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

A patient on oxygen is being taken to another department by wheelchair. What should the nurse check first?

  1. AThat the cylinder is the largest size available
  2. BThat the cylinder is placed on the patient’s lap
  3. CThat the oxygen is turned off during the transfer to save the supply in the tank
  4. DThat the portable cylinder has enough oxygen for the whole trip
2.感染控制与患者安全困难

A nurse finds that a patient has been taking their own sleeping pills from a bedside drawer while also receiving a hypnotic from the ward. What should the nurse do?

  1. AStop giving the hospital hypnotic without telling the provider or the pharmacy
  2. BSecure the home medication per policy and inform the provider
  3. CThrow the patient’s pills away in the bin
  4. DLet the patient keep them, since they are the patient’s own
3.护理学基础中等

A patient says, "I've never seen this tablet before," as the nurse offers it. What should the nurse do?

  1. AReassure the patient that the tablet is correct and give it
  2. BGive half the tablet until the doctor visits
  3. CStop and recheck the prescription before giving it
  4. DLeave the tablet on the table for the patient to take later
4.护理学基础困难

Three days after abdominal surgery, a patient coughs and the wound opens with bowel visible. What should the nurse do first?

  1. ACover it with sterile saline-soaked dressings and call for urgent help
  2. BPush the bowel gently back into the abdomen, then apply a firm bandage over it
  3. CLeave the wound uncovered so the surgeon can see it
  4. DSit the patient fully upright and ask them to cough again
5.微生物学中等

免疫系统的哪一部分产生抗体？

  1. A由 B 淋巴细胞分化而来的浆细胞
  2. B自然杀伤细胞
  3. C中性粒细胞
  4. D在淋巴结中被激活的细胞毒性 T 细胞
6.微生物学困难

一名疑似传染性肺结核的患者入院。需要采取哪些防护措施？

  1. A空气传播防护，最好使用负压病房，工作人员佩戴呼吸防护口罩
  2. B只需接触防护，戴手套和穿围裙
  3. C无须特殊防护，因为结核病只经血液传播
  4. D用外科口罩进行飞沫防护，且只在一米范围内

3溶液

1.感染控制与患者安全

答案: D · That the portable cylinder has enough oxygen for the whole trip

为什么是这个答案

The nurse checks the cylinder gauge and makes sure there is enough oxygen for the trip and possible delays. The cylinder is secured in a holder on the chair, not on the patient’s lap.

答案

D · That the portable cylinder has enough oxygen for the whole trip
2.感染控制与患者安全

答案: B · Secure the home medication per policy and inform the provider

为什么是这个答案

Unrecorded home medicines can lead to duplicate doses, interactions and falls. They are stored or sent home according to policy, and the provider is told so the treatment plan can be reviewed.

答案

B · Secure the home medication per policy and inform the provider
3.护理学基础

答案: C · Stop and recheck the prescription before giving it

为什么是这个答案

A patient questioning a medicine may be a sign of an error. The nurse holds the dose, checks the prescription and the drug and explains before giving it.

答案

C · Stop and recheck the prescription before giving it
4.护理学基础

答案: A · Cover it with sterile saline-soaked dressings and call for urgent help

为什么是这个答案

Evisceration is a surgical emergency. The nurse stays with the patient, covers the bowel with sterile moist dressings, positions them to reduce tension on the wound and calls for urgent surgical review.

答案

A · Cover it with sterile saline-soaked dressings and call for urgent help
5.微生物学

答案: A · 由 B 淋巴细胞分化而来的浆细胞

为什么是这个答案

被激活的 B 细胞分化为分泌抗体的浆细胞。细胞毒性 T 细胞和 NK 细胞则直接杀伤被感染的细胞。

答案

A · 由 B 淋巴细胞分化而来的浆细胞
6.微生物学

答案: A · 空气传播防护，最好使用负压病房，工作人员佩戴呼吸防护口罩

为什么是这个答案

结核分枝杆菌（M. tuberculosis）通过能长时间悬浮的空气飞沫核传播。患者应尽可能住在负压单间，工作人员佩戴 FFP2/FFP3 或 N95 呼吸防护口罩。

答案

A · 空气传播防护，最好使用负压病房，工作人员佩戴呼吸防护口罩

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