.Because a clogged strainer causes the door gasket to leak and floods the equipment room floor
• b.Because the strainer collects detergent solids that must be recovered and returned to the tank
• c.Because a clean strainer shortens the cycle time and increases the number of loads per shift
• d.Because debris restricts drainage and recirculation, which cuts spray pressure and cleaning✓

Debris caught in the strainer restricts water flow through the pump and spray system, so pressure at the arms falls and soil is redistributed rather than washed away; that is why cleaning the strainer is a daily operator task in most manuals. A blocked strainer does not cause a gasket to leak; door leaks come from gasket damage or misalignment. Solids trapped by the strainer are waste and are discarded, never returned to the wash tank. And cycle length is controlled by the programmed parameters, not by how clean the strainer happens to be.Device IFU

During the daily equipment check a technician finds a washer spray arm that turns stiffly and has two jets plugged with debris. What is the correct action?

• a.Report the finding to the supervisor and run the scheduled loads while the repair is arranged
• b.Clear the plugged jets and free the arm as the operator manual directs, then verify free rotation✓
• c.Load lighter trays on that level so the reduced spray pressure still reaches every instrument
• d.Record the finding on the daily log and recheck the arm at the end of the shift to see if it improves

Checking spray arms for free rotation and clear jets is a defined operator task, and the manual tells the technician how to clear them, so this is corrected on the spot and rotation is verified before the next load. Reporting it and running loads anyway knowingly processes trays through a machine that cannot deliver full impingement. Loading lighter trays does not restore the water pattern from blocked jets, and the shadowed items still come out soiled. Deferring the recheck to the end of the shift means an entire shift of loads passes through equipment already known to be impaired.AAMI ST79

A robotic instrument with a long channel is placed in a washer basket without being attached to a manifold port. Which statement about that load is correct?

• a.The channel will not be cleaned, because lumens need flow driven through them by the connector✓
• b.This is acceptable if the basket sits on the top level, where spray pressure is highest overall
• c.This is acceptable because the detergent solution wicks through any lumen by capillary action
• d.The channel will be cleaned only if the ultrasonic cycle is selected instead of the standard one

External spray cannot force water through a long narrow channel; the manifold and its lumen connectors exist to direct flow through the interior, and an unattached lumened device leaves the channel unprocessed. Shelf position changes nothing, because the interior of a lumen is shadowed no matter where the basket sits. Capillary wicking moves a small amount of liquid but produces none of the flow and mechanical action cleaning requires. Selecting a different cycle does not create flow through a channel that is not connected to a port, and lumen instructions normally require both brushing and flushing.Device IFU

Why are washer racks and baskets themselves inspected and cleaned on a schedule?

• a.Because soil, scale, and bent wires on a rack block spray and can hold instruments incorrectly✓
• b.Because clean racks let the department extend the interval between the chamber strainer cleanings
• c.Because racks are counted as patient care items and carry their own sterilization records
• d.Because rack weight affects the detergent dose the machine injects at the start of the wash

A rack is a working part of the process: built-up soil and scale contaminate the load, and bent or broken wires let instruments shift, nest, and shadow one another from the spray, so racks are inspected and cleaned per the manual and repaired when damaged. Racks are not patient care items and do not carry sterilization records of their own. Rack condition has no bearing on how often the chamber strainer needs cleaning; both are separate scheduled tasks. Detergent is dosed by the programmed cycle and water volume, not by how heavy the rack is.AAMI ST79

A washer-disinfector stops mid-cycle and displays an alarm code, and the load is still inside the chamber. What is the correct action?

• a.Open the door, move the wet trays to another washer, and start that machine on its shortest cycle
• b.Treat the load as unprocessed, tag the washer out of service, and report the code to the supervisor✓
• c.Leave the load in place until the next shift so the alarm can be shown to the arriving staff
• d.Reset the alarm and restart the same cycle repeatedly until the machine completes it normally

An interrupted cycle means the validated process was not completed, so the load is handled as still contaminated and reprocessed from the start in working equipment, while the machine is tagged out of service and the code reported to the supervisor so the fault can be diagnosed. Moving the trays and running a short cycle skips the full wash the items never received. Repeatedly resetting and restarting hides a fault and can damage the equipment further. Leaving a contaminated wet load sitting for a shift lets soil dry and biofilm develop, and it takes the washer out of production anyway.AAMI ST79

Several outlets in the decontamination area have red faceplates. What does that indicate to the technician?

• a.They are ground fault protected and are the only outlets approved for use near a wet sink
• b.They are rated for higher amperage and are reserved for the largest motors in the department
• c.They are on the emergency power branch and keep working when normal utility power is lost✓
• d.They are switched from a master control and are shut off automatically at the end of a shift

Red receptacles mark circuits fed by the essential electrical system, so equipment that must survive an outage is plugged into them; technicians should know which outlets those are before a power failure occurs. Color coding is not an amperage rating, which is indicated by the receptacle configuration itself. Ground fault protection near water is provided by ground fault interrupter devices, which are identified by their test and reset buttons rather than by faceplate color. And red outlets are not tied to a shift timer; they stay energized precisely because they are backed by the generator.NFPA 99

Instruments leave the washer with a light film, and the technician suspects the detergent is not being delivered. What is the correct first step?

• a.Check the chemical feed line for kinks and air, confirm dosage on the printout, and verify supply✓
• b.Pour detergent directly into the chamber before each load until a service visit takes place
• c.Increase the wash temperature by twenty degrees to compensate for the reduced chemical action
• d.Run every load twice, since two wash phases deliver roughly the same total amount of chemical action

Detergent delivery is verified by tracing the feed line for kinks, cracks, and air, confirming the container is not empty and the pickup is seated, and reading the dosage the machine records for the cycle; that identifies whether the fault is supply, line, or pump. Pouring chemical into the chamber bypasses the metering system and gives an unknown concentration. Raising temperature does not replace chemistry and can bake protein onto instruments. Running loads twice doubles turnaround while still delivering whatever wrong dose caused the problem in the first place.Device IFU

A laparoscopic instrument set arrives with disposable tips still attached to the reusable shafts. What is the correct action?

• a.Reprocess the tips with the shafts, since anything that entered the body is cleaned the same way
• b.Discard the entire instrument, because a device with a disposable component is single use overall
• c.Ask the supervisor whether the disposable tips may be reprocessed along with the shafts
• d.Remove and discard the single-use tips, then clean and reprocess the reusable shafts per the IFU✓

Sorting reusable from disposable is a decontamination task: single-use tips are removed and discarded, and the reusable shafts are disassembled, cleaned, and reprocessed under the manufacturer instructions. Reprocessing a single-use component treats a device with no validated reprocessing instructions as if it had them. Discarding the reusable shaft over an attached disposable tip throws away expensive instrumentation for no reason. Asking permission to combine the two delays a routine task that the device labeling already settles, because a component marked single use is discarded on sight.FDA

A hospital contracts with a third-party company to reprocess certain single-use devices as part of its sustainability program. Which statement about that arrangement is correct?

• a.The practice is prohibited outright in the United States and the contract itself violates federal rules
• b.The company may relabel devices as reusable without any submission because it is not the maker
• c.The devices may be reprocessed an unlimited number of times as long as they still look intact
• d.The reprocessor is regulated as a manufacturer and must meet clearance and labeling requirements✓

A third-party reprocessor of single-use devices is held to manufacturer obligations: it must obtain clearance for the device it reprocesses, validate the process, label the item, and track the number of permitted cycles, which is what makes the practice lawful and auditable. The practice is not prohibited; it is regulated. A reprocessor cannot simply declare a device reusable outside that framework. And use is limited to a validated number of cycles, so visual appearance is never the deciding factor for how many times a device may be reprocessed.FDA

Which item from an opened case cart goes into the regular waste stream rather than into a biohazard or sharps container?

• a.A saturated laparotomy sponge that drips fluid when it is lifted out of the basin with forceps
• b.A suture needle that was left loose among the instruments in the bottom of the tray pan
• c.A suction canister of body fluid that has not been solidified or emptied for disposal yet
• d.A dry paper count sheet that was clipped to the outside of the tray and is free of soil✓

Uncontaminated paper such as a clean count sheet is ordinary trash, and sending it to regulated waste needlessly raises disposal cost and volume. A suture needle is a contaminated sharp and must go directly into a puncture-resistant sharps container, handled with forceps rather than fingers. A canister of liquid body fluid is regulated waste and is handled per the facility's fluid disposal method. A dripping sponge releases liquid and meets the release test for regulated waste, so it belongs in a biohazard container, not in the trash.OSHA 29 CFR 1910.1030

A loaner tray for tomorrow morning's first case is delivered to the dock at 6:30 that same morning. What is the problem?

• a.Loaners must arrive early enough to be inventoried, cleaned, inspected, and fully reprocessed✓
• b.Loaner trays may be used directly from the vendor case if they arrive on the day of surgery
• c.Loaners require a two-day quarantine in sterile storage before they may be issued to a case
• d.Loaners must be delivered directly to the operating room rather than through the loading dock

Loaned instrumentation must reach the department with enough lead time to be inventoried against the vendor list, decontaminated, inspected, assembled, sterilized, and cooled, which is why facilities set an arrival deadline in advance of the case. Using a vendor tray straight from the case skips decontamination and sterilization entirely. There is no two-day quarantine requirement for loaners; the constraint is processing time, not shelf time. Routing loaners directly to the operating room bypasses the department that is responsible for reprocessing them.AAMI ST79

A loaner tray arrives sealed and marked sterile by the vendor, but no manufacturer instructions accompany it. What is the correct action?

• a.Place it directly into sterile storage, because the vendor seal shows it was already processed
• b.Hold the tray and notify the supervisor so the vendor instructions can be obtained before use✓
• c.Run it through the department's standard wrapped prevacuum cycle used for general instruments
• d.Assemble and sterilize it using the instructions from a similar tray owned by the department

A loaner set must be reprocessed by the receiving facility according to the device manufacturer's written instructions, and without those instructions the correct cycle, disassembly, and any special cleaning steps are unknown, so processing is held while the instructions are obtained. Accepting a vendor sterile claim and storing the tray skips the facility's own validated process. Defaulting to a house cycle assumes parameters that may not match the device, which is a common cause of wet or unsterile implant sets. Borrowing instructions from a similar-looking tray applies parameters validated for a different device.AAMI ST79

How should a basket of soiled instruments be prepared before it goes into a washer-disinfector?

• a.Instruments closed and stacked tightly so that more of the set fits into a single wash basket
• b.Heavy retractors placed on top of delicate items to hold the light instruments down in the spray
• c.Multi-part instruments left assembled so that no small components are lost during the cycle
• d.Instruments disassembled, hinges opened, sorted by type, and arranged in a single layer✓

Preparation for mechanical cleaning means taking apart every device the instructions say can be taken apart, opening box locks and ratchets so mating surfaces are exposed, separating sharp and delicate items from heavy ones, and laying instruments so water reaches all surfaces rather than piling them. Closed and tightly stacked instruments shield the very surfaces that hold soil. Putting heavy retractors on top of delicate items crushes them and shadows them from the spray. Leaving multi-part devices assembled traps soil in the joints; small parts are protected in a mesh container instead.AAMI ST79

A technician is about to use a high-pressure water gun to flush a cannulated instrument at the sink. How should the gun be used?

• a.Use it only after the gown is removed, because a wet gown loses its fluid resistance quickly
• b.Use it held above the sink rim so the technician can watch the debris leave the instrument
• c.Use it with a full face shield, with the tip inside the sink and directed away from the body✓
• d.Use it at the lowest available pressure so that no aerosol is created during the flushing step

Pressurized water and air guns create aerosols and splash, so they are used inside the sink or an enclosure with the stream directed away from the user, and full face and eye protection plus a fluid-resistant gown are worn. Holding the gun above the sink rim to watch debris sprays contaminated fluid into the room and at the face. Removing the gown removes protection at the exact moment the highest splash risk occurs. Dropping to the lowest pressure does not eliminate aerosol and may fail to clear the channel, so the instructions for the device set the pressure.AAMI ST79

After manual cleaning, a technician sees dried soil remaining in the serrations of two instruments in the tray. What is the correct action?

• a.Send the tray forward and mark the two instruments for closer inspection at the assembly bench
• b.Place the two instruments back in the ultrasonic and send the rest of the tray forward without them
• c.Ask the supervisor whether the tray may move forward, since only two instruments are affected
• d.Return both instruments to the wash sink for repeat cleaning, then inspect them again under light✓

Visual inspection is a step in the manual cleaning process, and an item that is not visibly clean is simply cleaned again and re-inspected, ideally with magnification and good lighting. Passing soiled instruments forward for someone else to catch moves contamination into the clean side. Asking permission to advance a visibly soiled item requests an exception to a rule that has no exception, and it delays work the technician can do immediately. Sending part of a set forward while two members are still in process breaks the set apart and creates count and tracking problems at assembly.AAMI ST79

What distinguishes utility water from critical water in the decontamination area?

• a.Utility water is heated above 180 degrees, while critical water is used at room temperature only
• b.Utility water is tap water used for flushing and washing; critical water is extensively treated✓
• c.Utility water is treated with a disinfectant, while critical water is filtered but left untreated
• d.Utility water is used for the final rinse, while critical water is reserved for the initial soak

Utility water is the ordinary supply used for flushing, washing, and intermediate rinsing, while critical water has been extensively treated by methods such as deionization or reverse osmosis with filtration to remove minerals, ions, and microbial contaminants, and it is used for the final rinse and for steam generation. Temperature does not define either category. Neither category is defined by adding a disinfectant to the supply. And the roles in the last statement are reversed, since the final rinse is exactly where critical water matters most.AAMI TIR34

How is the correct brush chosen for cleaning the channel of a cannulated instrument?

• a.The smallest available brush is used, since a narrow brush slides through without any resistance
• b.A brush with metal bristles is used, because plastic bristles bend before they dislodge dried soil
• c.The bristle diameter matches the lumen and the brush is long enough to exit the far end✓
• d.Any brush is acceptable as long as it is passed through the channel three times in each direction

A brush cleans only if its bristles contact the channel wall, so diameter is matched to the lumen and length is sufficient for the brush to pass fully through and be cleaned before it is drawn back, all per the device instructions. An undersized brush slides through touching nothing and gives false confidence. Metal bristles scratch the channel and destroy the passive layer, so soft bristles of the correct size are used. Counting passes is meaningless if the brush is the wrong size, and brushes are inspected for worn bristles and replaced when they no longer clean.AAMI ST79

A technician loads a washer-disinfector rack with basins, cups, and several trays for one cycle. Which loading practice is correct?

• a.Cups are set upright so that detergent solution collects inside them throughout the wash phase
• b.Basins are filled with water before the cycle starts so the detergent has more volume to work within
• c.Trays are stacked flat on top of one another so the maximum number of sets fits in the chamber
• d.Concave items are tilted or inverted, trays are spaced, and the rack is not loaded above capacity✓

Load configuration decides whether water reaches surfaces: concave items are positioned so solution drains rather than pools, items are spaced so they do not shadow one another, and the manufacturer's load capacity is respected. Prefilling basins with water adds weight and displaces spray without improving chemistry. Stacking trays flat blocks the spray from everything underneath and is a common cause of soiled instruments and wet loads. Cups placed upright hold dirty solution through the cycle and carry it into the rinse, which leaves residue behind.AAMI ST79

Ophthalmology reports a cluster of postoperative anterior segment inflammation after cataract cases. Which reprocessing factor is a recognized cause of toxic anterior segment syndrome?

• a.Sterilizing the cannulas at 270 degrees F rather than at 250 degrees F in a gravity cycle
• b.Storing the eye set in a rigid container instead of in a sequentially wrapped instrument tray
• c.Detergent or enzymatic residue left in cannulas because the final rinse was inadequate✓
• d.Using a chemical indicator strip inside the set rather than an external indicator on the wrap

Toxic anterior segment syndrome is a sterile inflammatory reaction caused by a substance that reaches the anterior chamber, and residues of detergent, enzymatic cleaner, ophthalmic viscoelastic, endotoxin, or metal ions left in tiny cannulas are among the documented sources; copious final rinsing with critical or sterile water addresses them. The two steam parameters listed are both validated cycles and are not associated with the syndrome. Container versus wrap is a packaging decision and does not introduce residue. Indicator placement is a monitoring choice with no chemical effect on the instruments.FDA

Which set of practices reduces the risk of toxic anterior segment syndrome when ophthalmic instruments are reprocessed?

• a.Soak the eye set longer in the same enzymatic bath used for the general orthopedic instruments
• b.Air dry the cannulas overnight after the wash so that any residue evaporates before assembly
• c.Process the eye set in the ultrasonic with every other set so the tank solution stays diluted
• d.Keep eye instruments separate, flush cannulas copiously, and finish with critical or sterile water✓

Recognized practice is to handle ophthalmic instrumentation as a dedicated stream: keep the sets separate from general instruments, clean promptly so residue never dries, flush cannulated pieces with large volumes of fluid, and use critical or sterile water for the final rinse, following the device instructions on detergent choice and on ultrasonic use. Extending a soak in a shared enzymatic bath increases the residue burden. Overnight air drying bakes residue onto the surface rather than removing it, since these residues are not volatile. Sharing an ultrasonic tank with general instruments carries soil and endotoxin onto the eye set.AAMI ST79

A gallon of glutaraldehyde solution is knocked off a shelf and breaks open across the floor of a small workroom. What is the correct response?

• a.Wipe it up with paper towels and rinse the residue down the floor drain with plenty of running water
• b.Prop the door open, turn on a fan, and continue processing while the vapor clears the room
• c.Evacuate and restrict the area, notify the supervisor, and follow the written spill response plan✓
• d.Neutralize it with the enzymatic detergent stored nearby, then mop the area with hot water

A large spill of a high-level disinfectant generates irritating vapor at concentrations a technician's routine protection is not rated for, so the correct sequence is to get people out, keep others from entering, report so the plan and trained responders are activated, and use the spill kit and personal protective equipment the safety data sheet specifies. Paper towels leave the responder standing in vapor and the drain may be an unlawful disposal route. Opening a door and running a fan pushes vapor into adjacent areas while staff keep working in it. Enzymatic detergent is not a neutralizer for glutaraldehyde.AAMI ST58

Under the Spaulding classification, how do the three device categories match to processing levels?

• a.Critical is sterilized, semi-critical is intermediate-level disinfected, non-critical is wiped dry
• b.Critical is high-level disinfected, semi-critical is sterilized, non-critical is simply rinsed
• c.Critical is sterilized, semi-critical gets high-level disinfection, non-critical gets low-level✓
• d.All three categories are sterilized, and the classification only sets the order of processing

Spaulding sorts devices by the risk of the tissue they contact: items entering sterile tissue or the vascular system are critical and are sterilized, items contacting mucous membranes or non-intact skin are semi-critical and receive high-level disinfection at minimum, and items contacting only intact skin are non-critical and receive low or intermediate-level disinfection. Swapping the first two levels would let a device entering sterile tissue be merely disinfected. Intermediate-level disinfection does not meet the semi-critical requirement. Sterilizing everything ignores that the classification exists precisely to set different processing levels.CDC

A vaginal ultrasound probe contacts mucous membranes but does not enter sterile tissue. How is it classified and processed?

• a.Non-critical, so wiping it with a low-level quaternary ammonium product between patients suffices
• b.Semi-critical, so it is cleaned and then given high-level disinfection at minimum per the IFU✓
• c.Critical, so it must be terminally sterilized in a steam cycle before every patient use
• d.Non-critical, so a wipe with seventy percent alcohol between patients is fully sufficient

Mucous membrane contact places the probe in the semi-critical category, so it is cleaned first and then receives high-level disinfection or sterilization as the device instructions permit, with a compatible chemistry. Treating it as non-critical and wiping with a quaternary ammonium product applies low-level disinfection to a device that needs far more. Calling it critical overstates the risk category, and most such probes cannot survive a steam cycle at all. An alcohol wipe is intermediate-level at best, has no cleaning power, and can fix protein and damage the probe housing.CDC

Which statement about disinfectant chemistry is accurate?

• a.Chlorine is an intermediate-level disinfectant that is fast acting but corrosive to many metals✓
• b.Alcohol is preferred for large environmental surfaces because it leaves no residue behind at all
• c.Quaternary ammonium compounds are high-level disinfectants suitable for semi-critical devices
• d.Phenolics are the recommended surface product for infant bassinets and for food contact surfaces

Chlorine compounds act quickly and inexpensively against a broad range of organisms and are used for blood spills, but they corrode metals, are inactivated by organic soil, and degrade in storage. Quaternary ammonium compounds are low-level disinfectants for non-critical surfaces and cannot serve semi-critical devices. Alcohol evaporates too quickly to hold contact time on a large surface, is flammable, and fixes protein, so it is a poor environmental product. Phenolics are specifically discouraged for infant bassinets and for food contact surfaces because of residue and toxicity concerns.CDC

A department is writing its procedure for manual high-level disinfection with a liquid chemical germicide. Which statement belongs in that procedure?

• a.Contact time may be shortened if the concentration test strip reads above the labeled minimum
• b.The item is cleaned and dried first, soaked for the labeled time and temperature, then rinsed✓
• c.Soaking longer than the labeled time is required for lumened items regardless of the label
• d.Rinsing after disinfection is optional when the item will be dried with filtered forced air

Every liquid chemical germicide is cleared for a stated concentration, exposure time, and solution temperature, and the item must be cleaned and dried before immersion so residual water does not dilute the solution below its effective concentration; a thorough rinse follows because the residue is toxic to tissue. A strip reading above the minimum confirms the solution is still usable but does not license a shorter soak. Rinsing is not optional, since forced air dries but does not remove chemical residue. Extending the soak beyond label direction is not a general lumen rule and can damage devices.AAMI ST58

The minimum effective concentration test strip on a glutaraldehyde basin fails on day nine of a fourteen-day reuse life. What is the correct action?

• a.Discard the solution, document the failed result, and refill the basin with fresh solution✓
• b.Consult the supervisor about running the remaining scopes before the shift ends that day
• c.Continue using the solution through day fourteen, since the reuse life printed on the jug governs
• d.Add fresh concentrate to the basin to bring the reading back above the minimum concentration

The reuse life is an outer limit, not a guarantee; dilution from wet instruments and organic load can drop a solution below its minimum effective concentration long before that date, and a failed strip means the solution is discarded and documented, whatever day it is. Asking permission to keep processing requests an exception to a rule the standard states plainly. Relying on the printed reuse date ignores the reason the strip is tested in the first place. Topping off with concentrate is not validated, gives an unknown mixture, and is specifically warned against.AAMI ST58

What must the record show after an endoscope receives high-level disinfection?

• a.Only the date and the reprocessor number, since the cycle printout carries all other details
• b.The surgeon's preference card and the count sheet used when the set was originally assembled
• c.Technician, device identifier, patient or procedure link, exposure time, temperature, and lot✓
• d.The purchase date of the endoscope and the date its next preventive maintenance is scheduled

High-level disinfection records must let the facility connect a specific device to a specific patient and a specific process, so they capture who performed it, which scope by serial or identification number, the patient or procedure it links to, the exposure time and solution temperature, the solution lot and concentration test result, and the reprocessor and cycle. A date and machine number alone cannot trace a scope to a patient during a look-back. Preference cards and count sheets belong to surgical case documentation. Purchase and maintenance dates are asset records, not reprocessing records.AAMI ST91

How are items handled after high-level disinfection is complete and the final rinse has been performed?

• a.Dried thoroughly, then stored and transported in a clean, closed, labeled container or cabinet✓
• b.Returned wet to the case cart, since residual moisture keeps the surface from drying and cracking
• c.Left to drip dry on an open counter and covered with a towel until the department needs them
• d.Sealed wet into a plastic bag right away, so no airborne contamination can reach the device

Residual moisture supports microbial growth and can dilute or defeat the disinfection just performed, so items are dried thoroughly, including alcohol flushing and forced air for channels where the instructions call for it, then kept in a clean closed container or ventilated cabinet with clear labeling and an expiration or use-by convention. Dripping on an open counter under a towel exposes the device to the room. Returning it wet to a cart carries fluid and contamination with it. Sealing a wet device into a bag creates the warmest, wettest growth environment available.AAMI ST91

Which safety measure is required when a technician works with an open basin of ortho-phthalaldehyde?

• a.A cloth surgical mask and examination gloves, which are the standard barrier for this chemistry
• b.Chemical-resistant gloves, eye protection, and a covered basin in an area with proper ventilation✓
• c.No barrier is needed once the basin lid is in place, since a covered basin releases no vapor
• d.A respirator is required for every single use, because the vapor pressure exceeds that of glutaraldehyde

Ortho-phthalaldehyde stains skin and protein gray and irritates the eyes and airway, so it is used with chemical-resistant gloves, eye and face protection, a gown, a covered basin, and ventilation or a fume containment arrangement, with an eyewash within reach and the safety data sheet on hand. A cloth surgical mask and thin examination gloves do not resist this chemistry. A respirator is not the routine control for a covered basin in a properly ventilated space. And a lid reduces vapor but does not remove the need for protection when the basin is opened and items are moved.AAMI ST58