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

Which instruction about using a standard walker is correct?

  1. AWalk well ahead of the walker for balance
  2. BPush up from the walker to stand from a chair
  3. CMove the walker forward, then step into it
  4. DCarry the walker and use it only when tired
2.感染控制与患者安全困难

A patient takes medicines prescribed by several providers. Which advice best reduces the risk of medication errors at home?

  1. AOnly tell each provider about the drugs they prescribed
  2. BKeep one up-to-date list of all medicines and use one pharmacy where possible
  3. CKeep each provider’s medicines in separate bags
  4. DStop taking any medicine that seems to repeat another one, without asking anyone
3.护理学基础中等

How should the ear be positioned when taking a tympanic temperature in an adult?

  1. AGently pull the outer ear down and back
  2. BGently pull the outer ear up and back
  3. CLeave the ear alone and insert the probe deeply
  4. DPush the outer ear forward against the cheek
4.护理学基础困难

A potassium result is unexpectedly high and the lab reports that the sample was haemolysed. What does this mean?

  1. AThe result may be falsely high and the test should be repeated
  2. BThe patient definitely has dangerous hyperkalaemia needing treatment
  3. CThe patient definitely has low potassium
  4. DThe result is accurate and needs no follow-up
5.微生物学中等

晚期 HIV 感染者发生耶氏肺孢子菌（Pneumocystis jirovecii）肺炎，属于：

  1. A机会性感染
  2. B食源性感染
  3. C人畜共患感染
  4. D媒介传播感染
6.微生物学困难

为什么在感染后的最初几周 HIV 抗体检测可能呈阴性？

  1. A机体尚未产生足以检测到的抗体
  2. B病毒在最初几周只藏在红细胞中
  3. C抗体被检测试剂破坏
  4. DHIV 根本不会引起抗体产生

3溶液

1.感染控制与患者安全

答案: C · Move the walker forward, then step into it

为什么是这个答案

The patient moves the walker forward, sets it down with all legs on the floor and then steps into it. To stand, they push up from the chair arms, because a walker can tip if used to pull up.

答案

C · Move the walker forward, then step into it
2.感染控制与患者安全

答案: B · Keep one up-to-date list of all medicines and use one pharmacy where possible

为什么是这个答案

A single complete medication list and one pharmacy allow interactions and duplicates to be detected. The list, including over-the-counter drugs and supplements, is shown at every visit.

答案

B · Keep one up-to-date list of all medicines and use one pharmacy where possible
3.护理学基础

答案: B · Gently pull the outer ear up and back

为什么是这个答案

Pulling the pinna up and back straightens the adult ear canal so the probe points at the eardrum. In young children the pinna is pulled down and back instead.

答案

B · Gently pull the outer ear up and back
4.护理学基础

答案: A · The result may be falsely high and the test should be repeated

为什么是这个答案

Red cells contain a lot of potassium, so haemolysis during collection can falsely raise the result. The sample is repeated, with the patient assessed in the meantime.

答案

A · The result may be falsely high and the test should be repeated
5.微生物学

答案: A · 机会性感染

为什么是这个答案

机会性感染利用的是减弱的免疫系统。在 HIV 感染中，当 CD4 计数降到较低水平时，这类感染就会变得常见。

答案

A · 机会性感染
6.微生物学

答案: A · 机体尚未产生足以检测到的抗体

为什么是这个答案

抗体需要数周才会出现。同时检测 p24 抗原的联合检测或病毒 RNA 检测可以缩短这一窗口期。

答案

A · 机体尚未产生足以检测到的抗体

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