CER Endoscope Reprocessing Fundamentals 3 — Questions and Answers
Question 1: When using an automated endoscope reprocessor (AER), which step must still be performed manually first?
- High-level disinfection
- Manual cleaning (Correct answer)
- Channel drying
- Final rinse with sterile water
Correct answer: Manual cleaning
Manual cleaning must always precede AER use because automated reprocessors cannot remove gross contamination; they are designed for disinfection, not cleaning.
Question 2: Which of the following high-level disinfectants requires a minimum exposure time of 20 minutes at 20°C?
- 2% glutaraldehyde (Correct answer)
- 0.55% ortho-phthalaldehyde (OPA)
- Peracetic acid
- Hydrogen peroxide
Correct answer: 2% glutaraldehyde
2% glutaraldehyde requires at least 20 minutes at 20°C (68°F) to achieve high-level disinfection of flexible endoscopes.
Question 3: What is the main advantage of ortho-phthalaldehyde (OPA) over glutaraldehyde for endoscope reprocessing?
- It has a shorter exposure time and lower vapor toxicity (Correct answer)
- It sterilizes rather than just disinfects
- It requires no personal protective equipment
- It is effective at lower temperatures
Correct answer: It has a shorter exposure time and lower vapor toxicity
OPA offers a shorter required exposure time (12 minutes) and produces significantly lower vapor pressure than glutaraldehyde, reducing occupational exposure risks.
Question 4: What action should be taken if an endoscope fails a leak test?
- Proceed with cleaning and disinfection, then retest
- Remove it from service and send it for repair (Correct answer)
- Increase the exposure time during high-level disinfection
- Perform a second leak test using higher pressure
Correct answer: Remove it from service and send it for repair
An endoscope that fails a leak test must be removed from service immediately and sent for repair, as immersion can cause extensive internal damage.
Question 5: Which personal protective equipment (PPE) is required when handling high-level disinfectants like glutaraldehyde?
- Standard nitrile gloves and a surgical mask
- Chemical-resistant gloves, gown, eye protection, and face shield (Correct answer)
- Standard gloves and gown only
- Eye protection alone is sufficient for brief exposures
Correct answer: Chemical-resistant gloves, gown, eye protection, and face shield
Chemical-resistant gloves, a gown, eye protection, and a face shield are required when handling glutaraldehyde because it is a potent sensitizer and irritant.
Question 6: What is the correct water quality for the final rinse after high-level disinfection?
- Tap water filtered through a 0.2-micron filter
- Sterile water or water filtered through a 0.1-micron filter (Correct answer)
- Distilled water
- Any potable water supply
Correct answer: Sterile water or water filtered through a 0.1-micron filter
The final rinse must use sterile water or water that has passed through a 0.1-micron or smaller filter to prevent recontamination from waterborne microorganisms.
Question 7: Which of the following best describes 'minimum effective concentration' (MEC) of a high-level disinfectant?
- The concentration at which the solution begins to cause skin irritation
- The lowest concentration that still achieves the required level of microbial kill (Correct answer)
- The concentration recommended by the manufacturer at time of activation
- The maximum concentration allowed by OSHA standards
Correct answer: The lowest concentration that still achieves the required level of microbial kill
MEC is the lowest concentration of a high-level disinfectant that still achieves the required microbial kill; solutions testing below MEC must be discarded.
CER Endoscope Reprocessing Fundamentals 3
When using an automated endoscope reprocessor (AER), which step must still be performed manually first?