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ADC Practice Question — Management of Sharps

What vaccination verification is required before…

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.

A new dental assistant starts work and reports she was vaccinated against hepatitis B as a child but never had her immunity checked. What vaccination verification is required before clinical duties, and what happens if she is a non-responder?

  • A. Non-responders to HBV vaccine cannot work in healthcare
  • B. She needs a blood test for anti-HBs antibody level: if ≥10 mIU/ml
  • C. Childhood vaccination provides lifelong immunity
  • D. Vaccination records alone are sufficient proof of immunity
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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: B

She needs a blood test for anti-HBs antibody level: if ≥10 mIU/ml, she is immune and can commence clinical duties. If <10 mIU/ml (non-responder or waned immunity), she needs a booster dose followed by repeat testing in 4-8 weeks. If still <10 after booster, a full re-vaccination course (3 doses) is given. If still a non-responder after two full courses (approximately 5-10% of the population), she should be counselled that she remains susceptible to HBV, must take extra precautions with sharps, requires HBIG after any significant exposure, and in some jurisdictions may have restrictions on exposure-prone procedures

Source: Odell 4th Ed, Case 31: A Sharps Injury
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Exam preparation FAQ

How are Management of Sharps questions structured in the ADC written exam?
ADC Management of Sharps questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.
Should I memorise guidelines word-for-word for Management of Sharps?
Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.

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