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 helping a patient from bed into a wheelchair, what should the nurse do with the wheelchair?

  1. APlace it on the patient’s weaker side so that side is supported
  2. BLock the brakes and place it close to the bed on the patient’s stronger side
  3. CLeave the brakes off so the chair can move along with the patient during the pivot
  4. DPlace it at the foot of the bed, facing away
2.感染控制与患者安全困难

Which patient with a suspected infection meets the qSOFA criteria that signal a higher risk of a poor outcome?

  1. ARespiratory rate 24/min, new confusion, systolic BP 95 mmHg
  2. BRespiratory rate 16/min, alert, systolic BP 105 mmHg, WBC 13,000/mm3
  3. CRespiratory rate 20/min, alert, systolic BP 110 mmHg, heart rate 110/min
  4. DRespiratory rate 18/min, alert, systolic BP 130 mmHg, temperature 38.5 °C
3.护理学基础中等

How does pursed-lip breathing help a patient with COPD?

  1. AIt keeps the airways open longer and slows the breathing
  2. BIt makes the patient breathe faster to take in more air
  3. CIt increases the amount of carbon dioxide in the blood
  4. DIt replaces the need for inhaled medicines
4.护理学基础困难

A patient with a new colostomy has been taught stoma care. Which statement shows a need for further teaching?

  1. A"I'll measure the stoma again as it shrinks over the next weeks."
  2. B"I'll cut the opening much bigger than my stoma so it doesn't rub."
  3. C"I'll dry the skin well before putting on a new bag."
  4. D"I'll check the skin around my stoma when I change the bag."
5.微生物学中等

哪种微生物引起结核病？是什么使它难以用革兰氏法染色？

  1. A肺炎链球菌，它有荚膜
  2. B肺炎支原体，它没有细胞壁来摄取染料
  3. C结核分枝杆菌，其细胞壁蜡质、富含分枝菌酸
  4. D嗜肺军团菌，它生活在变形虫体内
6.微生物学困难

细菌把药物泵出细胞时，使用的是哪种耐药机制？

  1. A仅通过孔蛋白减少摄入
  2. B酶灭活
  3. C外排泵
  4. D靶点改变

3溶液

1.感染控制与患者安全

答案: B · Lock the brakes and place it close to the bed on the patient’s stronger side

为什么是这个答案

Locked brakes stop the chair rolling away during the transfer. Placing it close to the bed on the stronger side lets the patient lead with their strong leg.

答案

B · Lock the brakes and place it close to the bed on the patient’s stronger side
2.感染控制与患者安全

答案: A · Respiratory rate 24/min, new confusion, systolic BP 95 mmHg

为什么是这个答案

qSOFA scores one point each for a respiratory rate of 22/min or more, altered mental status and a systolic BP of 100 mmHg or less. Two or more points mean higher risk, so the first patient needs urgent escalation.

答案

A · Respiratory rate 24/min, new confusion, systolic BP 95 mmHg
3.护理学基础

答案: A · It keeps the airways open longer and slows the breathing

为什么是这个答案

Breathing out slowly through pursed lips creates back-pressure that keeps small airways open, helping to empty trapped air and reducing breathlessness.

答案

A · It keeps the airways open longer and slows the breathing
4.护理学基础

答案: B · "I'll cut the opening much bigger than my stoma so it doesn't rub."

为什么是这个答案

An opening that is too large leaves skin exposed to output, causing soreness and leaks. Checking the skin, re-measuring and drying the skin are correct.

答案

B · "I'll cut the opening much bigger than my stoma so it doesn't rub."
5.微生物学

答案: C · 结核分枝杆菌，其细胞壁蜡质、富含分枝菌酸

为什么是这个答案

结核分枝杆菌的细胞壁富含分枝菌酸，因此不易被革兰氏染色，需用抗酸染色鉴定。

答案

C · 结核分枝杆菌，其细胞壁蜡质、富含分枝菌酸
6.微生物学

答案: C · 外排泵

为什么是这个答案

外排泵主动把四环素类和氟喹诺酮类等抗生素排出，使细胞内浓度过低而无法起效。

答案

C · 外排泵

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