CER Endoscope Reprocessing Fundamentals 4 — Questions and Answers
Question 1: How should a reprocessed flexible endoscope be stored after drying?
- Coiled tightly in a sealed plastic bag
- Hanging vertically in a ventilated cabinet with caps removed (Correct answer)
- Immersed in a disinfectant solution until next use
- Lying horizontally in a closed drawer
Correct answer: Hanging vertically in a ventilated cabinet with caps removed
Endoscopes should be hung vertically in a well-ventilated cabinet with all caps and valves removed to allow complete drying and prevent microbial growth.
Question 2: What is the recommended maximum storage time for a reprocessed endoscope stored in a drying cabinet before it must be reprocessed?
- 24 hours
- 48 hours
- 7 days
- There is no universally agreed maximum — follow facility policy based on evidence (Correct answer)
Correct answer: There is no universally agreed maximum — follow facility policy based on evidence
No universal consensus exists on maximum hang time; facilities should follow evidence-based guidelines and manufacturer instructions, with many recommending reprocessing after 5–7 days of storage.
Question 3: Which enzyme is most important in enzymatic detergents used for endoscope pre-cleaning?
- Lipase
- Protease (Correct answer)
- Amylase
- Cellulase
Correct answer: Protease
Protease is the primary enzyme in enzymatic detergents used for endoscope cleaning because it breaks down protein-based organic material, which constitutes the bulk of clinical bioburden.
Question 4: What does the term 'critical item' mean according to the Spaulding Classification?
- An item that contacts intact skin and requires low-level disinfection
- An item that contacts mucous membranes and requires high-level disinfection
- An item that enters sterile tissue or the vascular system and requires sterilization (Correct answer)
- An item that is used in critical care settings
Correct answer: An item that enters sterile tissue or the vascular system and requires sterilization
Critical items enter sterile body cavities or the vascular system and present the highest infection risk, requiring sterilization before use.
Question 5: During manual channel brushing, what should be done when the brush exits the distal end of the channel?
- Immediately retract the brush back through the channel
- Rinse the brush in clean water before the return stroke (Correct answer)
- Continue brushing in the same direction only — never retract through the channel
- Inspect the brush for bristle integrity before reinserting
Correct answer: Rinse the brush in clean water before the return stroke
The brush should be rinsed in clean enzymatic solution or water after each pass to remove debris before reinsertion, preventing redistribution of contamination.
Question 6: What is the primary hazard associated with using glutaraldehyde without adequate ventilation?
- Fire and explosion risk
- Respiratory sensitization and occupational asthma (Correct answer)
- Skin bleaching and chemical burns
- Rapid degradation of the disinfectant solution
Correct answer: Respiratory sensitization and occupational asthma
Glutaraldehyde vapor is a respiratory sensitizer that can cause occupational asthma and other respiratory conditions even at low concentrations, making adequate ventilation essential.
Question 7: Which of the following accessories used during endoscopy is considered a single-use item and must NEVER be reprocessed?
- Biopsy forceps used for tissue sampling (Correct answer)
- Water bottles and their connecting tubing
- Endoscope caps and valves
- Light guide cables
Correct answer: Biopsy forceps used for tissue sampling
Biopsy forceps that penetrate the mucosa are classified as critical single-use items; reprocessing them risks patient infection and is prohibited by FDA regulations and manufacturer instructions.
CER Endoscope Reprocessing Fundamentals 4
How should a reprocessed flexible endoscope be stored after drying?