RADT 153 — Unit 2 Practice Exam

What is medical asepsis?

Creating an environment that is as clean as possible by minimizing the number of microorganisms — it does not completely eliminate them. Medical asepsis is essentially cleanliness.

What is surgical asepsis?

The complete elimination of ALL microorganisms AND their reproductive spores. Required any time there is a break in skin or a mucous membrane is involved.

What is the key difference between medical asepsis and surgical asepsis?

Medical asepsis minimizes microorganisms (cleanliness). Surgical asepsis completely eliminates all microorganisms AND their reproductive spores. Surgical asepsis is required for any invasive procedure.

What does it mean to sterilize something?

To completely eliminate ALL microorganisms including their reproductive spores. This is different from disinfection, which only reduces microorganisms without eliminating all spores.

What is the difference between disinfection and sterilization?

Disinfection reduces microorganisms significantly but does NOT eliminate all spores — some organisms survive. Sterilization completely eliminates all microorganisms AND their spores. Boiling water = disinfection. Autoclaving = sterilization.

Why is boiling water considered disinfection and NOT sterilization?

Because some microorganisms and spores can survive and withstand very high temperatures. Since not all microorganisms are eliminated, it is disinfection — not sterilization.

What are two examples of physical disinfection methods?

Boiling water and ultraviolet (UV) rays.

What is the most common method of sterilization and how does it work?

Autoclaving — steam under pressure above 270°F. It works like pressure cooking: the combination of heat and pressure completely eliminates all microorganisms and their spores.

What materials CANNOT be autoclaved?

Rubber, plastic, and resin — they cannot withstand the high heat of autoclaving. Different materials require different sterilization methods.

Why are there different methods of sterilization?

Because instruments are made from many different materials (cotton, cloth, rubber, plastic, resin) that cannot all withstand the same sterilization process. The method must match the material.

What is an invasive procedure?

Any procedure involving a break in skin, contact with a mucous membrane, or any instrument — including non-sharp items like cotton balls and gauze — entering the body.

12. Give four examples of invasive procedures from the review.

1. Inserting a urinary catheter

2. Any injection (breaks the skin)

3. Wound care / applying a dressing to broken skin

4. Tracheostomy care (opening in the neck with a breathing apparatus — cleaning that site is invasive)

13. Why does surgical asepsis apply to invasive procedures?

Because the skin is the body's number one protective barrier. Once that barrier is broken, microorganisms have a direct pathway into the body — surgical asepsis is required to prevent infection.

14. What causes nosocomial infections?

Poor medical asepsis and surgical asepsis practices. Nosocomial infections are hospital-acquired infections resulting from failure to maintain a clean and sterile environment.

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SECTION 3: ZONES AND BARRIERS

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15. What are the three zones in a surgical environment and where is each located?

Zone 1 (Unrestricted): Waiting rooms, reception areas — no special attire required.

Zone 2 (Semi-restricted): Locker rooms, pre-surgical and post-surgical areas — scrubs required, no mask needed.

Zone 3 (Restricted): The surgical room itself — scrubs plus mask and head cover required.

16. What attire is required in Zone 2?

Scrubs only. No mask or head cover required.

17. What attire is required in Zone 3?

Scrubs plus mask and head cover. In the OR, this is mandatory with no exceptions.

18. What is the key difference in attire between Zone 2 and Zone 3?

The mask. Zone 2 requires only scrubs. Zone 3 requires scrubs plus mask and head cover — because Zone 3 is the surgical room.

19. What is the purpose of barriers in a surgical environment?

To prevent outside contaminants from entering the sterile space. Every time a door to the surgical room opens, outside air and potential microorganisms enter. Barriers minimize this risk.

20. Why should traffic in and out of a surgical room be minimized?

Every time the door opens, outside air and its microorganisms enter the surgical room. Fewer entries means lower contamination risk to the sterile environment.

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SECTION 4: DRESS AND BEHAVIOR PROTOCOL

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21. Are long nails (including artificial nails) allowed in the surgical environment?

No. Long and artificial nails are not allowed. They harbor microorganisms and can puncture sterile gloves.

22. Is jewelry allowed in the surgical environment?

No. Jewelry is not allowed. It harbors microorganisms and can interfere with sterile technique.

23. Are shoe covers required, and what is their actual purpose?

No — shoe covers are optional. Their only purpose is to protect shoes from blood and fluid splash. They do NOT contribute to sterility. Anything below the waist is never sterile regardless.

24. Why are open-toed shoes and Crocs discouraged in the surgical environment?

Blood or fluid can enter through holes or open areas and contact porous skin. Sharp instruments can also injure exposed toes. They do not provide adequate protection — but they are discouraged, not prohibited.

25. How must a mask be properly worn in surgery?

It must fully cover both the nose and mouth with no gaps. It should not be cross-tied. It is single-use — do not reuse it.

26. What are the common causes of contamination in a surgical environment?

1. Contaminated instruments

2. Contaminated gloves

3. Wet or damp sterile field (moisture allows microorganism strike-through)

4. Poor ventilation (air circulation carries microorganisms)

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SECTION 5: SCRUBBED IN & STERILITY

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27. What does "being scrubbed in" mean?

Being directly involved at the surgical site and dressed in sterile attire. Scrubbed-in personnel are the only ones considered sterile in the room.

28. What two things make a person sterile?

A sterile gown AND sterile gloves — both are required. Everything else (scrubs, mask, head cover) is considered clean but not sterile.

29. Who is considered directly involved in an invasive procedure?

Those working at the surgical site — the scrubbed-in personnel (surgeon, scrub tech, etc.).

30. Who is considered indirectly involved in an invasive procedure?

Those in the room but NOT at the surgical site — such as the RT at the X-ray controls, the circulator, and others. They must be constantly aware of their surroundings and must not touch anything sterile.

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SECTION 6: TEAM ROLES — MATCHING

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31. What does a surgeon do?

Plans and performs the surgical or interventional procedure. The primary physician responsible for the operation. In IR, this role is filled by a radiologist or vascular specialist.

32. What does a surgical assistant do?

Assists the surgeon directly during the procedure — passes instruments, provides exposure, and supports the primary physician at the surgical site. Is part of the sterile team.