OSSSC Nursing Officer-2023
Applied Microbiology & Infection control
Medium
Which of the following item is NOT sterilized by antiseptic solution?
Appeared in: OSSSC Nursing Officer-2023
Explanation
- Surgical scissors are classified as 'critical' items under the Spaulding classification because they are used to cut skin and tissues, entering sterile parts of the body.
- Critical items present a high risk of infection if contaminated and therefore must undergo sterilization, which completely eliminates all microbial life, including spores.
- The standard method for sterilizing metal surgical instruments is steam under pressure (autoclaving), not chemical solutions like antiseptics.
- Antiseptic solutions are designed for use on living tissue (e.g., skin preparation before surgery) and are not strong enough to achieve sterilization of instruments.
Why Other Options Were Wrong
- Option A: A suction catheter is a 'semicritical' item because it contacts the mucous membranes of the respiratory tract. It requires high-level disinfection (HLD), which can be done with chemical solutions, but not sterilization by autoclave.
- Option B: An enema tube is a 'semicritical' item as it comes into contact with the mucous membranes of the gastrointestinal tract. It requires high-level disinfection, not sterilization.
- Option D: A nasogastric (NG) tube is also a 'semicritical' item because it passes through the nares and esophagus into the stomach, contacting mucous membranes. It requires high-level disinfection. Many are also single-use and come pre-sterilized.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Spaulding Classification and Principles of Sterilization vs. Disinfection as background academic context rather than a clinical decision trigger.
- Understanding and applying the Spaulding classification is fundamental to preventing healthcare-associated infections (HAIs). Improperly processed instruments can transmit pathogens and lead to serious patient harm.
- Nurses are directly responsible for ensuring that patient care items are appropriately cleaned, disinfected, or sterilized before use. This includes checking sterilization indicators on packages and adhering to facility protocols.
- What if the item was a flexible endoscope? An endoscope is a classic example of a semicritical item that is difficult to clean. It requires meticulous manual cleaning followed by high-level disinfection. Failures in endoscope reprocessing are a known cause of infectious outbreaks in healthcare settings.
How to Approach the Question
- First, identify the negative keyword 'NOT'. This means you are looking for the item that does not belong with the specified method.
- Define the key terms in the question: 'sterilized' and 'antiseptic solution'. Recall that sterilization is the complete destruction of all microbes, while antiseptics are for use on skin.
- Apply the Spaulding classification to each option. Categorize each item as critical, semicritical, or noncritical based on where it will be used on a patient.
- Determine the required level of processing for each category. Critical items need sterilization. Semicritical items need high-level disinfection.
- Compare the required processing level with the method mentioned in the question ('sterilized by antiseptic solution').
- The surgical scissor is a critical item requiring true sterilization (e.g., autoclave), making 'antiseptic solution' an incorrect method. The other items are semicritical and are processed differently, making the scissor the correct answer to the 'NOT' question.
Concept Tested & Keywords
- Concept Tested: Spaulding Classification and Principles of Sterilization vs. Disinfection
- Stem keywords: sterilized, antiseptic solution
- Lead-in keywords: NOT
- Negative lead-in flag: The question asks which item is NOT processed in a specific way, requiring careful elimination of the options that are.
Question ID
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Reference Book
E6 Nursing Fundamentals Taylor p. 172-174
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 82-84
E6 Nursing Fundamentals Potter Perry 12e Part 2 p. 231-233
Practise the full OSSSC Nursing Officer-2023
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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