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CNOR 2024 Zander Exam with complete solutions 2024_2025.
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CNOR 2024 Zander Exam with complete solutions 2024_2025.
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CNOR 2024 Zander Exam with completesolutions 2024/2025
Name the 3 Spaulding Classification Systems - ANSWER-Critical
Semi-Critical
Non-Critical
Meaning of Critical Spaulding Classification System - ANSWER-Items MUST be
sterile.
Items will enter -sterile tissue- or -vascular system-
Examples of items in Critical Spaulding Classification System - ANSWER--
Instruments-
-Laparoscopes- -Arthroscopes-
-*Cutting endoscope accessories for biopsy*-
-Cardiac Caths-
-IV caths- - Needles-
-*Urinary Caths-
Meaning of Semi-Critical Spaulding Classification System - ANSWER-Items
SHOULD be sterile.
Items will contact -broken skin- or -MM-
If the manufacturers instructions say it WON'T tolerate sterilization, they CAN be
HLD (but only IF MF SAYS).
-Spores survive HLD-
,Examples of items in Semi-Critical Spaulding Classification System - ANSWER--
Bronchoscopes
-GI Scopes/GI endoscopes
-RT equipment (laryngoscope blades)
-Anesthesia equipment
Meaning of Non Critical Spaulding Classification System - ANSWER--Will be in
contact with INTACT SKIN
-Intermediate or Low Level Disinfection or Cleaning.
-Disinfect with an FDA approved disinfectant that's effective against HEP B.
Examples of items in Non Critical Spaulding Classification System - ANSWER--
Furniture
-Laundry/Linens
-OR bed
-BP Cuff/Leads/Monitors/Stethoscopes
-Tourniquets
Requirement for decontamination area: - ANSWER--Must have a physical WALL
or SEPARATION between decontam and processing areas.
-This includes Immediate Use Areas.
-Why: Because decontam requires NEGATIVE PRESSURE
Sterile Processing Workflow - ANSWER-Decontamination (always 1st) -->
Prep&Pack -->Sterilization
-->Distribute/Store
Most important step to prevent infection: - ANSWER-Cleaning and Pre-treating
with a non-drying enzymatic solution in order to avoid biofilm, which
encapsulates spores.
Decontamination processes - ANSWER--Disassemble everything
-Brush lumens/channels using a brush based on mfr instruction for correct
diameter and length of lumen
-Brush lumens/channels/crevices/joints UNDER WATER
-Automated (washers/ultrasonic) more effective than manual cleaning.
Two Types of Steam Sterilization - ANSWER--Pre-Vac Autoclave/Dynamic Air
Removal
-Gravity Displacement
,PreVac settings - ANSWER-270-276
3 min (NON porous instruments/regular instruments)
4 min (POROUS or LUMEN instruments, heavy plastic, rubber, wooden handles,
poole suction)
PreVac/Dynamic Air Removal setting for porous (heavy plastic, rubber, wood
handels) or lumen instruments (poole suction/channels) - ANSWER-270-276 for 4
min
PreVac/Dynamic Air Removal setting for Non Porous instruments - ANSWER-270-
276 for 3 min
How does PreVac/Dynamic Air Removal autoclave work? - ANSWER--Sucks air
out of chamber with a VACCUM then steam is released and snaps down onto
inst/trays.
-DRAINS MUST BE CLEAN
-Most common. Most effective.
Gravity Displacement Autoclave settings - ANSWER-270-276
3 min: NonPorous/reg instruments
10 min: Porous/Lumens
Gravity Displacement autoclave settings for porous/lumens - ANSWER-270-276
10 min
Gravity Displacement autoclave settings for NonPorous/reg inst - ANSWER-270-
276 3 min
How does Gravity Displacement autoclave work? - ANSWER-Steam pushes air
down to a thermometer in the drain, the air exits the chamber, drain closes, cycle
starts.
-Not great for trays or packages.
-Rarely used.
, Both PreVac/Dynamic Air Removal and Gravity time and temperature
requirements are for the instrument and autoclave only.
For certain containers/systems such as One Tray system or containers with lids: -
ANSWER-I will follow the manufacturers instructions!
3 ways to avoid condensation with steam sterilization items: - ANSWER-- Allow
airflow between trays and pkgs and all the way around.
-Remove loads immediately (don't crack the door to cool).
-Don't place items on cooling racks or solid surfaces (can place on lined
surfaces).
How many classes of Chemical Integrators? - ANSWER-6
What kind of chemical integrators react to heat? - ANSWER-Class 1 Chemical
Indicator
-Reacts to HEAT only. Verifies exposure only.
-Tape-Locks-Filter dots
What kind of chemical integrator is an External Indicator? - ANSWER-Class 1
Chemical Indicator
External Indicator that reacts to Heat only
-Tape-Locks-Filter dots
What class of Chemical Indicator is the Bowie Dick, and what does it react to? -
ANSWER--Class 2 Chemical Indicator
-Reacts to PRESSURE and ONLY indicates a VACUUM was created.
-Used only with PreVac/Dynamic Air Removal cycles
What class of chemical indicator measures
-Single Parameter?
-Multi Parameter? - ANSWER--Class 3 Single (Ex: quality of steam)
-Class 4 Multi (Ex: Time+Temp)
-Class 3&4 are usually made by the manufacturer.
Which class of chemical indicator is the most common all inclusive integrator? -
ANSWER-Class 5 Chemical Integrator/Indicator is the
-most common
-covers ALL parameters (time/temp/pressure/steam quality)
-ALL INCLUSIVE
-internal
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