Chapter 04: Control of Microorganisms. All Answers

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MULTIPLE CHOICE 1. The chemical or physical method that destroys all forms of life is called: a. sterilization. b. disinfection. c. bacteriostatic. d. bactericidal. A Sterilization is t... he destruction of all forms of life, including bacterial spores. Disinfection is a process that eliminates a defined scope of microorganisms, including in some cases spores. Bacteriostatic inhibits the growth of microorganisms. Bactericidal kills bacteria. REF: 60 OBJ: Level 1: Recall 2. Organisms that are the most resistant to heat, chemicals, and radiation are: a. parasites. b. prions. c. bacteria. d. viruses. B Prions are naked pieces of protein, so they are harder to kill than any other organism. Viruses usually contain a nucleic acid, and all the mentioned forms of killing can effectively disrupt their nucleic acid. Bacteria and parasites are complete organisms that are killed by disinfection and sterilization, even in the spore and cyst stages. REF: 61 OBJ: Level 1: Recall 3. After using the phone, the laboratory tech sprayed the receiver with a chemical spray. This process will kill a defined scope of microorganisms. What is this process called? a. Sterilization b. Bacteriostatic c. Disinfection d. Bactericidal C Disinfection kills a defined scope of microorganisms. Sterilization kills all organisms and spores at a site. Bacteriostatic and bactericidal are adjectives that describe the particular action of chemical agents: to inhibit bacterial growth or kill bacteria. REF: 60 OBJ: Level 2: Interpretation 4. Before performing a phlebotomy, the phlebotomist will clean the area on a patient’s arm with a substance before inserting the needle. This substance is called a(n): a. disinfectant. b. sterilizer. c. antiseptic. d. bactericidal. C An antiseptic is a substance applied to the skin for the purpose of eliminating or reducing the number of bacteria present. A disinfectant is a chemical agent used to kill microorganisms on an inanimate object. To sterilize is to kill all life; skin will still have organisms growing after wiping. Bactericidal is the process of killing bacteria. REF: 60 OBJ: Level 2: Interpretation 5. All the following factors play a significant role in the selection and implementation of the appropriate method of disinfection except: a. temperature. b. contact time. c. biofilms. d. humidity. D Humidity is not important when attempting to disinfect or kill organisms. Temperature, contact time, and biofilms all play a role in selection and implementation of the appropriate method of disinfection. REF: 60 OBJ: Level 1: Recall 6. When eliminating organisms from inanimate objects, higher numbers of organisms require longer exposure times because: a. all disinfecting agents are not alike and some require shorter times. b. the chemical composition of the disinfecting agent varies. c. disinfecting agents containing carbon tetrachloride require longer times to act. d. it takes longer to eliminate 99% of microorganisms. D When there are higher numbers of microorganisms, it takes longer to kill 99% of microorganisms present. Although disinfectants are different, it still takes longer to kill more organisms. The chemical composition of a disinfecting agent may affect the time required to kill microorganisms, but microbial load is a determining factor. REF: 61 OBJ: Level 1: Recall 7. If this is present on a surface to be disinfected, it can shield microorganisms from the disinfectant or inactivate the disinfectant. What is this substance? a. Bleach (sodium hypochlorite) b. Organic material c. Hydrochloric acid d. Water B Organic matter (e.g., blood, pus) can keep the disinfectant from reaching and killing the microorganism. Bleach, hydrochloric acid, and water can counteract another disinfectant, but they cannot shield microorganisms from a disinfectant. REF: 61 OBJ: Level 1: Recall 8. Disinfectants are usually used at temperatures of: a. 50° to 100° C. b. 0° to 10° C. c. 25° to 50° C. d. 20° to 22° C. D Disinfectants are usually used at room temperature (20° to 22° C). Too high or too low a temperature can actually inactivate a disinfectant. REF: 62 OBJ: Level 1: Recall 9. Pasteurization achieves: a. disinfection. b. sterilization. c. asepsis. d. filtration. A Pasteurization kills foodborne pathogens, but not microbial spores present in a liquid. Because sterilization is killing of all microorganisms plus spores and cysts, pasteurization only disinfects. Asepsis describes no bacteria present. Filtration describes another method of disinfection where microorganisms are removed from a liquid by a physical device—a filter. REF: 63 OBJ: Level 1: Recall 10. Chemosterilizers exert their killing effect through all the following mechanisms except: a. denaturation of cellular proteins. b. damage of RNA and DNA. c. inactivating enzyme substrates. d. reactions with components of the cytoplasmic membrane. C Inactivating an enzyme substrate may or may not have an effect on cellular function. If a chemical can denature proteins that are used by the cell, damage RNA or DNA, or react with components of the cell membrane, they can damage the cell. REF: 64 OBJ: Level 1: Recall 11. Alcohols use what mechanism to inactivate microorganisms? a. Denature proteins. b. Destroy DNA. c. Denature RNA. d. Inhibit cell wall synthesis. A Alcohols disrupt the tertiary and quaternary structure of the cell wall proteins to destroy microorganisms. They do not have the capability to destroy DNA, denature RNA, or inhibit cell wall synthesis. REF: 65 OBJ: Level 1: Recall 12. The tech needs to sterilize a piece of equipment that cannot be autoclaved or gas sterilized because the equipment contains lenses, metal, and rubber components. What solution should be used to sterilize this piece of equipment? a. 10% Bleach b. 37% Formalin c. Glutaraldehyde d. 90% Alcohol C Glutaraldehyde is the sterilant of choice, because it is not inactivated by organic material, and it can kill both microbes and spores, depending on contact time. Ten percent bleach cannot be used because it is a corrosive and can corrode metal; 37% formalin cannot be used because it is a carcinogen, and the Occupational Safety and Health Administration (OSHA) does not recommend it for routine sterilizing or disinfecting; 90% alcohol can be corrosive, but it is also inactivated with any organic material that may be present on the instrument. REF: 65 OBJ: Level 1: Recall 13. For the most effective microbial killing, all iodophors must be properly diluted because: a. they stain the skin if too concentrated. b. this decreases contact time for adequate killing. c. there must be enough free iodine to kill the microorganisms. d. this increases contact time for adequate killing. C The reason for diluting iodophors properly is that the dilution ratio is important to ensure there is enough free iodine to kill microorganisms. When iodophors are used as skin preparations, contact time is essential for killing microorganisms. Contact time does not depend on dilution. Iodophors are considered nonstaining. REF: 65 OBJ: Level 1: Recall 14. Even though hypochlorites are inexpensive and have a broad range of microbes that they kill, they are not used as sterilants because of the: a. corrosive nature of the compound. b. activation required by organic matter. c. short exposure time for sporicidal action. d. long exposure time for sporicidal action. D Hypochlorites require a long exposure time to kill spores, and they are inactivated by organic material present on an object. They are not used as a disinfectant because they are corrosive. REF: 66 OBJ: Level 1: Recall 15. Disinfectants containing heavy metal compounds have been replaced as disinfectants, except for _____, which is still used as a prophylactic treatment in newborns to prevent gonococcal conjunctivitis. a. silver nitrate b. copper sulfate c. ammonium nitrate d. mercuric chloride A Silver nitrate is used to swab the eyes of newborns to protect them from gonococcal conjunctivitis. Mercuric chloride is a preservative used in parasitology. Copper sulfate is used to estimate the amount of hemoglobin in a drop of blood. Ammonium nitrate is used as a component of gunpowder. REF: 67 OBJ: Level 1: Recall 16. Many materials in hospitals that must be sterilized cannot withstand steam sterilization. Gas sterilization is used instead, which uses: a. nitrous oxide. b. oxygen. c. ethylene oxide. d. carbon dioxide. C Ethylene oxide is usually mixed with nitrogen or carbon dioxide before use because it is explosive in its pure form. It is used in hospitals and in the manufacturing industry for sterilizing thermoplastic products. Nitrous oxide, oxygen, and carbon dioxide are all gases, but they do not kill microbes or their spores. REF: 67 OBJ: Level 1: Recall 17. Why should health care workers wash their hands after coming into contact with a patient? a. To reduce the amount of red blood cells transmitted from one patient to the next b. To reduce the occurrence of hemolytic transfusion reactions c. To reduce the need for antiseptics and disinfectants d. To reduce the spread of pathogenic bacteria from one individual to another D Any pathogenic bacteria present on the hands of one individual will be passed on to the next individual unless the hands are washed to remove the pathogens. Hands visibly contaminated with red blood cells are always washed after becoming soiled. Hemolytic transfusion reactions are caused by the intravenous administration of red blood cells. Antiseptics and disinfectants will always be needed to cleanse skin and inanimate objects to free them of pathogenic bacteria. REF: 64 OBJ: Level 1: Recall 18. High-level disinfectants are active against all the following except: a. parasites. b. spores. c. fungi. d. tubercle bacilli. A High-level disinfectants are active against vegetative cells, tubercle bacilli, spores, fungi, and viruses. These disinfectants may have no activity against parasite cysts or egg forms. REF: 62 OBJ: Level 1: Recall 19. Which agency regulates the use, sale, and distribution of antimicrobial pesticide products for certain inanimate, hard, nonporous surfaces, or incorporated into substances under the pesticide law? a. Antimicrobial Division of Environmental Protection Agency (EPA) b. Centers for Disease Control and Prevention (CDC) c. U.S. Army Medical Research Institute for Infectious Diseases (USAMRIID) d. U.S. Food and Drug Administration (FDA) A The Antimicrobial Division of the EPA regulates the use of antimicrobials on inanimate, nonporous surfaces. The CDC acts as a clearinghouse for information of medically important bacteria and houses one of two biosafety level 4 laboratories. The other biosafety level 4 laboratory is found at the Army infectious disease research facility, USAMRIID. The FDA regulates substances that are put into the body. REF: 68 OBJ: Level 1: Recall 20. What two alcohols are effective in killing the hepatitis B virus (HBV)? a. 50% isopropyl and 50% butanol b. 95% propanol and 70% ethanol c. 70% isopropyl and 95% ethanol d. 70% pentanol and 70% isopropyl C The only two alcohols used in U.S. hospitals that kill HBV are 70% isopropyl and 95% ethanol. REF: 63 OBJ: Level 1: Recall 21. Which chemical is a saturated 5-carbon dialdehyde that has broad-spectrum activity, rapid killing action, and remains active in the presence of organic matter? a. Formalin b. Formaldehyde c. Haloaldehyde d. Glutaraldehyde D Glutaraldehyde is a good killing agent because it has broad-spectrum activity, rapid killing action, remains active in the presence of organic matter, and can be used on sensitive equipment. Formalin is designated as a carcinogen by the Occupational Safety and Health Administration (OSHA), and worker exposure limits have been set. These adverse effects limit its usefulness. Formaldehyde is a gas that is usually known as formalin. Haloaldehyde is not used as a disinfectant. REF: 65 OBJ: Level 2: Interpretation 22. What disinfectants are cationic, surface-activated agents that work by reducing the surface tension of molecules in a liquid, resulting in the disruption of the cellular membrane of microbes? a. Quaternary ammonium compounds b. Heavy metals c. Chlorines d. Iodophors A Quaternary ammonium compounds are disinfectants that are cationic, surface-activated agents that disrupt the cellular membrane of microbes. Heavy metals are bacteriostatic. The mechanism by which chlorines kill microorganisms is the oxidative effects of hypochlorous acid. Iodophors kill through the action of periodic acid. REF: 66 OBJ: Level 2: Interpretation 23. Which organization regulates chemical skin antiseptics? a. Environmental Protection Agency (EPA) b. Food and Drug Administration (FDA) c. Centers for Disease Control and Prevention (CDC) d. National Institutes of Health (NIH) B The FDA regulates chemical skin antiseptics. The Antimicrobial Division of the EPA regulates disinfectants. The CDC is the nation’s clearinghouse on infectious diseases. The NIH is a conglomerate of special federal agencies that award research grants to further knowledge in a particular area. REF: 70 OBJ: Level 1: Recall 24. The main goal of handwashing is to: a. sterilize a person’s hand. b. increase the risk of passing on pathogens. c. eliminate transient flora. d. disinfect a person’s hands. C A person’s hands are never sterile; therefore, the best handwashing scenario would be to cleanse the hands of transient flora. Sterilizing someone’s hands would also strip the hands of essential oils that would contribute to drying and cracking of the skin. Washing would eliminate most pathogens, thereby decreasing, not increasing, a person’s ability to transmit pathogens. Disinfection occurs when microorganisms are killed on inanimate objects. REF: 68 OBJ: Level 1: Recall 25. Routine handwashing in health care settings mandates washing at all the following times except: a. in high-risk areas such as ICU and burn units. b. on entering protective isolation units. c. before and after routine patient contact. d. when gloves become soiled during a procedure or dressing change on the same patient. D Soiled gloves are changed during a procedure or dressing change on a single patient, but the hands are not washed until contact with that patient terminates. REF: 69 OBJ: Level 1: Recall 26. The purpose of surgical hand scrubs and waterless hand rubs is to: a. eliminate the transient flora and most of the resident flora on the skin. b. remove all physical dirt and some residential flora. c. remove all resident flora. d. remove all transient flora. A Surgical scrubs try to eliminate as much bacteria from the surgeon’s hand as possible. In case the surgeon’s glove is torn or punctured, very little bacteria will enter the surgical wound. So as much transient and resident flora as possible must be removed by the surgical hand scrubs and waterless hand rubs. REF: 69 OBJ: Level 1: Recall 27. The most common iodophor used in the United States for preoperative skin preparation is: a. calcium iodophor. b. 95% ethanol and iodine. c. tincture of iodine. d. povidone iodine. D Povidone-iodine contains a low amount of free molecular iodine, reducing toxic effects, staining, and irritation. It also provides slow and continuous release of iodine. Tincture of iodine is not used as frequently. Calcium iodophor and 95% ethanol and iodine are not used for preoperative surgical skin preparation. REF: 65 OBJ: Level 1: Recall 28. Which topical antiseptic disrupts the microbial cell membrane and precipitates the cellular contents? a. Chlorhexidine gluconate b. Povidone-iodine c. 95% Ethanol d. 60% Isopropyl alcohol A The bactericidal mechanism for chlorhexidine gluconate is to disrupt the microbial cell membrane and precipitate the cellular contents. Povidone-iodine uses hypoiodonic acid and free iodine to disrupt the cell and eventually kill it. The bactericidal mechanism for alcohols is denaturing proteins. REF: 66 OBJ: Level 2: Interpretation 29. This compound is a diphenyl ether, and it exerts its bactericidal effects by disrupting the cell wall. It has good activity against gram-positive cocci, but poor activity against fungi. What is its name? a. 95% ethanol b. Triclosan c. Chlorhexidine gluconate d. Povidone-iodine B Triclosan is a diphenyl ether, and it exerts its bactericidal effects by disrupting the cell wall. Ninety-five percent ethanol denatures the cellular proteins. Chlorhexidine gluconate disrupts the cellular membrane and spills the cell’s contents. Povidone-iodine kills the bacteria with free iodine and hypoiodonic acid. REF: 67 OBJ: Level 2: Interpretation 30. Laboratory safety includes all the following areas except: a. radioactivity. b. chemical. c. isolation. d. fire. C Isolation safety and precautions are usually practiced in conjunction with the patient on the floor or outpatient setting. In the laboratory, there are few patients, so safety focuses on areas like radioactivity, chemical safety, and fire safety. REF: 72 OBJ: Level 1: Recall 31. Why is laboratory-acquired infection an obvious hazard for personnel working in a microbiology laboratory? a. Microbiology personnel do not always adhere to safety practices. b. Safety practices are not applicable for the microbiology laboratory. c. In-service education is not provided for microbiology staff. d. Personnel deal with a variety of infectious agents: viral, fungal, parasitic, and bacterial. D All specimens handled by laboratory techs are considered to be potentially infectious. Therefore, if a person is careless, a laboratory-acquired infection can occur. Microbiology personnel should follow safety procedures for their own safety. Safety procedures do apply to the microbiology laboratory, and training is provided to each employee. REF: 74 OBJ: Level 1: Recall 32. The comprehensive safety program for the microbiology laboratory needs to fulfill all the following provision except it: a. is specific to the hospital and does not need to conform to state, local, and federal regulations. b. must address biologic hazards. c. must teach correct techniques for lifting and moving heavy objects and patients (where applicable). d. must describe the safe handling, storage, and disposal of chemicals. A The safety program must comply with federal and state regulations, hospital procedures, and good laboratory practice. It needs to address all safety hazards (fire, chemical, radiologic, and biologic) and be uniformly applied. Procedures need to be written, and employees need to take responsibility for keeping their workplace safe. REF: 73 OBJ: Level 1: Recall 33. Processing of patient specimens and handling of actively growing cultures of microorganisms puts an employee at risk of potential contact with the infectious agent through all the following routes except: a. mucous membranes. b. blood splashed onto intact skin. c. inhalation of aerosols. d. accidental ingestion. B When working with specimens and culture plates, there is little chance of contracting an infection if blood is splashed onto intact skin. Infection—through the mucous membranes by rubbing eyes with contaminated hands, from inhaling aerosolized microorganisms, or by accidental ingestion—is possible when handling specimens and actively growing culture plates. REF: 74 OBJ: Level 1: Recall 34. All of the following organisms can typically cause infection from aerosolization of specimens except: a. Mycobacterium tuberculosis. b. Brucella spp. c. Staphylococcus aureus. d. Francisella tularensis. C Cases of S. aureus infection of laboratory workers occur often, but not usually through aerosol inhalation. Many reported cases of laboratory workers being infected with M. tuberculosis after being exposed to aerosols when processing sputum specimens fill the literature. Brucella and F. tularensis are very infectious organisms and several cases a year are reported of laboratory workers who contract the disease after processing culture specimens. REF: 74 OBJ: Level 1: Recall 35. The most common route of infection of laboratory workers with hepatitis B virus (HBV) and human immunodeficiency virus (HIV) is: a. mucous membranes. b. inhalation. c. ingestion. d. needlestick. D HBV and HIV are bloodborne pathogens that are transmitted through exposure to blood and body fluids. Although infection through the mucous membranes has occurred, the most common route of infection of health care workers is through needlesticks where the organisms are introduced into the bloodstream. REF: 74 OBJ: Level 1: Recall 36. What protective measures can a laboratory worker take when working with actively growing cultures to ensure that they do not become infected? a. Ensure that fungal cultures are sealed and worked in a biosafety cabinet. b. Wash their hands at the end of their shift. c. Handle specimens routinely, using extra care for HIV and HBV cultures. d. Take off bandages on fingers when reading plates. A Fungal cultures produce many infectious spores that can disseminate rapidly via the ventilation system if a plate is opened on the bench in a laboratory. These cultures should always be handled in a biosafety cabinet. Bench technicians should wash their hands frequently to ensure the number of pathogenic microorganisms on their hands is always low. All specimens should be handled as though they are HBV and HIV positive—with extreme care. Cuts on the hand should always be covered by finger cots or gloves. REF: 77 OBJ: Level 1: Recall 37. The laboratory exposure control plan should contain all the following except: a. engineer and work practice controls. b. review of control plan every 5 years. c. methods of compliance for Standard Precautions. d. guidelines for handling and disposal of regulated waste. B The exposure control plan is mandated by the Occupational Safety and Health Administration (OSHA) to protect workers against bloodborne pathogens. This plan must be reviewed and updated annually. It must contain a determination of tasks and procedures that may result in an occupational hazard, a plan to investigate all exposure incidents and a plan to prevent these from reoccurring, methods of compliance for Standard Precautions, engineering and work practice controls, personal protective equipment, guidelines for ensuring that the work site is maintained in a clean and sanitary manner, guidelines for handling and disposal of regulated waste, and a training program for all employees (OSHA Bloodborne Standards). REF: 73 OBJ: Level 1: Recall 38. Universal/Standard Precautions require that: a. only some body fluids be considered infectious and capable of transmitting disease. b. body fluids with visible blood be treated as noninfectious. c. blood and body fluids from all patients be considered infectious and capable of transmitting disease. d. urine and feces be considered noninfectious. C Anything that comes from a patient is capable of transmitting disease. Blood and all body fluids, including secretions and excretions, except sweat, regardless of whether visible blood is present, are considered infectious. REF: 73 OBJ: Level 1: Recall 39. Engineering controls and work practice controls to ensure Standard Precautions are followed include all the following except: a. eyewash stations. b. the use of safety needles. c. plastic shield barriers. d. fire blankets. D The Occupational Safety and Health Administration (OSHA) defines engineering controls as controls that isolate or remove the hazard from the workplace. Some examples of engineering controls are the use of closed tube sampling by laboratory equipment, the use of safety needles and single-use holders, eyewash stations, emergency showers, and plastic shield barriers. Ideally laboratories should have negative air pressure, access to the laboratory should be limited, and there should be a plan to prevent insect infestation. REF: 74 OBJ: Level 1: Recall 40. Standard Precautions do not address which of the following? a. Handwashing b. Gloves c. Laboratory coats d. Respirators D Respirators are not included in the items addressed by Standard Precautions because they are used in a biosafety level 3 laboratory. To ensure the guidelines required in Standard Precautions are followed within the laboratory, engineering controls and work practice controls are instituted, and employers must provide personal protective equipment. REF: 73 OBJ: Level 1: Recall 41. Safety program and work practice controls consist of all of the following except: a. ensuring written procedures are in place for a task. b. altering the manner in which a task is performed to reduce exposure to infectious agents. c. allowing workers to eat at the bench if it gets busy and they do not have time to take a lunch break. d. reviewing the procedure manual annually. C Safety programs and work practice controls consist of altering the manner in which a task is performed to reduce the likelihood of exposure to infectious agents. This is accomplished by no mouth pipetting; no eating, drinking, or applying cosmetics in the laboratory; disinfecting workstations at the end of each shift and after any spill of infectious material; no recapping or breaking of contaminated needles; disposal of needles in an appropriate puncture-resistant container; performing procedures in a manner to minimize splashing and the generation of air droplets; placing specimens for transport in well-constructed containers with secure lids to prevent leakage of infectious materials; and frequent handwashing. REF: 74 OBJ: Level 1: Recall 42. All of the following are examples of personal protective equipment (PPE) except: a. gloves. b. laboratory coats. c. safety glasses. d. prescription glasses. D PPE must be protective and appropriate. Blood and body fluids must not be able to penetrate the PPE material. Prescription glasses are not considered PPE because splashes of blood and body fluids can get to the eye by coming in around the sides, top, and bottom of the glasses. Safety glasses form a barrier where body fluids cannot come in around the sides, top, or bottom. REF: 74 OBJ: Level 1: Recall 43. Technicians are doing the morning chemistry run. Once they load the specimens onto the instrument, they remove their gloves to do paperwork in a clean area of the laboratory. What should the technicians do after removing their gloves? a. Reposition the tubes in the racks. b. Take a break and eat a snack. c. Call any critical values. d. Wash their hands. D As soon as the gloves come off, the technicians must wash their hands to ensure that all potential pathogens are removed before the technicians touch inanimate objects in the clean area of the laboratory. REF: 78 OBJ: Level 3: Synthesis 44. The biosafety levels were categorized using all the following criteria except: a. the bacterial load necessary to cause infection. b. the organism’s ability to cause serious illness. c. the organism’s mode of transmission. d. whether there is treatment available for an infection. A Bacterial load was not a criterion. The four biosafety levels were derived from categories of etiologic agents. These categories include the organism’s ability to cause serious illness, the organism’s mode of transmission, whether there is treatment available for infection, and whether there are any preventive measures, such as vaccines. REF: 78 OBJ: Level 1: Recall 45. A biosafety level 1 (BSL-1) level of containment is used for organisms that: a. cause 90% mortality of infected people. b. are well classified and not known to cause disease in healthy people. c. cause 90% morbidity of infected people. d. can be transmitted through aerosols. B This is the lowest level of biosafety. These organisms pose a minimal threat to laboratory personnel and the environment. Laboratory work can be conducted on open bench tops. Employees should be trained in laboratory procedures and supervised by a scientist with training in microbiology. REF: 78 OBJ: Level 1: Recall 46. A biosafety level 2 (BSL-2) level of containment is used for organisms that: a. can cause a catastrophe if released. b. usually cause 90% mortality in the population. c. create a moderate potential hazard for employees and the environment. d. do not cause significant harm to employees and the environment. C These organisms pose a moderate hazard. Guidelines for laboratories that handle these agents include having a biosafety cabinet, limiting access to the laboratory when cultures are out, having employees receive immunizations for contact with possible pathogens, having an up-to-date biosafety manual, wearing personal protective equipment (PPE), and restricting use of sharp items to times when no alternative equipment can be used. REF: 78 OBJ: Level 1: Recall 47. Because biosafety level 3 (BSL-3) organisms have the potential for aerosol transmission, and diseases with these agents may have serious lethal consequences, all of the following guidelines apply to BSL-3 laboratories except BSL-3 laboratories should: a. be separated from other parts of the building by an anteroom. b. have restricted access with documentation of personnel entering and exiting the laboratory. c. have solid ceiling and floor seams, and any seams must be sealed. d. have positive air pressure. D BSL-3 laboratories must follow BSL-2 safety guidelines and must also have a class II or III biologic safety cabinet; must ensure that employees wear appropriate personal protective equipment (PPE); should be separated from the other parts of the building by an anteroom; should have negative air pressure and the air from inside the laboratory should be directed outside without recirculation; should have ceilings and floors that are solid and any seams sealed; and must be constructed so that all parts of the laboratory can be easily cleaned and disinfected. BSL-4 laboratories should have restricted access. REF: 79 OBJ: Level 1: Recall 48. Biosafety level 4 (BSL-4) organisms are dangerous, exotic, and pose an increased risk of aerosol-transmitted infections and life-threatening disease. Two examples of BSL-4 organisms are: a. Marburg and Congo-Crimean hemorrhagic fever. b. St. Louis encephalitis virus and Coccidioides immitis. c. Mycobacterium tuberculosis and Ebola. d. Francisella tularensis and Ebola. A The only two BSL-4 organisms listed are Marburg and Congo-Crimean hemorrhagic fever. St. Louis encephalitis virus, M. tuberculosis, and F. tularensis are all BSL-3 organisms. REF: 79 OBJ: Level 1: Recall 49. The Clinical Laboratory Standards Institute (CLSI) defines hazardous waste as: a. those wastes that present an aerosol, infectious, or sharps danger to laboratory and hospital personnel. b. those substances that singly or in combination pose a significant present or potential threat or hazard to human health. c. exotic and indigenous microorganisms and chemicals that present an infectious, explosive, corrosive, or irritant risk. d. all the following classes of substances: microorganisms, toxic chemicals, electricity, fire, and bloodborne pathogens. B Those substances that singly or in combination pose a significant present or potential threat or hazard to human health is the definition provided in the standard. The rest choices are incomplete. REF: 79 OBJ: Level 1: Recall 50. OSHA requires laboratories to have what document to ensure that laboratory personnel have a thorough working knowledge of the hazards of the chemicals with which they work? a. Chemical control plan b. Standard operating procedures c. Chemical hygiene plan d. OSHA compliance plan C OSHA regulations require that employees compile a chemical hygiene plan that details the hazards of the chemicals used in the workplace. This plan must also contain a provision for hazardous communication training. REF: 80 OBJ: Level 1: Recall 51. A Material Safety Data Sheet (MSDS) contains all the following information except: a. the nature of a chemical (flammable, toxic, carcinogenic). b. general characteristics. c. precautions when using a chemical. d. classification of a chemical (acid, base, protein). D MSDSs document the nature of a chemical (flammable, toxic, carcinogenic), general characteristics, precautions to take in using a chemical, emergency information, spill cleanup procedure, and disposal recommendations. REF: 81 OBJ: Level 1: Recall 52. If a laboratory uses hazardous chemicals, it must: a. keep a chemical inventory and Material Safety Data Sheets (MSDSs) on hand. b. keep chemicals in a special corrosive cabinet. c. keep chemicals in a special locking cabinet. d. post chemical names and locations on the door of the laboratory. A A laboratory must maintain a current inventory of hazardous chemicals, and the MSDSs for those particular chemicals according to 29 CFR Part 1910, Subpart 2, Toxic and Hazardous Substances (OSHA). REF: 81 OBJ: Level 1: Recall 53. Laboratory safety for hazardous chemicals includes: a. restricting use of these chemicals to specific individuals. b. using fume hoods to prevent inhalation of fumes. c. locking chemicals in one specific “corrosives” cabinet. d. providing biohazard training to affected individuals. B Laboratory safety for hazardous chemicals includes using fume hoods to prevent inhalation of fumes, personal protective devices (fume masks, gloves, aprons, and eyewear), acid and flammable spill kits, and warning signs in appropriate places announcing the hazardous chemical. REF: 81 OBJ: Level 1: Recall 54. Most institutions use the RACE acronym to respond to a fire emergency. RACE stands for: a. race, alert, cite, evacuate. b. run, avoid, call, emergency. c. rescue, alarm, contain, extinguish. d. retrieve, announce, close, exit. C RACE stands for rescue (remove anyone who is in danger), alarm (know where the nearest fire pull box or alarm station is located and know the number to call to report the fire), contain (close doors to contain fire and smoke), and extinguish (use the properly rated fire extinguisher on small fires). REF: 89 OBJ: Level 1: Recall 55. The best way to care for your back is to prevent back injuries. All of the following are some ways to prevent back injuries except: a. carefully lifting heavy objects overhead. b. using good posture. c. using the legs to lift, not the back. d. asking for assistance when a load is too heavy. A Carrying heavy trays of culture plates, lifting heavy loads in and out of autoclaves, and sitting or standing improperly can all contribute to back stress injuries. Using good posture, using the legs to lift (not the back), asking for assistance when a load is too heavy, and staying physically fit all help prevent back injuries. REF: 89 OBJ: Level 1: Recall 56. The Joint Commission requires the following safety training to be documented in an employee’s record except: a. proper storage of gases. b. biosafety level training. c. bloodborne pathogen training. d. hazardous materials management. B Biosafety level training is not required by The Joint Commission, because this training is laboratory specific. The remaining training applies to all employees in a hospital. REF: 89 OBJ: Level 1: Recall 57. Three levels of laboratories outlined in the Laboratory Response Network (LRN) include all the following except: a. sentinel. b. reference. c. first responder. d. national responder. C The Centers for Disease Control and Prevention (CDC) developed the LRN in 1999 so that laboratories could respond quickly and effectively to a bioterrorism event. The three levels of laboratories contained in this document include sentinel, reference, and national responder. REF: 90 OBJ: Level 1: Recall 58. In the LRN program, hospital-based microbiology laboratories are classified as which type of laboratory? a. Reference b. National c. Primary d. Sentinel D There are only 100 reference laboratories in the United States and two national laboratories (CDC and the United States Army Medical Research Institute for Infectious Disease [USAMRIID]). The remaining hospital laboratories are designated as sentinel laboratories. REF: 90 OBJ: Level 1: Recall 59. Category A bioterrorism agents: a. pose the highest threat because they are easily transmitted and highly infectious. b. have moderate morbidity and low mortality and are not easily transmitted. c. are emerging pathogens. d. are enteric pathogens. A Category B bioterrorism agents have moderate morbidity and low mortality and are not easily transmitted. Category C bioterrorism agents are emerging pathogens. Enteric pathogens are usually considered gram-negative rods. REF: 90 OBJ: Level 1: Recall 60. Once bioterrorism is suspected, a sentinel laboratory should perform all culture manipulation using what safety guidelines? a. BSL-2 b. BSL-3 c. BSL-4 d. BSL-1 B All manipulations should be handled using biosafety level 3 (BSL-3) guidelines, and all work should be done in a class II or III biologic safety cabinet. As soon as possible after a sample has been identified as a potential bioterrorism agent, it should be referred to the appropriate Laboratory Response Network (LRN) Reference laboratory. REF: 90 OBJ: Level 1: Recall [Show More]

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