# A nurse on the medical-surgical unit is reviewing reprocessing requirements for reusable equipment after each patient use. Which assignment of equipment to Spaulding classification is correct?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=372801&lang=en  
> language: en  
> subject: NCLEX-RN  
> category: SIPC

## Question

A nurse on the medical-surgical unit is reviewing reprocessing requirements for reusable equipment after each patient use. Which assignment of equipment to Spaulding classification is correct?

## Option

1. Stethoscope and blood pressure cuff — semicritical, requiring high-level disinfection.
2. Vaginal speculum and rigid bronchoscope — non-critical, requiring low-level disinfection.
3. Surgical instruments entering sterile tissue — semicritical, requiring high-level disinfection.
4. Surgical instruments entering sterile tissue — critical, requiring sterilization; vaginal speculum and rigid bronchoscope — semicritical, requiring high-level disinfection; stethoscope and blood pressure cuff — non-critical, requiring low-level disinfection. **✔ Correct answer**

**Correct answer: 4**

## Explanation

The Spaulding classification (CDC) groups patient-care items by infection risk and prescribes reprocessing accordingly. (1) Critical items enter sterile tissue or the vascular system — surgical instruments, implants, urinary catheters into the bladder — and require sterilization. (2) Semicritical items contact mucous membranes or non-intact skin — endoscopes, vaginal specula, respiratory therapy equipment — and require high-level disinfection (HLD). (3) Non-critical items contact intact skin only — stethoscopes, blood pressure cuffs, bedrails — and require low-level disinfection or cleaning. Choice 4 correctly assigns each example. Choices 1, 2, 3 misclassify either the category or the level of reprocessing.

## In-depth explanation

The Spaulding classification, published by Earle Spaulding in 1957 and adopted by CDC, organizes reprocessing of patient-care items into three categories defined by the infection risk of their use. Critical items penetrate sterile tissue or the vascular system and must be sterilized — surgical instruments, implants, urinary catheters that enter the bladder. Semicritical items contact mucous membranes or non-intact skin and must undergo high-level disinfection (HLD), with sterilization preferred when feasible — gastrointestinal endoscopes, vaginal speculae, rigid bronchoscopes, respiratory therapy equipment, anesthesia equipment. Non-critical items contact intact skin only and require low-level disinfection or cleaning — stethoscopes, blood pressure cuffs, bedrails, bedside tables. Outbreak investigations have repeatedly traced healthcare-associated infections to misclassification or skipping of HLD on semicritical items, especially flexible endoscopes, which require thorough manual cleaning before HLD.

## Clinical scenario

A nurse on the medical-surgical unit is reviewing **reprocessing requirements for reusable equipment** after each patient use using the **Spaulding classification**.

## Key concepts

- **Critical Items** — Penetrate sterile tissue or vascular system. Examples: surgical instruments, implants, urinary catheters entering the bladder, intravenous catheters. Reprocessing: sterilization (steam autoclave is the most common; ethylene oxide or hydrogen peroxide plasma for heat-sensitive items).
- **Semicritical Items** — Contact mucous membranes or non-intact skin. Examples: GI endoscopes, vaginal speculae, rigid bronchoscopes, respiratory therapy and anesthesia equipment. Reprocessing: high-level disinfection (HLD); sterilization preferred when feasible. Thorough manual cleaning before HLD is essential.
- **Non-Critical Items** — Contact intact skin only. Examples: stethoscopes, blood pressure cuffs, bedrails, bedside tables. Reprocessing: low-level disinfection or cleaning between patients with EPA-registered hospital-grade disinfectants.

## Related questions

- [A long-term care resident colonized with vancomycin-resistant enterococcus (VRE) on an adm…](https://mymerci.kr/pages/nclex_q.php?qn_id=372716&lang=en)
- [A nurse receives a phone call from the laboratory: a postoperative patient's potassium is …](https://mymerci.kr/pages/nclex_q.php?qn_id=372746&lang=en)
- [A telemetry unit nurse manager reviews the unit's response to alarm fatigue per The Joint …](https://mymerci.kr/pages/nclex_q.php?qn_id=372750&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=372801&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=372801&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=372801&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=372801&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=372801&lang=vi)

---

More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en)

_For study reference only. Always follow current clinical guidelines and your institution’s protocols._