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

Which toy is safest for a toddler?

  1. AA large toy with no small parts that can come off
  2. BA toy with small magnets that come out easily
  3. CA bag of marbles to sort by color
  4. DA balloon to play with when an adult is out of the room
2.感染控制与患者安全困难

An 82-year-old patient is prescribed diphenhydramine at bedtime for sleep. Why should the nurse raise this with the prescriber?

  1. AIt raises blood pressure in most older adults
  2. BIt is only available as an IV drug and cannot be given by mouth at bedtime
  3. CIt is too weak to help an older person sleep
  4. DIt is strongly anticholinergic and can cause confusion and falls in older adults
3.护理学基础中等

A patient with expressive aphasia after a stroke understands speech but struggles to find words. Which approach helps most?

  1. AAsk simple yes/no questions and allow plenty of time
  2. BSpeak louder and more slowly than usual
  3. CTalk to the family instead of the patient
  4. DFinish their sentences quickly for them to save them frustration
4.护理学基础困难

在年轻成人的早期低血容量性休克中，哪项体征通常在血压下降之前出现？

  1. A皮肤温暖潮红
  2. B心率减慢
  3. C血压极低
  4. D心率加快伴肢端发凉
5.微生物学中等

Streptococcus pneumoniae 的主要毒力因子、也是其疫苗的靶点是什么？

  1. A它的类霍乱毒素
  2. B它的多糖荚膜
  3. C它的鞭毛
  4. D它的芽孢
6.微生物学困难

为什么青霉素类对 Mycoplasma pneumoniae 无效？

  1. A它有一层厚厚的蜡质分枝菌酸层，阻止药物进入
  2. B它产生大量 β-内酰胺酶
  3. C它只生活在红细胞内
  4. D它没有可供青霉素作用的细胞壁

3溶液

1.感染控制与患者安全

答案: A · A large toy with no small parts that can come off

为什么是这个答案

Small parts, marbles, magnets and uninflated or broken balloons are choking hazards for young children. Toys should be large, sturdy and suited to the child’s age.

答案

A · A large toy with no small parts that can come off
2.感染控制与患者安全

答案: D · It is strongly anticholinergic and can cause confusion and falls in older adults

为什么是这个答案

First-generation antihistamines such as diphenhydramine are on the Beers list because they cause confusion, constipation, urinary retention and falls in older adults. Safer approaches to sleep should be discussed.

答案

D · It is strongly anticholinergic and can cause confusion and falls in older adults
3.护理学基础

答案: A · Ask simple yes/no questions and allow plenty of time

为什么是这个答案

Short questions that can be answered with yes, no or a gesture, picture boards and patience let the patient communicate. Hearing is not the problem, so shouting does not help.

答案

A · Ask simple yes/no questions and allow plenty of time
4.护理学基础

答案: D · 心率加快伴肢端发凉

为什么是这个答案

心动过速和血管收缩的代偿起初能维持正常血压，因此低血压是晚期征象。心动过速、皮肤发凉和毛细血管再充盈缓慢就应促使采取行动。

答案

D · 心率加快伴肢端发凉
5.微生物学

答案: B · 它的多糖荚膜

为什么是这个答案

荚膜保护 S. pneumoniae 免受吞噬。荚膜型有很多种，肺炎球菌疫苗含有最常见型别的荚膜多糖。

答案

B · 它的多糖荚膜
6.微生物学

答案: D · 它没有可供青霉素作用的细胞壁

为什么是这个答案

支原体缺乏细胞壁，因此 β-内酰胺类没有作用靶点。改用作用于核糖体的大环内酯类或四环素类。

答案

D · 它没有可供青霉素作用的细胞壁

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