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 in bed has a generalized tonic-clonic seizure. What should the nurse do?

  1. AGive sips of water to keep the airway moist
  2. BPut a padded tongue blade between the teeth to protect the tongue from biting
  3. CHold the arms and legs firmly to stop the movements
  4. DTurn the patient on their side and protect them from injury without restraining
2.感染控制与患者安全困难

A patient with pulmonary tuberculosis has been on treatment. Which findings usually allow airborne isolation to end?

  1. AThe patient has been in hospital for one week and has taken every dose of medicine
  2. BThe cough has stopped, even with no sputum tests
  3. COne negative chest x-ray after starting treatment
  4. DThree negative sputum smears, clinical improvement and continued therapy
3.护理学基础中等

A catheterised patient has had no urine in the bag for two hours. What should the nurse check first?

  1. AThe patient's blood glucose level and recent insulin doses
  2. BThe tubing for kinks or blockage and where the bag is
  3. CNothing, as two hours without urine is normal
  4. DWhether the patient has eaten or drunk anything recently
4.护理学基础困难

A patient who had a GCS of 15 this morning now opens their eyes only to voice and is confused. What should the nurse do?

  1. ARecord it and recheck at the next routine time
  2. BLet the patient sleep, as they are probably tired
  3. CTreat it as deterioration and escalate urgently
  4. DGive a sedative to calm the confusion
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麦角固醇是细菌细胞壁的主要结构成分
  4. D麦角固醇只存在于病毒中
6.微生物学困难

一名患者在吃了自制罐装蔬菜后出现复视、吞咽困难和下行性弛缓性瘫痪。最可能的原因是什么？

  1. A肉毒毒素，它阻断乙酰胆碱的释放
  2. B运动神经元的病毒感染
  3. C破伤风毒素，它阻断抑制性神经递质
  4. D革兰氏阴性菌的内毒素

3溶液

1.感染控制与患者安全

答案: D · Turn the patient on their side and protect them from injury without restraining

为什么是这个答案

The nurse stays with the patient, turns them to the side to keep the airway clear, moves hard objects away and times the seizure. Objects in the mouth and restraint can cause injury.

答案

D · Turn the patient on their side and protect them from injury without restraining
2.感染控制与患者安全

答案: D · Three negative sputum smears, clinical improvement and continued therapy

为什么是这个答案

Airborne precautions usually continue until the patient is on effective therapy, is improving clinically and has three negative sputum smears for acid-fast bacilli, according to policy.

答案

D · Three negative sputum smears, clinical improvement and continued therapy
3.护理学基础

答案: B · The tubing for kinks or blockage and where the bag is

为什么是这个答案

Kinked or trapped tubing, a bag above bladder level or a blocked catheter are common causes. If these are fine, the patient is assessed for low output and the doctor informed.

答案

B · The tubing for kinks or blockage and where the bag is
4.护理学基础

答案: C · Treat it as deterioration and escalate urgently

为什么是这个答案

The score has dropped to about 13. Any new fall in consciousness or new confusion needs urgent escalation, a full ABCDE assessment and a check of glucose.

答案

C · Treat it as deterioration and escalate urgently
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 · 肉毒毒素，它阻断乙酰胆碱的释放

为什么是这个答案

肉毒梭菌（Clostridium botulinum）能在罐装不当的低酸性食品中生长并产生肉毒毒素。该毒素阻断神经末梢释放乙酰胆碱，导致下行性弛缓性瘫痪。

答案

A · 肉毒毒素，它阻断乙酰胆碱的释放

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