ADC Practice Question — Chemical Indicators

What is the correct sequence of daily tests Emily must perform before loading the first batch of instruments?

Infection control in the ADC exam tests decision-making around exposure incidents, instrument classification, and decontamination protocols. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

Emily, the dental assistant at Dr Park's practice, arrives at 7:30 AM to prepare the reprocessing area. The practice uses a Type B pre-vacuum steam steriliser. She needs to perform the required daily tests before processing the first load of instruments for the day. What is the correct sequence of daily tests Emily must perform before loading the first batch of instruments?

A. Bowie-Dick test → Vacuum leak rate test → First live load
B. First live load with Class 6 CI → Bowie-Dick test → Remaining loads
C. Vacuum leak rate test → Bowie-Dick test → First live load
D. Biological indicator test → Vacuum leak rate test → First live load

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Sources cited

Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more

Show the answer and cited explanation

Correct answer: C

The vacuum leak rate test must be performed prior to commencing the first sterilising cycle of the day (for sterilisers without automatic air leak detection). The Bowie-Dick type test must be run immediately after the vacuum leak rate test and before any live load with RMDs, in an otherwise empty chamber using a special cycle. (ICG pp.49)

Source: ICG Section D: Steam Steriliser Performance Tests

Remy's study tip — The differentiator is usually the Spaulding classification level or the step order in a protocol.

Exam preparation FAQ

How do I approach an unfamiliar Chemical Indicators vignette?

Extract key clinical data from the stem before reading options. There are usually 3–4 critical variables that determine the correct answer.

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