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 visitor with a cold wants to see a patient who has severe neutropenia. What should the nurse advise?

  1. AVisit as usual after washing the hands
  2. BPostpone the visit until the visitor is well
  3. CVisit but avoid touching the patient’s bed
  4. DVisit only if the cold started more than a day ago
2.感染控制与患者安全困难

A patient on a general ward for two days is found to have smear-positive pulmonary TB. What should the nurse do besides moving the patient to an airborne isolation room?

  1. ANothing more, because the patient has now been isolated
  2. BInform infection prevention so exposed patients and staff can be identified and followed up
  3. CClose the ward to all new admissions for a full year
  4. DTell all the exposed patients to start TB drugs at once, before any testing
3.护理学基础中等

What is the main purpose of a wound drain after surgery?

  1. ATo give antibiotics directly into the wound until it has fully healed
  2. BTo remove fluid or blood that could collect and delay healing
  3. CTo keep the wound edges apart until it heals
  4. DTo measure the temperature inside the wound
4.护理学基础困难

In an emergency a doctor gives a verbal order for a medicine. What should the nurse do?

  1. AWrite it down, read it back and make sure it is signed later as per policy
  2. BGive it and tell the doctor nothing more
  3. CRefuse to give any medicine until a written prescription has been completed
  4. DAsk another nurse to remember the order
5.微生物学中等

在诊断实验室中，PCR 的作用是什么？

  1. A给细菌染色以便观察
  2. B大量复制特定的 DNA 序列以便检测
  3. C使细菌在琼脂平板上生长得更快
  4. D它测量患者血清样本中特定抗体的水平
6.微生物学困难

为什么人可以多次得流感，而麻疹通常只得一次？

  1. A麻疹病毒没有表面抗原
  2. B流感病毒攻击并破坏感染后形成的记忆细胞
  3. C流感病毒经常改变其表面抗原
  4. D麻疹由细菌引起

3溶液

1.感染控制与患者安全

答案: B · Postpone the visit until the visitor is well

为什么是这个答案

Patients with severe neutropenia cannot fight infections well. People with respiratory or other infections should not visit until they are well; other visitors perform hand hygiene.

答案

B · Postpone the visit until the visitor is well
2.感染控制与患者安全

答案: B · Inform infection prevention so exposed patients and staff can be identified and followed up

为什么是这个答案

Infection prevention and public health carry out a contact investigation to identify and screen people exposed while the patient was not isolated. Treatment of contacts depends on their test results.

答案

B · Inform infection prevention so exposed patients and staff can be identified and followed up
3.护理学基础

答案: B · To remove fluid or blood that could collect and delay healing

为什么是这个答案

Drains let blood, serous fluid or pus escape, preventing collections such as seromas and haematomas. The nurse records the amount and type of drainage.

答案

B · To remove fluid or blood that could collect and delay healing
4.护理学基础

答案: A · Write it down, read it back and make sure it is signed later as per policy

为什么是这个答案

Verbal orders are used only where local policy allows, such as emergencies. Reading back the drug, dose and route confirms the order, and it is documented and signed as soon as possible.

答案

A · Write it down, read it back and make sure it is signed later as per policy
5.微生物学

答案: B · 大量复制特定的 DNA 序列以便检测

为什么是这个答案

聚合酶链反应能把目标序列扩增数百万倍，可以检测难以培养的病原体；RNA 病毒需先转化为 DNA（RT-PCR）。

答案

B · 大量复制特定的 DNA 序列以便检测
6.微生物学

答案: C · 流感病毒经常改变其表面抗原

为什么是这个答案

流感病毒的血凝素和神经氨酸酶会通过漂移（小突变）和转变（基因重配）而改变，旧抗体可能识别不了新毒株。麻疹病毒抗原稳定。

答案

C · 流感病毒经常改变其表面抗原

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