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 nurse finds a used needle in a patient’s bed linen. What should the nurse do?

  1. ALeave it where it is for the housekeeping staff to remove later in the day
  2. BRecap it with two hands before throwing it away
  3. CPick it up by the hub or with forceps, put it in a sharps container and report it
  4. DFold it into the linen and send it to the laundry
2.感染控制与患者安全困难

Several patients arrive with suspected inhalational anthrax after a deliberate release. Which precautions are needed for their care?

  1. ADroplet precautions with surgical masks
  2. BAirborne precautions in negative-pressure rooms, because spores are inhaled
  3. CStandard precautions, because it is not spread from person to person
  4. DContact precautions with gowns and gloves
3.护理学基础中等

What is the correct order of techniques when assessing the abdomen?

  1. AInspection, auscultation, percussion, palpation
  2. BAuscultation, palpation, inspection, percussion
  3. CInspection, palpation, percussion, auscultation
  4. DPalpation, inspection, auscultation, percussion
4.护理学基础困难

Three days after abdominal surgery, a patient coughs and the wound opens with bowel visible. What should the nurse do first?

  1. ALeave the wound uncovered so the surgeon can see it
  2. BCover it with sterile saline-soaked dressings and call for urgent help
  3. CPush the bowel gently back into the abdomen, then apply a firm bandage over it
  4. DSit the patient fully upright and ask them to cough again
5.微生物学中等

引起唇疱疹和水痘的病毒属于哪个病毒科？

  1. A小 RNA 病毒
  2. B冠状病毒
  3. C逆转录病毒
  4. D疱疹病毒
6.微生物学困难

发现了革兰氏阳性球菌。哪项试验能迅速区分葡萄球菌和链球菌？

  1. A抗酸染色
  2. B凝固酶试验
  3. C在麦康凯琼脂上的生长
  4. D触酶试验

3溶液

1.感染控制与患者安全

答案: C · Pick it up by the hub or with forceps, put it in a sharps container and report it

为什么是这个答案

A loose needle is a hazard to everyone who handles the linen. The nurse disposes of it safely without recapping, using an instrument if needed, and reports the incident so the cause can be addressed.

答案

C · Pick it up by the hub or with forceps, put it in a sharps container and report it
2.感染控制与患者安全

答案: C · Standard precautions, because it is not spread from person to person

为什么是这个答案

Inhalational anthrax is caught by breathing in spores from the environment and does not spread from person to person, so standard precautions are enough. Decontamination may still be needed for people with spores on their skin or clothing.

答案

C · Standard precautions, because it is not spread from person to person
3.护理学基础

答案: A · Inspection, auscultation, percussion, palpation

为什么是这个答案

In the abdomen the nurse listens before touching, because percussion and palpation can change bowel sounds. In other body systems palpation and percussion come before auscultation.

答案

A · Inspection, auscultation, percussion, palpation
4.护理学基础

答案: B · Cover it with sterile saline-soaked dressings and call for urgent help

为什么是这个答案

Evisceration is a surgical emergency. The nurse stays with the patient, covers the bowel with sterile moist dressings, positions them to reduce tension on the wound and calls for urgent surgical review.

答案

B · Cover it with sterile saline-soaked dressings and call for urgent help
5.微生物学

答案: D · 疱疹病毒

为什么是这个答案

单纯疱疹病毒（唇疱疹）和水痘-带状疱疹病毒（水痘、带状疱疹）都是疱疹病毒，潜伏在感觉神经节中并可再次激活。

答案

D · 疱疹病毒
6.微生物学

答案: D · 触酶试验

为什么是这个答案

葡萄球菌产生触酶（过氧化氢酶），把过氧化氢分解为水和氧气气泡；链球菌则不产生。随后用凝固酶试验在葡萄球菌中鉴定 S. aureus。

答案

D · 触酶试验

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