CBSPD CFER Certified Flexible Endoscope Reprocessor

When should bedside pre-cleaning of a flexible endoscope begin after the procedure ends?

• AWithin minutes, before bioburden dries
• BWithin 4 hours when the technician is available
• COnly after transport to the decontamination room
• DAfter the leak test is performed

What is the primary reason for performing point-of-use pre-cleaning on a flexible endoscope?

• ATo prevent organic material from drying and forming biofilm
• BTo replace the need for manual cleaning
• CTo disinfect the scope before transport
• DTo verify channel patency

How should a contaminated flexible endoscope be transported from the procedure room to the decontamination area?

• AIn a closed, leak-proof, labeled biohazard container
• BCoiled openly on a clean transport tray
• CWrapped in a clean blue wrap
• DIn its original storage cabinet hanger

Which solution is typically used at the bedside to wipe the exterior insertion tube during pre-cleaning?

• AAn enzymatic detergent solution on a lint-free cloth
• B70% isopropyl alcohol
• CA sterile saline rinse
• D0.55% ortho-phthalaldehyde

What action immediately follows wiping the insertion tube during point-of-use treatment?

• ASuction enzymatic detergent and water through the channels
• BPlace the scope into a peracetic acid bath
• CHang the scope in a drying cabinet
• DBegin the leak test in the procedure room

Why must the elevator mechanism on a duodenoscope receive special attention during pre-cleaning?

• AIts hinged design traps biofilm and was implicated in CRE outbreaks
• BIt contains active electronic components
• CIt cannot be exposed to any liquid
• DIt is the only sterile portion of the scope

What is the maximum recommended time between the end of a procedure and the start of manual reprocessing per most manufacturer IFUs?

• A1 hour, unless delayed reprocessing protocol is followed
• B8 hours under any conditions
• C24 hours if the scope is bagged
• DThere is no time limit

Which PPE is required when performing bedside pre-cleaning of a contaminated flexible endoscope?

• AFluid-resistant gown, gloves, mask, and eye protection
• BSterile gown and sterile gloves only
• CSurgical mask and gloves only
• DNo PPE if the scope was used on a low-risk patient

How should the transport container be labeled when moving a contaminated endoscope?

• AWith a biohazard symbol indicating contaminated contents
• BWith the patient's room number
• CWith a green 'clean' tag
• DNo labeling is necessary inside a hospital

Why are clean and contaminated endoscopes never transported in the same container?

• ATo prevent cross-contamination of reprocessed scopes
• BTo avoid scratching the lenses
• CBecause clean scopes weigh less
• DBecause manufacturers ship them separately

What information should accompany a contaminated scope to the decontamination area?

• AScope serial number and procedure identifier for traceability
• BOnly the patient's full chart
• CThe next scheduled procedure time
• DNothing - tracking begins after HLD

What is the consequence of allowing bioburden to dry inside endoscope channels?

• AFormation of biofilm that resists cleaning and disinfection
• BImproved disinfectant penetration
• CReduced channel diameter that can be polished smooth
• DNo consequence if HLD contact time is doubled

Which item should be removed from the scope before transport to decon?

• ADisposable valves and accessories used during the procedure
• BThe light guide connector
• CThe umbilical cord
• DThe bending section rubber

Why must the air/water and biopsy channels be flushed during bedside pre-cleaning?

• ATo remove gross debris before it dries inside narrow lumens
• BTo pressurize the scope for the leak test
• CTo prime the channels with disinfectant
• DTo verify image quality

Where should bedside pre-cleaning supplies (enzymatic, cloths, container) be staged?

• AStocked and ready in the procedure room before the case begins
• BRetrieved from central supply after the case ends
• CStored in the patient's room
• DPulled from the decontamination sink area

When in the reprocessing workflow must a leak test be performed?

• AAfter pre-cleaning and before manual cleaning
• BAfter manual cleaning and before HLD
• CAfter HLD and before drying
• DOnly weekly as preventive maintenance

What is the purpose of underwater inspection during a leak test?

• ATo visualize bubbles indicating exact leak location
• BTo rinse residual detergent from the scope
• CTo activate the disinfectant
• DTo soften the bending rubber

If a leak is detected during testing, what is the correct action?

• ARemove the scope from service and send for repair without further reprocessing
• BContinue with manual cleaning to determine if it worsens
• CIncrease HLD contact time to compensate
• DApply silicone sealant and proceed

How long should a wet leak test typically be observed per manufacturer IFU?

• AAt least 30-60 seconds while articulating the bending section
• B5 seconds with the scope straight
• C10 minutes with the scope coiled
• DOnly as long as the technician chooses

What type of detergent is required for manual cleaning of flexible endoscopes?

• ALow-foaming, neutral or near-neutral pH enzymatic detergent
• BHigh-foaming alkaline degreaser
• CBleach-based solution
• DPlain hospital-grade soap

Which of the following is required when using enzymatic detergent for endoscope cleaning?

• ASingle-use solution discarded after each scope
• BReuse for an entire shift to conserve cost
• CReuse until visibly soiled
• DReuse for 24 hours regardless of soil load

Why must a dedicated channel brush be matched to the channel size being cleaned?

• AAn undersized brush misses surfaces; an oversized brush damages channels
• BAll brushes are identical; sizing is cosmetic
• CBrush size affects only the handle
• DSizing applies only to disposable brushes

What is the correct technique when brushing a flexible endoscope channel?

• APass the brush completely through, clean visible debris from the bristles, and repeat unt…
• BReverse direction inside the channel multiple times
• CBrush only halfway and withdraw
• DUse one pass per channel regardless of soil

How should manual cleaning of the scope exterior be performed?

• ASubmerged in detergent and wiped with a soft, lint-free cloth
• BSprayed with high-pressure water above the sink
• CWiped with a stiff metal brush
• DCleaned only with dry cloths to avoid water damage

What temperature range is typically specified for enzymatic detergent solutions?

• APer IFU, generally 20-43°C (68-110°F)
• BAbove 80°C to maximize activity
• CBelow 5°C to preserve enzymes
• DBoiling water only

What is verified by a borescope inspection of an endoscope channel?

• AInternal channel cleanliness, scratches, or residual debris invisible from the outside
• BExternal lens magnification
• CLight guide brightness
• DPatient image clarity

Which adjunct cleaning verification can detect residual protein or ATP after manual cleaning?

• AATP bioluminescence or protein test swabs
• BVisual inspection alone
• CMEC strips for HLD
• DSpore strip biological indicators

Why must each channel be brushed individually using its specifically sized brush?

• ADifferent channel diameters require different brushes for full bristle contact
• BOnly the biopsy channel actually needs brushing
• CAir channels never need cleaning
• DSuction channels are too small to brush

What is the recommended status of channel brushes that show damaged bristles?

• ADiscard immediately - damaged brushes cannot clean properly and may shed
• BContinue use until end of shift
• CTrim the bristles and continue
• DUse only on less-soiled scopes

After manual cleaning, what is the next required step before high-level disinfection?

• AThorough rinse with utility or critical water per IFU
• BImmediate transfer to drying cabinet
• CApplication of alcohol
• DSpore strip placement

Why is it dangerous to skip the leak test even on a scope that passed yesterday?

• ADamage can occur during any procedure or handling between cycles
• BLeak tests are only required quarterly
• CYesterday's test remains valid for one week
• DSkipping is acceptable if the scope looks intact

Which water quality is generally recommended for the final rinse after HLD per AAMI ST91?

• ACritical water (treated, low microbial and endotoxin levels)
• BTap water with no treatment
• CSaline solution
• DDistilled vinegar

How is the scope's exterior pressurized during a typical leak test?

• AConnected to a leak tester that pressurizes the internal cavity with air
• BBy submerging in heated water
• CBy suctioning detergent through it
• DBy blocking all channels and squeezing

Where in the workflow should the dirty-to-clean separation occur in the decontamination room?

• AA physical barrier or one-way workflow from dirty to clean
• BSame sink for cleaning and rinsing
• CCombined wash and HLD basin
• DNo separation is needed if technicians wear PPE

What is the purpose of using channel adapters during manual cleaning?

• ATo direct detergent flow through every internal channel
• BTo replace the scope's distal tip
• CTo plug channels permanently
• DTo bypass the leak test

What action is required if the scope is dropped during reprocessing?

• AInspect, leak test, and contact the manufacturer if damage is suspected
• BContinue reprocessing if it looks intact
• CSpray with disinfectant and proceed
• DDiscard the scope immediately

Which step is critical immediately after attaching the leak tester but before submerging the scope?

• AVerify the scope holds pressure (dry leak check)
• BAdd bleach to the water
• CHeat the scope to 60°C
• DApply alcohol to all valves

Why should the scope be fully immersed during manual cleaning rather than cleaned at a partial depth?

• ASubmersion prevents aerosolization of contaminated fluids
• BSubmersion makes the scope easier to bend
• CPartial cleaning is faster and equally effective
• DSubmersion is only required for sterilizable scopes

What documentation should be captured for each leak test?

• APass/fail result, technician initials, scope serial, and date/time
• BOnly the technician's name
• COnly the scope serial number
• DNo documentation is required if the test passed

What is the most common point of failure leading to inadequate flexible endoscope cleaning?

• ASkipping or shortening manual cleaning steps before HLD
• BUsing a slightly oversized rinse basin
• CStoring the scope vertically
• DWearing double gloves

Which high-level disinfectant requires no activation step and is commonly used at 0.55% concentration?

• AOrtho-phthalaldehyde (OPA)
• BGlutaraldehyde
• CPeracetic acid
• DHydrogen peroxide gas plasma

What is the typical contact time for 2% glutaraldehyde to achieve high-level disinfection?

• A12 minutes at 25°C
• B30 seconds at 20°C
• C2 hours at room temperature
• D5 minutes at 5°C

What is the typical immersion contact time for 0.55% OPA at 20°C?

• A12 minutes
• B30 seconds
• C60 minutes
• D8 hours

What is the function of MEC test strips in HLD?

• ATo verify the disinfectant remains at or above its Minimum Effective Concentration
• BTo activate fresh glutaraldehyde
• CTo measure water hardness
• DTo detect protein residue on the scope

When must MEC test strips be used during HLD?

• ABefore each cycle (or at least daily) per the IFU
• BOnce per month
• COnly when the disinfectant changes color
• DOnly when a new bottle is opened

Which HLD is associated with high vapor concentrations and requires monitoring of workplace air?

• AGlutaraldehyde
• B0.55% OPA
• C0.2% peracetic acid
• DSodium hypochlorite

What is a known disadvantage of OPA (ortho-phthalaldehyde)?

• AStains skin, clothing, and protein residue gray-black
• BRequires activation prior to use
• CInactivated by light within minutes
• DGenerates toxic chlorine gas