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. ATurn the patient on their side and protect them from injury without restraining
  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. DGive sips of water to keep the airway moist
2.感染控制与患者安全困难

一名患者伤口曾感染 MRSA，现在需要换药。哪种个人防护装备是恰当的？

  1. A仅戴无菌手套，不穿隔离衣或其他防护
  2. B隔离衣和手套，若可能有飞溅则加戴护目装备和口罩
  3. C仅戴 N95 呼吸器，因为 MRSA 是耐药菌
  4. D不用个人防护装备，只要事后清洁双手即可
3.护理学基础中等

A nurse posts about an "interesting patient" on social media without naming them. Why is this a problem?

  1. AIt is not a problem because no name was given
  2. BIt is only a problem if the post also includes a photograph of the patient
  3. CThe patient may still be identifiable, which breaches confidentiality
  4. DIt is not a problem if the account is private
4.护理学基础困难

A patient with severe anaemia has an SpO₂ of 98%. Why can this reading be misleading?

  1. AAnaemia damages the light sensor of the oximeter
  2. BThe red cells present are saturated, but the blood carries little oxygen
  3. CAnaemia makes the oximeter read about 10% higher than the true saturation
  4. DPatients with anaemia always have a low true saturation
5.微生物学中等

胃溃疡最常见的病因是哪种细菌？

  1. AStaphylococcus aureus
  2. BEscherichia coli
  3. CHelicobacter pylori
  4. DClostridioides difficile
6.微生物学困难

19世纪40年代，伊格纳兹·塞麦尔维斯降低了维也纳一家产科诊所的产褥热死亡率。他引入了什么措施？

  1. A在检查产妇之前用漂白粉（氯化石灰）溶液洗手
  2. B在分娩前给所有母亲接种疫苗
  3. C用青霉素治疗产妇
  4. D让产妇在分娩后留在单独的隔离病房

3溶液

1.感染控制与患者安全

答案: A · 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

A · 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: B · 隔离衣和手套，若可能有飞溅则加戴护目装备和口罩

为什么是这个答案

MRSA 通过接触传播，因此应穿隔离衣、戴手套。标准预防要求在可能有伤口渗液飞溅时加用眼部和面部防护。伤口 MRSA 不需要呼吸器。

答案

B · 隔离衣和手套，若可能有飞溅则加戴护目装备和口罩
3.护理学基础

答案: C · The patient may still be identifiable, which breaches confidentiality

为什么是这个答案

Details such as the ward, the condition or the date can reveal who a patient is. Professional codes forbid sharing patient information on social media, even without names.

答案

C · The patient may still be identifiable, which breaches confidentiality
4.护理学基础

答案: B · The red cells present are saturated, but the blood carries little oxygen

为什么是这个答案

SpO₂ shows the percentage of haemoglobin that carries oxygen, not how much haemoglobin there is. With very little haemoglobin the oxygen content of the blood can be low despite a normal saturation.

答案

B · The red cells present are saturated, but the blood carries little oxygen
5.微生物学

答案: C · Helicobacter pylori

为什么是这个答案

幽门螺杆菌定植于胃黏膜，产生脲酶在局部中和胃酸。它导致大多数消化性溃疡，治疗采用抗生素加质子泵抑制剂。

答案

C · Helicobacter pylori
6.微生物学

答案: A · 在检查产妇之前用漂白粉（氯化石灰）溶液洗手

为什么是这个答案

塞麦尔维斯注意到，由同时做尸检的医生负责的病房死亡率更高。用漂白粉进行手消毒使死亡人数大幅下降，而那时细菌学说还远未被接受。

答案

A · 在检查产妇之前用漂白粉（氯化石灰）溶液洗手

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