Deck 10: Prevention of Disease Transmission in Oral Health Care

Question 1

Use Case A to answer The Following questions
CASE A
Maria, a dental hygienist, is air polishing Kyle's teeth.
Kyle is a 9-year-old boy currently undergoing phase I orthodontics. The air temperature in the office is warm today because of a malfunctioning air conditioning unit. Because of this situation, Maria has opted not to use a face mask. She feels that the face shield she is wearing will be adequate protection; she also thinks that a face mask will make it difficult for her to breathe normally and will make her feel more uncomfortably hot. She finishes the treatment and dismisses her client. Two weeks later, vesicles break out all over her skin. Maria visits her health care provider and is diagnosed with chickenpox.
In this case, which of the following infection-control procedures likely would have prevented disease transmission?

A)Using barriers
B)Cleaning the environmental surfaces
C)Processing the instruments in cassettes
D)Wearing proper PPE

Answer 1

Wearing proper PPE

Question 2

Glutaraldehyde is a high-level disinfectant, so it can be used to sterilize heat-sensitive items.

A)Both statements are true
B)Both statements are false
C)The first statement is true; the second is false
D)The first statement is false; the second is true

Answer 2

Both statements are true

Question 3

All of the following viruses are bloodborne pathogens EXCEPT one. Which one is the EXCEPTION?

A)Human immunodeficiency virus
B)Hepatitis B virus
C)Hepatitis C virus
D)Varicella zoster virus

Answer 3

Varicella zoster virus

Question 4

Alcohol-based hand rubs may be used instead of handwashing between clients because the rubs have been found to be more effective than handwashing, especially when visible soil is present.

A)Both the statement and the reason are true
B)Both the statement and the reason are false
C)The statement is true; the reason is false
D)The statement is false; the reason is true

Question 5

Use Case B to answer The Following questions
CASE B
While hand-scaling tenacious calculus, a dental hygienist's curette slips off the client's tooth and penetrates the hygienist's fulcrum finger. He sees a small spot of blood forming under his glove.
The employee has sustained a percutaneous injury and may have been exposed to a bloodborne pathogen. In this situation, what is the responsibility of the employer according to the OSHA?

A)None, an employee works at his own risk
B)Pay for the treatment of any acquired disease
C)Give the employee the following day off with pay
D)Arrange for a consultation with a qualified health care provider

Question 6

Which of the following methods will achieve sterilization?

A)Dry heat at 320°F for 50 minutes
B)Steam autoclave at 200°F for 30 minutes
C)Chemical vapor at 270°F for 20 minutes
D)Ethylene oxide gas for 5 hours

Question 7

Use Case A to answer The Following questions
CASE A
Maria, a dental hygienist, is air polishing Kyle's teeth.
Kyle is a 9-year-old boy currently undergoing phase I orthodontics. The air temperature in the office is warm today because of a malfunctioning air conditioning unit. Because of this situation, Maria has opted not to use a face mask. She feels that the face shield she is wearing will be adequate protection; she also thinks that a face mask will make it difficult for her to breathe normally and will make her feel more uncomfortably hot. She finishes the treatment and dismisses her client. Two weeks later, vesicles break out all over her skin. Maria visits her health care provider and is diagnosed with chickenpox.
What is the source of the microbes in this case?

A)Client's mouth
B)Hygienist's hands
C)Contaminated instrument
D)Clinical contact surface

Question 8

The CDC recommends disinfecting clinical contact surfaces with an intermediate level disinfectant that is tuberculocidal because Mycobacterium tuberculosis var. bovis is a resistant microbe and all other less resistant microbes would also be killed.

A)Both the statement and the reason are true
B)Both the statement and the reason are false
C)The statement is true; the reason is false
D)The statement is false; the reason is true

Question 9

Use Case A to answer The Following questions
CASE A
Maria, a dental hygienist, is air polishing Kyle's teeth.
Kyle is a 9-year-old boy currently undergoing phase I orthodontics. The air temperature in the office is warm today because of a malfunctioning air conditioning unit. Because of this situation, Maria has opted not to use a face mask. She feels that the face shield she is wearing will be adequate protection; she also thinks that a face mask will make it difficult for her to breathe normally and will make her feel more uncomfortably hot. She finishes the treatment and dismisses her client. Two weeks later, vesicles break out all over her skin. Maria visits her health care provider and is diagnosed with chickenpox.
Which of the following modes of disease spread is depicted in this case?

A)Direct contact
B)Indirect contact
C)Droplet infection
D)Airborne infection

Question 10

Use Case B to answer The Following questions
CASE B
While hand-scaling tenacious calculus, a dental hygienist's curette slips off the client's tooth and penetrates the hygienist's fulcrum finger. He sees a small spot of blood forming under his glove.
All the following information should be included in the incident exposure report EXCEPT one. Which one is the EXCEPTION?

A)Date and time of exposure
B)How the exposure occurred
C)Presence of HCV in blood
D)Client's Social Security Number

Question 11

Use Case B to answer The Following questions
CASE B
While hand-scaling tenacious calculus, a dental hygienist's curette slips off the client's tooth and penetrates the hygienist's fulcrum finger. He sees a small spot of blood forming under his glove.
What is the level of risk related to the transmission of HCV from this exposure?

A)High
B)Moderate
C)Low
D)Very low

Question 12

Which term is used for the practice of treating a client's blood, bodily fluids, nonintact skin, and mucous membranes as potentially infectious?

A)Standard precautions
B)Pervasive precautions
C)Universal precautions
D)Protective precautions

Question 13

Use Case B to answer The Following questions
CASE B
While hand-scaling tenacious calculus, a dental hygienist's curette slips off the client's tooth and penetrates the hygienist's fulcrum finger. He sees a small spot of blood forming under his glove.
After removing his glove, what should the hygienist do next?

A)Scrub the finger using a stiff brush
B)Squeeze the finger to let out the contaminants
C)Wash the finger with antimicrobial soap
D)Immerse the finger in bleach for 1 minute

Question 14

Use Case A to answer The Following questions
CASE A
Maria, a dental hygienist, is air polishing Kyle's teeth.
Kyle is a 9-year-old boy currently undergoing phase I orthodontics. The air temperature in the office is warm today because of a malfunctioning air conditioning unit. Because of this situation, Maria has opted not to use a face mask. She feels that the face shield she is wearing will be adequate protection; she also thinks that a face mask will make it difficult for her to breathe normally and will make her feel more uncomfortably hot. She finishes the treatment and dismisses her client. Two weeks later, vesicles break out all over her skin. Maria visits her health care provider and is diagnosed with chickenpox.
Which of the following pathogens is responsible for the acquisition of chickenpox?

A)Treponema pallidum
B)Coxsackievirus
C)Varicella zoster virus
D)Epstein-Barr virus

Question 15

Use Case A to answer The Following questions
CASE A
Maria, a dental hygienist, is air polishing Kyle's teeth.
Kyle is a 9-year-old boy currently undergoing phase I orthodontics. The air temperature in the office is warm today because of a malfunctioning air conditioning unit. Because of this situation, Maria has opted not to use a face mask. She feels that the face shield she is wearing will be adequate protection; she also thinks that a face mask will make it difficult for her to breathe normally and will make her feel more uncomfortably hot. She finishes the treatment and dismisses her client. Two weeks later, vesicles break out all over her skin. Maria visits her health care provider and is diagnosed with chickenpox.
Which of the following microorganism type is responsible for chickenpox?

A)Bacterium
B)Prion
C)Virus
D)Fungus

Question 16

Use Case A to answer The Following questions
CASE A
Maria, a dental hygienist, is air polishing Kyle's teeth.
Kyle is a 9-year-old boy currently undergoing phase I orthodontics. The air temperature in the office is warm today because of a malfunctioning air conditioning unit. Because of this situation, Maria has opted not to use a face mask. She feels that the face shield she is wearing will be adequate protection; she also thinks that a face mask will make it difficult for her to breathe normally and will make her feel more uncomfortably hot. She finishes the treatment and dismisses her client. Two weeks later, vesicles break out all over her skin. Maria visits her health care provider and is diagnosed with chickenpox.
Which of the following pathways of cross-contamination is depicted in this case?

A)Client to dental team
B)Dental team to client
C)Client to client
D)Office to community

Question 17

Use Case B to answer The Following questions
CASE B
While hand-scaling tenacious calculus, a dental hygienist's curette slips off the client's tooth and penetrates the hygienist's fulcrum finger. He sees a small spot of blood forming under his glove.
The dental hygienist elects to be tested for HCV, and he is informed of the results. Which of the following actions is he then required to take?

A)Inform his employer of the results
B)Document the results on the incident report
C)Inform the CDC and the OSHA
D)None of the above is required

Question 18

What is the ultimate goal of infection control in the oral health care setting?

A)Prevent all pathogens from entering the client treatment area
B)Sterilize clinical contact surfaces between clients
C)Reduce the dose of microbes that may be shared
D)Eliminate all microbes emanating from the source

Question 19

An unvaccinated OHCW with weeping dermatitis of her hands touches a drawer pull contaminated with HBV and later contracts the disease. Which of the following modes of disease spread would be involved in this situation?

A)Direct contact
B)Indirect contact
C)Droplet infection
D)Airborne infection

Question 20

Use Case B to answer The Following questions
CASE B
While hand-scaling tenacious calculus, a dental hygienist's curette slips off the client's tooth and penetrates the hygienist's fulcrum finger. He sees a small spot of blood forming under his glove.
The client's blood was tested and she was found to have hepatitis C virus (HCV). Postexposure prophylaxis (PEP) of the exposed employee (dental hygienist) is not recommended because HCV cannot be transmitted in the dental setting.

A)Both the statement and the reason are TRUE
B)Both the statement and the reason are FALSE
C)The statement is true; the reason is FALSE
D)The statement is false; the reason is TRUE

Question 21

All of the following are true related to using instrument cassettes EXCEPT one. Which one is the EXCEPTION?

A)Unwrap the cassette in view of the client
B)Unwrap with clean hands
C)Exposure to bioburden is decreased
D)The use of cassettes is less time efficient

Question 22

Many OHCWs experience skin problems on their hands related to the use of gloves. In most cases, these problems are caused by an allergic response to latex proteins in gloves.

A)Both statements are true
B)Both statements are false
C)The first statement is true; the second statement is false
D)The first statement is false; the second statement is true

Question 23

All of following characteristics describe EPA-registered intermediate-level disinfectants EXCEPT one. Which one is the EXCEPTION?

A)Must inactivate Mycobacterium tuberculosis var.bovis
B)Will kill vegetative bacteria and most viruses
C)Must be used on surfaces with visible blood
D)Will achieve sterilization if long contact time is used

Question 24

Which of the following statements best characterizes the resident flora on hands?

A)They colonize the deeper layers of the skin
B)They are less resistant to removal by handwashing
C)They are the primary source of disease transmission
D)They are associated with allergic contact dermatitis

Question 25

Which of the following packaging materials should not be used with chemical-vapor sterilization?

A)Paper wrap
B)Paper pouches
C)Plastic pouches
D)Cloth wrap

Question 26

Which of the following characteristics best describes the use of protective barriers for clinical contact surfaces?

A)They need to be changed only when visibly soiled
B)They should not replace disinfection between clients
C)They are ideally used for surfaces that are difficult to disinfect
D)They decrease the cost of maintaining asepsis

Question 27

An individual should be tested for antibodies to HBV 1 to 2 months after receiving the last dose of the hepatitis B vaccine. The reason for this testing is that not all individuals will seroconvert.

A)Both statements are true
B)Both statements are false
C)The first statement is true; the second statement is false
D)The first statement is false; the second statement is true

Question 28

Gloves to be used intraorally should be donned:

A)Prior to operatory setup
B)Prior to unwrapping the cassette
C)Prior to taking the blood pressure
D)Prior to entering the client's mouth

Question 29

Which of the following indicators is used to determine sterility?

A)External indicator
B)Integrated indicator
C)Biologic indicator
D)Chemical indicator

Question 30

Face shields provide maximum coverage for the face and protection from spatter during oral health care procedures. Therefore, wearing a facemask is not required when using a face shield.

A)Both statements are true
B)Both statements are false
C)The first statement is true; the second statement is false
D)The first statement is false; the second statement is true

Question 31

Sterilization failure is most often caused by:

A)The autoclave not working properly
B)Improper packaging materials used
C)Overloading the steam autoclave sterilizer
D)Not reaching the effective temperature

Question 32

In which of the following methods are biologic monitors containing spores of Geobacillus stearothermophilus used to verify sterilization?

A)Steam autoclave
B)Dry-heat oven
C)Ethylene oxide gas
D)Rapid-heat transfer

Question 33

Which of the following pathogens has been identified in the biofilm that accumulates inside dental unit water lines?

A)Pseudomonas aeruginosa
B)Neisseria meningitidis
C)Candida albicans
D)Treponema pallidum

Question 34

Which of the following statements is true regarding the handling of regulated infectious waste?

A)Containers of infectious waste must be identified with the biohazard symbol
B)Infectious waste can be disinfected and then combined with the regular trash
C)Infectious waste must be sterilized before leaving the oral health care setting
D)Infectious waste does not require any special handling in some states

Question 35

Which of the following characteristics is an advantage of chemical-vapor sterilization?

A)A ventilation system is not required
B)It can sterilize closed containers
C)Extra drying time is not needed
D)It is the least costly method of sterilization

Question 36

The primary reason for routinely wearing powder-free gloves is to:

A)Reduce airborne latex proteins
B)Help with glove donning
C)Eliminate skin problems
D)Reduce glove costs

Question 37

Which of the following is the OSHA primarily concerned with protecting?

A)Employee
B)Employer
C)Client
D)Community

Question 38

All practitioners who are vaccinated for hepatitis B will become immune to the virus. Therefore, the CDC does not recommend booster injections.

A)Both statements are true
B)Both statements are false
C)The first statement is true; the second statement is false
D)The first statement is false; the second statement is true

Question 39

Which of the following individuals may file a complaint with the OSHA regarding an oral health care facility?

A)Dentist (employer) at the facility
B)Employee at facility
C)Client at facility
D)Dentist at another facility

Question 40

All of the following are vaccine preventable illnesses EXCEPT one. Which one is the EXCEPTION?

A)Hepatitis B virus (HBV)
B)Hepatitis A virus (HAV)
C)Hepatitis C virus (HCV)
D)Varicella zoster virus (VZV)

Question 41

All of the following materials are considered regulated infectious waste EXCEPT one. Which one is the EXCEPTION?

A)Extracted tooth
B)Blood-soaked gauze
C)Anesthetic needle
D)Saliva-coated gloves

Question 42

Which of the following methods or materials is the most effective for preventing transmission of hepatitis B in the oral health care setting?

A)Vaccination with HBV surface antigen
B)Disinfecting surfaces contaminated with HBV
C)Wearing double gloves for HBV carriers
D)Screening clients for active HBV infection

Question 43

Dental handpieces are considered critical items and must be sterilized using:

A)The heat sterilization method
B)A chemical sterilant
C)Ethylene oxide gas sterilization
D)A high-level disinfectant

Question 44

A chemical indicator is used on the outside of packaging to identify the items that have been processed through the sterilizer. The chemical indicator changes color when the packages are sterile.

A)Both statements are true
B)Both statements are false
C)The first statement is true; the second statement is false
D)The first statement is false; the second statement is true

Question 45

The primary reason for clients to perform a pre-procedural rinse before undergoing oral health care is to:

A)Give the client fresh breath
B)Eliminate food particles
C)Reduce the microbes in aerosols
D)Prevent infection in the client's mouth

Question 46

What is the maximum level of bacteria that the EPA allows in dental unit water?

A)100 CFU/mL (colony-forming unit per milliliter)
B)300 CFU/mL
C)500 CFU/mL
D)800 CFU/mL

Question 47

To prevent cross-contamination, the practice of using a cotton roll taped to the bracket tray for wiping debridement instruments instead of a gauze square wrapped around the finger is considered:

A)Standard bioburden control
B)Safe practice control
C)Engineering control
D)Work practice control

Question 48

All of the following methods inhibit the formation of biofilm in dental unit waterlines (DUWLs) EXCEPT one. Which one is the EXCEPTION?

A)Flushing waterlines for 2 minutes
B)Independent water reservoir
C)Chemical disinfection of waterlines
D)Sterile water delivery systems

Question 49

How often should biologic indicators be used to test sterilizing equipment? Biologic monitors should be used once every:

A)Day
B)Week
C)Month
D)Quarter

Question 50

In most cases, what is the number of bacteria in the water exiting from an untreated dental unit water line?

A)Lower than in drinking water
B)The same as in drinking water
C)Higher than in drinking water
D)Depends on municipal water