感染控制与患者安全：速成包

公式表、每个专题的关键方法步骤和 6 道练习题，完整解答附在最后。

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1公式与方法

感染控制与患者安全

方法

  1. 对每位患者都从标准预防开始：手卫生、针对预期暴露的个人防护装备、安全使用锐器。
  2. 按传播途径追加预防措施：接触传播（隔离衣、手套）、飞沫传播（外科口罩）、空气传播（N95、负压病房）。
  3. 保持无菌物品的无菌状态：如有疑问就视为不无菌；更换，绝不擦拭。
  4. 预防环境中的伤害：防跌倒措施，约束仅作为最后手段，火灾时用 RACE 和 PASS。
  5. 核对给药的正确原则、两个身份识别信息，以及对高警示药物的额外保障；报告差错和险兆事件。

2练习题

1.感染控制与患者安全中等

Before inserting a peripheral IV, the nurse cleans the skin with chlorhexidine-alcohol. What should the nurse do next?

  1. AFeel for the vein again with an ungloved finger
  2. BLet it dry fully and do not touch the site again
  3. CBlow on the site so it dries faster
  4. DWipe it off with a dry gauze straight away
2.感染控制与患者安全困难

A visitor becomes very agitated and starts shouting at the nurse in a patient’s room. What should the nurse do first?

  1. ATurn away from the visitor and continue with the patient’s care as normal
  2. BKeep a safe distance and a clear exit, speak calmly and call security if needed
  3. CRaise the voice to show who is in charge
  4. DTouch the visitor’s arm to help them calm down
3.护理学基础中等

Why does long-term immobility increase the risk of kidney stones?

  1. ALying flat makes the kidneys produce extra uric acid
  2. BCalcium released from bone raises the calcium in the urine
  3. CThe kidneys stop producing urine during bed rest
  4. DPatients on bed rest drink too much fluid
4.护理学基础困难

A patient with heart failure weighs 2 kg more than yesterday on the same scales. What does this most likely show?

  1. AAbout 2 litres of fluid has been retained
  2. BThe patient has gained 2 kg of body fat
  3. CThe patient is becoming dehydrated
  4. DThe scales must have been faulty
5.微生物学中等

许多抗真菌药物以麦角固醇为靶点。为什么这样有效？

  1. A麦角固醇存在于真菌细胞膜中，而人体细胞中没有
  2. B人体细胞利用麦角固醇产生能量
  3. C麦角固醇只存在于病毒中
  4. D麦角固醇是细菌细胞壁的主要结构成分
6.微生物学困难

抗生素的最低抑菌浓度（MIC）是：

  1. A在体外阻止可见细菌生长的最低浓度
  2. B患者能耐受的最高剂量
  3. C开始出现副作用时的血浆浓度
  4. D在体外杀死 99.9% 细菌接种物的最低浓度

3溶液

1.感染控制与患者安全

答案: B · Let it dry fully and do not touch the site again

为什么是这个答案

Chlorhexidine-alcohol must dry completely to kill organisms effectively. Touching the site after cleaning contaminates it, so the vein is located before prepping or with a sterile glove.

答案

B · Let it dry fully and do not touch the site again
2.感染控制与患者安全

答案: B · Keep a safe distance and a clear exit, speak calmly and call security if needed

为什么是这个答案

In a potentially violent situation, the nurse keeps a safe distance and a clear path to the door, uses calm, simple words and gets help early. Touching or arguing with an agitated person can make things worse.

答案

B · Keep a safe distance and a clear exit, speak calmly and call security if needed
3.护理学基础

答案: B · Calcium released from bone raises the calcium in the urine

为什么是这个答案

Without weight-bearing, bone releases calcium, and urine also drains less well when lying flat. Mobilisation and adequate fluids reduce the risk.

答案

B · Calcium released from bone raises the calcium in the urine
4.护理学基础

答案: A · About 2 litres of fluid has been retained

为什么是这个答案

A rapid weight change over a day reflects fluid, not fat; 1 kg is roughly 1 litre. Daily weights taken at the same time on the same scales are a sensitive measure of fluid retention.

答案

A · About 2 litres of fluid has been retained
5.微生物学

答案: A · 麦角固醇存在于真菌细胞膜中，而人体细胞中没有

为什么是这个答案

真菌细胞膜含有麦角固醇，而人体细胞膜含有胆固醇。唑类阻断麦角固醇的合成，两性霉素与麦角固醇结合，因此它们能选择性地作用于真菌。

答案

A · 麦角固醇存在于真菌细胞膜中，而人体细胞中没有
6.微生物学

答案: A · 在体外阻止可见细菌生长的最低浓度

为什么是这个答案

MIC 是抑制可见生长的最低浓度。最低杀菌浓度（MBC）是杀死 99.9% 细菌的最低浓度。

答案

A · 在体外阻止可见细菌生长的最低浓度

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