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To prevent or minimize HAIs among OHCP and patients, oral healthcare facilities, like all healthcare facilities, are mandated to develop a written infection control/exposure control protocol predicated on a hierarchy of preventive strategies.

A. True B. False

Which of the following statements, in reference to the mandated Infection Control/Exposure Control Protocol, are correct?

A. Standard Precautions (periodically expanded with new evidence-based elements) and Transmission-Based Precautions provide the fabric for an effective Infection Control/Exposure Control Protocol. B. The office Infection Control/Exposure Control Protocol is predicated on the concept that blood and all other body fluids (secretions and excretions with the exception sweat) are potentially infectious. C. The office Infection Control/Exposure Control Protocol is a hierarchy of preventive strategies designed to protect OHCPs and patients alike. D. All of the above.

The information from which inferences can be drawn about the quality of infection control/exposure control practices includes ____________.

A. Infection control/exposure control strategies should be appropriate for the oral healthcare setting. B. As these strategies deviate from optimal design and implementation, the quality (value, outcome) of infection control/exposure control program decreases at an accelerated rate. C. It is recommended that an Office Infection-Control Coordinator (OICC) be appointed with responsibility for the development and management of the office infection control/exposure control program. D. The creation and maintenance of a safe work environment mandates the commitment and accountability of all OHCP. E. All of the above.

The objectives of the education and training program are to educate OHCPs regarding ____________.

A. the risk of healthcare-associated infections B. preventive strategies C. exposure management and follow-up D. administrative controls E. All of the above.

Principal prerequisites for cross-infection include a ____________.

A. source or reservoir of infectious agents B. susceptible host with a portal of entry receptive of the agent C. mode of transmission for the agent D. All of the above.

Pathogens may be transferred from the source to a host by contact transmission, i.e., direct or indirect contact transmission; or respiratory transmission, i.e., inhalation of droplets or droplet nuclei (airborne transmission).

A. True B. False

Pathogenic organisms of concern in the oral healthcare setting include ____________.

A. HBV, HCV, HIV B. measles, mumps, and rubella viruses; herpes simplex virus and varicella zoster virus C. influenza and respiratory syncytial viruses; group A streptococci and Mycobacterium tuberculosis D. emerging pathogens such as MRSA and others E. All of the above.

All of the following statements with respect to education and training are correct EXCEPT which one?

A. An education and training program is to be completed by all OHCPs prior to initial assignment to tasks and procedures in which exposure to blood and OPIM may occur and at least annually thereafter. B. An education and training program is to be scheduled during nonworking hours and the cost is to be borne by the OHCP. C. An education and training program is to be conducted by person(s) knowledgeable about the subject and the speaker is to provide an opportunity for interactive questions and answers. D. An individual training record is to be maintained on all OHCP for the most recent 3-year period.

All of the following statements are correct in relation to hepatitis B vaccination EXCEPT which one?

A. Primary immunization with hepatitis B vaccine consists of a series of three intramuscular injections. B. Post-vaccination confirmation of seroconversion is mandated 1-2 months after the third dose. C. OHCP who fail to develop an adequate antibody response to the primary vaccination series, a second 3-dose vaccine series is recommended. D. If no antibody response occurs to the hepatitis B vaccination series, testing for HBsAg is strongly recommended.

All of the following statements with respect to hepatitis B vaccination are true EXCEPT which one?

A. Hepatitis B vaccination is to be made available to all OHCP, without a history of prior immunization, at the time of initial assignment to tasks in which exposure to blood or OPIM may occur. B. If the hepatitis B vaccination series is declined, the OHCP must sign a copy of the Mandatory Hepatitis B Vaccination Declination Form. C. The U.S. Public Health Service recommends routine booster doses of the hepatitis B vaccine. D. Other vaccines highly recommended for all OHCP include influenza, measles, mumps, rubella, varicella, and pertussis.

Personal protective equipment (PPE) is designed to protect the skin and mucous membranes (eyes, nose, and mouth) and respiratory epithelium of OHCP from exposure to a source or reservoir of pathogenic organisms by contact transmission, i.e., direct or indirect contact transmission; and respiratory transmission, i.e., inhalation of droplets or droplet nuclei (airborne transmission).

A. True B. False

Which of the following statements are true regarding protective clothing?

A. Protective clothing is to be changed daily, when it becomes visibly soiled, and as soon as possible if penetrated by blood or OPIM. B. Protective clothing is removed before leaving the work area. C. Dirty protective clothing is to be placed in designated areas before leaving the work area. D. All of the above.

All of the following statements are true regarding gloves EXCEPT which one?

A. To reduce the risk of latex-related allergies, only powder-free, low-allergen latex gloves, or non-latex (nitrile, vinyl) gloves should be used. B. Gloves should not be changed when torn or punctured until treatment of the patient is completed. C. Gloves may not be washed because it can lead to the formation of glove micro-punctures (wicking) and subsequent hand contamination. D. Double gloving is acceptable for extensive oral surgical procedures.

Which of the following statements are true regarding facemasks?

A. Surgical masks, which cover both the nose and the mouth, must be worn by all OHCPs during the clinical process likely to generate splash, spatter, and aerosols. B. Masks should be changed whenever visibly soiled. C. When lengthy procedures are performed and the facemask becomes wet, the facemask should be changed as soon as possible. D. All of the above.

Protective eyewear with solid side shields or a face shield must be worn by OHCP and patients during the clinical process likely to generate splash, splatter, and aerosols.

A. True B. False

The technique of wetting the hands under warm running water, applying an antimicrobial soap (e.g., chlorhexidine, iodine and iodophors, chloroxylenol, or triclosan), rubbing the hands together vigorously for 15 seconds to work-up a lather, using the fingernails to clean the fingernails on the opposing hand, rinsing the soap off with the hands held under warm running water, and drying the hands with a disposable paper towel is ____________.

A. routine handwashing B. antiseptic handwashing C. antiseptic hand rub D. surgical asepsis

All of the following statements are correct with respect to preparing the DTR for the patient except which one?

A. Place protective plastic covers on clinical contact surfaces such as headrests, dental unit control switches, air and water line hoses, light handles, chairside light curing unit, and other hard-to-clean areas and equipment. B. Have appropriate instrument packs and supplies ready to begin treatment. This includes all necessary PPE (gloves, masks, eye protection, etc.) for the provider, assistant and the patient. C. Check all sterilized instrument packs and packages to ensure they are intact and the external chemical indicator has changed to the appropriate color. D. Open packs in advance of the patient's arrival.

All of the following precautions are correct with respect to the treatment phase of patient care except which one?

A. All procedures are performed in such a manner as to minimize splashing, spraying, spattering, and the generation of droplets (aerosols). B. Prior to dental procedures, patients must rinse with chlorhexidine gluconate-, essential oil-, or povidone iodine-containing mouthwash. C. Use rubber dental dam, high volume evacuator (HVE) and other protective barriers, engineering and work practice controls wherever possible. D. Use one handed “scoop” technique or a recapping safety device to recap anesthetic needles.

All of the following precautions are correct with respect to the DTR-turn-around between patients except which one?

A. Wear heavy-duty utility gloves and other PPE while handling contaminated instruments and cleaning contaminated surfaces. B. Place instruments in cassette tray (or properly labeled and approved container) for transport to the central sterilization room (CSR). C. Clean and disinfect clinical contact surfaces that were not barrier protected with an EPA-registered hospital disinfectant with a tuberculocidal claim (i.e., intermediate-level disinfectant). D. Remove gloves, perform hand hygiene and then it is safe to transport instrument trays, packs, and cassettes to the receiving side of CSR or another designated holding space.

Which of the following procedures are to be performed when securing the DTR at the end of the day?

A. Wear appropriate gloves, face protection, and eye protection while cleaning contaminated surfaces. B. Clean and disinfect all contact surfaces, dental unit surfaces, and countertops with an EPA-registered disinfectant. C. Flush and clean each water line and suction hoses, follow manufacturer’s instructions if waterline treatment products are used. Follow manufacturer’s instructions for cleaning and maintenance of dental unit water bottles. D. All of the above.

Generally, blood and/or saliva-tinted items (e.g., disposable clinic gowns, gloves, and patient bibs) are not considered regulated waste and are placed in the regular trash receptacle.

A. True B. False

All of the following statements are correct relative to regulated waste except which one?

A. Disposable sharps (e.g., needles, local anesthetic cartridges, orthodontic wires, scalpel blades, suture needles, endodontic files, and broken instruments are placed in a rigid, puncture-resistant, leak-proof container with a secure lid for storage and transportation. B. Other regulated waste (e.g., items that drip when held vertically, release fluid when compressed, have dried on fluid that could flake off in transit) is placed in small biohazard bag and are disposed of into a centralized Regulated Waste Receptacle after each appointment. C. Regulated waste is disposed of according to the requirements established by national, as opposed to local and state, environmental agencies. D. Biohazard labels (fluorescent orange or orange red, with lettering or symbols in a contrasting color) are affixed as close as feasible to containers of regulated waste.

In the receiving, cleaning, and decontamination section of the central instrument processing area, reusable instruments are first cleaned with a hands-free process using an ultrasonic system with a strainer-type basket.

A. True B. False

Noncritical items, i.e., items that contact only skin during their intended use may be disinfected with an EPA-registered intermediate level disinfectant without a tuberculocidal claim.

A. True B. False

Heat-tolerant semi-critical and critical items must be heat sterilized in an FDA cleared device.

A. True B. False

Which of the following is true regarding monitoring the correct functioning of a sterilizer?

A. A chemical indicator should be placed in a visible area of each package before sterilization processing. B. A biological indicator spore test should be processed through a sterilizer cycle at least once a week. C. Mechanical monitoring, i.e., confirming the manufacturer’s recommended settings cycle time, temperature, and pressure should be completed with each load. D. All of the above.

All handpieces, unless disposable, are heat sterilized between patients according to manufacturers’ recommendations.

A. True B. False

Backflow in low-volume suction lines occur and microorganisms present in the lines may be retracted into the patient’s mouth when:

A. A seal is created around the saliva ejector. B. A section of the suction tubing holding the tip is positioned above the patient’s mouth. C. During simultaneous use of other evacuation devices (high-volume). D. All of the above.

Ideally, FDA-cleared film barrier pouches should be used when exposing dental films; after exposure, the film should be removed from the pouch and placed in a clean container.

A. True B. False

All of the following statements are correct in relation to infection control-related issues in association with oral surgical procedures EXCEPT which one?

A. For oral surgical procedures, clinicians must perform surgical hand asepsis. B. When using laser or electrosurgical units, the thermal destruction of tissue creates laser plumes or surgical smoke, which does not contain aerosolized infectious material. C. For oral surgical procedures, clinicians must don surgeon’s gloves. D. When performing oral surgical procedures, only sterile saline or sterile water can be used as a coolant.

All of the following statements are correct in relation to extracted teeth EXCEPT which one?

A. Extracted teeth are considered to be potentially infectious. B. Extracted teeth containing dental amalgams are to be placed in the medical waste container for final disposal by incineration. C. Extracted teeth can be disinfected and returned to the patient upon request. D. Extracted teeth must be heat-sterilized or disinfected in 10% formalin before clinical exercises or study.

All of the following statements are correct in relation to laboratory asepsis EXCEPT which one?

A. Environmental surfaces must be barrier-protected or cleaned and disinfected in the same manner as clinical contact surfaces in treatment areas. B. Metal impression trays and face bow forks may be disinfected with an EPA-registered hospital level disinfectant with tuberculocidal claim. C. Articulators, case pans, lathes, pressure pots, and water baths are to be cleaned and disinfected between patients according to manufacturers’ recommendations. D. Burs, polishing points, rag wheels, and laboratory knives used on contaminated or potentially contaminated prostheses or other material are to be heat-sterilized, disinfected, or discarded between cases according to manufacturers’ recommendations.

Impressions, prostheses, and other devices must be rinsed under running tap water to remove blood and OPIM, disinfected with an EPA-registered intermediate-level disinfectant with tuberculocidal claim, and thoroughly rinsed under running tap water before handling.

A. True B. False

Charts should be notated and radiographs viewed before gloving or after the gloves are removed and the hands are washed, unless cover gloves are worn.

A. True B. False

All of the following statements are correct in relation to environmental infection control EXCEPT which one?

A. To prevent contamination of clinical contact surfaces cover them with materials impervious to moisture. B. Before removing gloves and performing hand hygiene, place clean barriers on clinical contact surfaces after each patient. C. Housekeeping surfaces such as floors and sinks are cleaned regularly with a detergent and water or an EPA-registered hospital disinfectant/detergent designed for general housekeeping purpose. D. At the end of each day, general cleaning and disinfection of clinical contact surfaces are performed regardless of barrier protection.

All of the following statements are correct in relation to post-exposure evaluation and follow-up EXCEPT which one?

A. Immediately after an exposure incident wash injuries with soap and water and apply an antiseptic agent (if available). B. Following a needlestick or sharp object injury a post-exposure evaluation must be made within 2 hours of exposure. C. Report the exposure incident to the Office Infection-Control Officer or other designated person immediately following exposure. D. The source person must be identified within 24 hour of an exposure incident.

After percutaneous, mucous membrane, or non-intact skin exposure to blood or OPIM the consulting physician will initiate post-exposure prophylaxis (if applicable) and follow-up according to the latest CDC recommendations.

A. True B. False

In a community-based oral healthcare setting, implementation and enforcement of TB infection-control protocol provides for prompt ____________.

A. identification of patients with suspected or confirmed TB disease B. isolation of patients with suspected or confirmed TB disease from other patients and OHCPs C. referral of patients suspected or confirmed TB disease for medical evaluation and /or urgent dental care to a facility with appropriate environmental controls and respiratory-protection controls D. All of the above.

To prevent the transmission of respiratory tract infections, the implementation of Respiratory Hygiene/Cough Etiquette applies to which of the following persons with cough, congestion, rhinorrhea, or increased production of respiratory secretions entering an oral healthcare facility?

A. Patients B. Visitors C. OHCPs D. All of the above.

To minimize latex allergy-related health problems among OHCPs and patients:

A. Reduce exposure to latex-containing materials by substituting non-latex products when appropriate and using appropriate work practice controls. B. Train and educate of OHCPs to recognize signs and symptoms of latex-related adverse effects. C. Refer OHCP with signs and symptoms suggestive of latex allergy to a physician to confirm diagnosis. D. All of the above.

To minimize the exposure of patients to OHCPs who have been exposed to or have been diagnosed with an infectious disease, which of the following factors are considered in imposing restrictions on clinical practice?

A. Mode of transmission B. Period of infectivity C. Level of circulating viral burden D. Level of risk for the transmission of a pathogen in association with a procedure E. All of the above.

Which of the following are considered Category I procedures, i.e., procedures with minimal risk of bloodborne pathogen transmission?

A. Routine preventive dental procedures - not requiring the administration of local anesthesia B. Operative, endodontic, and prosthetic procedures and periodontal scaling and root planning C. Minor surgical procedures D. Periodontal curettage, gingivectomy, and mucogingival and osseous surgery

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Clinical Practice Guideline for an Infection Control/Exposure Control Program in the Oral Healthcare Setting Test Preview

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Clinical Practice Guideline for an Infection Control/Exposure Control Program in the Oral Healthcare Setting
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