Questions for SSI:

Select the best answer for the following questions:

  1. The mortality associated with SSIs following cardiac surgery is 7-25%
  2. True
  3. False
  4. Risk factors for SSI following cardiac surgery include
  5. Diabetes
  6. Removing hair with a razor
  7. Obesity
  8. a and c
  9. All of the above
  10. Prophylactic antibiotics must have therapeutic levels at the site of incision prior to incision to be effective. In order to achieve this:
  11. All antibiotics should be given 2 hours prior to incision to allow maximum effectiveness
  12. If indicated, Vancomycin or Clindamycin should be given over one hour and must be completely infused before incision is made
  13. Cephalosporin antibiotics (e.g cefazolin (Ancef)) should be given no more than 1 hour before incision.
  14. b and c
  15. None of the above.
  16. The STS recommends Cefazolin as the first line agent for surgical prophylaxis.
  17. True
  18. False
  19. 1st generation Cephalosporins with a short half-life should be redosed every 4 hours during the surgical procedure.
  20. True
  21. False
  22. Prophylactic antibiotics should be continued
  23. Until chest tubes are removed
  24. Until all drains are removed
  25. Until pacing wires are removed
  26. All of the above
  27. a and c only
  28. None of the above
  29. For patients with a true penicillin allergy, the recommended antibiotics for prophylaxis is: Vancomycin. When administering Vancomycin, one should consider adding Gentamicin.
  30. True
  31. False
  32. If a patient reports a simple rash to a penicillin in the past, you should never give a cephalosporin
  33. True
  34. False
  35. Because there is an increasing number of patients with MRSA colonization in the community, all cardiac surgery patients should receive Vancomycin as part of their antibiotic prophylaxis for cardiac surgery.
  36. True
  37. False
  38. Mupirocin can be used intra-nasally for MRSA de-colonization. There is demonstrated benefit in those patients who are not colonized.
  39. True
  40. False
  41. When removing hair for surgery, it is best that patients shave at home so not to contaminate the site or the operating room on the day of surgery.
  42. True
  43. False
  44. When removing hair, ideally it should be removed the night before surgery to allow time for the skin to heal prior to using the skin prep.
  45. True
  46. False
  47. When removing hair, it is best that hair be removed from the extended chest area. If you only remove the hair from right around the site then hair from nearby areas would be a potential contaminant.
  48. True
  49. False
  50. Skin prep for the primary and donor site incisions can occur at the same time as the skin prep for central line insertion to improve efficiency.
  51. True
  52. False
  53. When prepping for surgery, chlorhexidine should be applied in a spiral motion like Betadine, starting at the incision site and moving outward to avoid dragging contaminants into the area of the surgical site. It is meant to be ‘painted’ on the skin like Betadine.
  54. True
  55. False
  56. When using a chlorhexidine skin prep, the skin incision needs to be made
  57. Within one minute after prep
  58. Anytime before the prep dries
  59. 3 minutes or after the prep dries
  60. Within 3 minutes after prep
  61. The needleless connector on IV tubing lines needs to be scrubbed for 30 seconds with 70% alcohol or Chlorascrub before access.
  62. True
  63. False
  64. Surgical site infections that occur after discharge are not attributed to the primary surgical procedure.
  65. True
  66. False
  67. The Society of Thoracic Surgeons blood glucose management recommendations are to keep intraop and postoperative glucoses below
  68. ≤200 mg/dL
  69. ≤180mg/dL
  70. 80-110 mg/dL
  71. To be compliant with the Surgical Care Improvement Program’s metric for glucose control in cardiac surgery
  72. The post-prandial glucoses need to be ≤200mg/dL during the first 2 days following surgery
  73. All glucoses need to be ≤200mg/dL during the first 2 days following surgery
  74. The first morning glucoses need to be ≤200mg/dL during the first 2 days following surgery
  75. The glucoses at 6AM need to be ≤200mg/dL on the first 2 days following surgery
  76. The glucoses at 6AM need to be ≤180mg/dL on the first 2 days following surgery

Answers

1. a

2. e

3. d

4. a

5. a

6. f

7. a

8. b

9. b

10. b

11. b

12. b

13. b

14. b

15. b

16. c

17. a

18. b

19. b

20. c