CSLB General Building (B) Trade Practice Test

Câu hỏi luyện tập mẫu

Một vài câu hỏi thực tế từ ngân hàng miễn phí này, kèm giải thích đầy đủ. Dùng công cụ luyện tập ở trên cho toàn bộ.

1. 1. Decontamination

   A surgical case has just ended and the scrub person is preparing instruments for transport to the decontamination area. What is the correct point-of-use treatment?

   • a.Remove gross soil and keep the instruments moist until they reach decontamination
   • b.Allow the instruments to air dry so blood flakes off during transport
   • c.Spray the instruments with saline and wrap them in a dry towel
   • d.Perform a full manual wash at the sterile field before transport

   Đáp án: a

   Giải thích: Point-of-use treatment means wiping away gross soil and applying a moisture-retention product or damp towel so bioburden does not dry onto surfaces. Dried blood and protein are far harder to remove and can block sterilant contact. Saline is corrosive to instrument alloys, and full cleaning is never performed in the operating room because it creates contaminated aerosols in a sterile environment.

   Nguồn: AAMI ST79

2. 2. Decontamination

   A technician fills the wash sink with very hot water to speed up cleaning. Why must manual cleaning water stay below approximately 140 degrees F (60 degrees C)?

   • a.Higher temperatures cause the detergent to foam excessively and overflow the sink
   • b.Higher temperatures make it impossible to see instruments below the water line
   • c.Heat above that point coagulates protein soil and bonds it to the instrument surface
   • d.Higher temperatures deactivate the chlorides that dissolve blood

   Đáp án: c

   Giải thích: Protein denatures and coagulates with heat, so hot water effectively bakes blood and tissue onto instruments and makes removal much harder. Enzymatic detergents also lose activity outside the temperature window on the label. Foaming, visibility, and chloride activity are not the reason for the temperature limit.

   Nguồn: AAMI ST79

3. 3. Decontamination

   Instrument sets are consistently arriving in decontamination with hard, dried blood in box locks and serrations. What is the most likely root cause?

   • a.Point-of-use treatment is not being performed and the sets sit too long before processing
   • b.The washer-disinfector detergent concentration is set too high
   • c.The decontamination area humidity is above 60 percent
   • d.The transport carts are being covered too tightly

   Đáp án: a

   Giải thích: Dried, baked-on soil is the classic signature of missing point-of-use treatment combined with delayed transport, and the fix is education of the procedural areas plus prompt pickup. Excess detergent does not create dried soil, and it would be observed after washing rather than on arrival. High humidity would tend to keep soil moist, and covering carts protects rather than harms the instruments.

   Nguồn: AAMI ST79

4. 4. Sterilization

   What is a standard gravity displacement steam cycle for a wrapped instrument set at 250 degrees F (121 degrees C)?

   • a.3 minutes
   • b.10 minutes
   • c.30 minutes
   • d.60 minutes

   Đáp án: c

   Giải thích: At the lower temperature of 250 degrees F, a gravity cycle needs about 30 minutes of exposure to achieve the required lethality, plus drying time. Shorter exposures of 3 or 10 minutes do not deliver sufficient lethality at that temperature for a wrapped set. Sixty minutes exceeds the validated requirement and unnecessarily stresses instruments; time and temperature are inversely related, so higher temperature permits shorter exposure.

   Nguồn: AAMI ST79

5. 5. Sterilization

   Immediate-use steam sterilization (IUSS) is requested for a single dropped instrument during a case. Which statement is correct?

   • a.The item must still be thoroughly cleaned and decontaminated before it is placed in the sterilizer
   • b.Cleaning may be abbreviated because the exposure temperature is higher
   • c.The item may be flash sterilized unwrapped and stored for later use if kept covered
   • d.IUSS eliminates the need for physical, chemical, and biological monitoring

   Đáp án: a

   Giải thích: IUSS shortens the packaging and drying steps, not the cleaning step, and a device that is not properly cleaned cannot be sterilized by any cycle. Items processed by IUSS are transported for immediate use and are not stored for later cases. Physical monitors and chemical indicators are used with every IUSS cycle, and the sterilizer is monitored biologically at least daily or weekly per policy.

   Nguồn: AAMI ST79

6. 6. Sterilization

   Rigid sterilization containers are being loaded into a steam sterilizer along with wrapped trays. What is correct practice?

   • a.Stack containers three high to conserve shelf space
   • b.Place containers on the top shelf so condensate drains onto the wrapped trays below
   • c.Place containers flat on the shelf, do not stack unless the container manufacturer validates stacking, and keep them from touching chamber walls
   • d.Turn containers on edge so water drains from the filter ports

   Đáp án: c

   Giải thích: Containers must sit level so condensate can drain through the designed pathway, and stacking is permitted only when the container manufacturer has validated it, because stacking can block steam access and trap moisture. Items should never contact chamber walls, where they can be scorched or collect condensate. Putting containers above absorbent wrapped packs invites wet packs, and turning them on edge defeats the drainage design.

   Nguồn: AAMI ST79

7. 7. Monitoring & QA

   A Class 1 chemical indicator is applied to the outside of every wrapped tray. What does it tell the user?

   • a.That all critical parameters of the cycle were met
   • b.That the contents are sterile and safe for patient use
   • c.That the package has been exposed to a sterilization process and distinguishes processed from unprocessed packages
   • d.That air was successfully removed from the chamber

   Đáp án: c

   Giải thích: Class 1 process indicators, such as autoclave tape and preprinted pouch indicators, only distinguish processed from unprocessed items and do not measure whether the cycle was adequate. Confirming that all critical variables were met is the role of Class 5 integrating indicators, and air removal is verified by a Class 2 Bowie-Dick test. Sterility is never established by any single indicator.

   Nguồn: AAMI ST79

8. 8. Monitoring & QA

   A nurse reports that a tray opened in the operating room contained an internal chemical indicator that did not change. What is the correct action?

   • a.Do not use the tray, return it for reprocessing, and investigate the cycle records and the rest of the load
   • b.Use the tray if the external tape changed color, since two indicators are redundant
   • c.Use the tray but document the indicator failure afterward
   • d.Replace the indicator and reseal the tray in the operating room

   Đáp án: a

   Giải thích: An internal indicator that failed to change means sterilant may not have reached the interior of the package, so the tray is treated as unsterile and reprocessed while the load records and remaining packages are reviewed. External tape only shows the package was exposed to a process, so it cannot override an internal failure. Resealing or using the tray and documenting later places the patient at risk.

   Nguồn: AAMI ST79

9. 9. Prep, Packaging & Storage

   A peel pouch is being prepared for a single ring-handled instrument. Which practice is correct?

   • a.Select a pouch size that lets the item fit without stressing the seals, place the item so the handle enters the pouch first, and do not double pouch unless the pouch manufacturer validates it
   • b.Fill the pouch completely so the instrument cannot shift during handling
   • c.Fold the pouch over to fit a long instrument and seal it with tape
   • d.Write the contents on the paper side with a ballpoint pen

   Đáp án: a

   Giải thích: A properly sized pouch keeps the seals intact, permits steam entry through the porous side, and allows the package to be opened aseptically with the handle presented first. Overfilling stresses seals, and folding or taping a pouch prevents sterilant contact and creates an unvalidated package. Labeling is done on the plastic side, outside the seal, with a non-bleeding marker, because writing on the paper side can damage the sterile barrier.

   Nguồn: AAMI ST79

10. 10. Infection Prevention & Safety

    Which list correctly ranks microorganisms from most resistant to least resistant to sterilization and disinfection?

    • a.Prions, bacterial spores, mycobacteria, nonenveloped viruses, fungi, vegetative bacteria, enveloped viruses
    • b.Enveloped viruses, vegetative bacteria, fungi, bacterial spores, prions
    • c.Vegetative bacteria, bacterial spores, prions, fungi, mycobacteria
    • d.Fungi, prions, enveloped viruses, bacterial spores, mycobacteria

    Đáp án: a

    Giải thích: Prions are the most resistant agents known and require special extended reprocessing protocols, followed by bacterial spores, which is why spores are used as the challenge organism in biological indicators. Enveloped viruses such as hepatitis B and HIV are among the easiest organisms to inactivate because their lipid envelope is fragile. The other sequences reverse or scramble this hierarchy.

    Nguồn: CDC