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 is on a ventilator. Which bed position helps to prevent ventilator-associated pneumonia?

  1. ALying completely flat
  2. BTrendelenburg position
  3. CHead of the bed raised 30 to 45 degrees
  4. DHead of the bed raised about 10 degrees
2.感染控制与患者安全困难

A nurse asks a colleague to “just glance” at an insulin infusion before starting it. What makes a check truly independent?

  1. AThe second nurse looks at the bag label from the doorway
  2. BThe second nurse signs the record after the infusion has already been started by the first
  3. CThe first nurse reads the details aloud and the second agrees
  4. DThe second nurse checks the order, drug, dose and pump settings separately without being told the answer
3.护理学基础中等

Why is hand hygiene still needed after removing gloves?

  1. AGloves can have tiny holes and hands can be contaminated during removal
  2. BHand hygiene is only needed if the gloves were sterile
  3. CGlove powder causes skin allergies and must always be washed off the hands
  4. DIt is not needed, as the gloves protected the hands
4.护理学基础困难

A pulse oximeter reads 82% on a patient with cold hands who is talking in full sentences with a normal respiratory rate. What is the best first action?

  1. ACheck the patient and probe, then warm the hand or move the probe
  2. BIgnore the reading because the patient looks well
  3. CRecord the reading and recheck it at the next routine set of observations
  4. DRemove any oxygen because the reading must be wrong
5.微生物学中等

下列哪一项是科赫法则之一？

  1. A该疾病必须对抗生素有反应
  2. B将该生物接种到健康易感宿主体内时，必须引起相同的疾病
  3. C该生物必须肉眼可见
  4. D该生物也必须能在健康人体内找到
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. BHIV 根本不会引起抗体产生
  3. C抗体被检测试剂破坏
  4. D病毒在最初几周只藏在红细胞中

3溶液

1.感染控制与患者安全

答案: C · Head of the bed raised 30 to 45 degrees

为什么是这个答案

Raising the head of the bed to 30–45 degrees reduces aspiration of oral and gastric secretions into the lungs. It is part of the usual ventilator care bundle, unless contraindicated.

答案

C · Head of the bed raised 30 to 45 degrees
2.感染控制与患者安全

答案: D · The second nurse checks the order, drug, dose and pump settings separately without being told the answer

为什么是这个答案

In an independent double check, the second person works through each step on their own, then the two results are compared. Reading the answer aloud or glancing invites confirmation bias.

答案

D · The second nurse checks the order, drug, dose and pump settings separately without being told the answer
3.护理学基础

答案: A · Gloves can have tiny holes and hands can be contaminated during removal

为什么是这个答案

Gloves reduce, but do not remove, the risk of hand contamination. Hand hygiene is performed after glove removal every time.

答案

A · Gloves can have tiny holes and hands can be contaminated during removal
4.护理学基础

答案: A · Check the patient and probe, then warm the hand or move the probe

为什么是这个答案

Cold peripheries, movement and nail varnish can give falsely low readings. The nurse assesses the patient first, then checks the waveform and probe site; a low reading is never ignored until it is explained.

答案

A · Check the patient and probe, then warm the hand or move the probe
5.微生物学

答案: B · 将该生物接种到健康易感宿主体内时，必须引起相同的疾病

为什么是这个答案

科赫法则指出，该微生物必须在每个病例中都能找到，能进行纯培养，能在健康宿主中引起该病，并能从该宿主体内再次分离出来。有些病原体无法培养，因此这些法则有其局限性。

答案

B · 将该生物接种到健康易感宿主体内时，必须引起相同的疾病
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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