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

After teaching a patient about a new medication, how does the nurse best check understanding?

  1. AAsk “Do you understand?” and accept a yes
  2. BAsk the family whether they understood the teaching
  3. CAsk the patient to explain in their own words how and when to take it
  4. DGive a printed leaflet about the drug and assume the patient will read it at home
2.感染控制与患者安全困难

一名重度痴呆患者夜间独自下床，已经跌倒两次。哪种方案最恰当？

  1. A夜间把患者绑在椅子上
  2. B低位床、床报警器、定时如厕巡视、夜灯和防滑袜
  3. C拉起四侧床栏，夜间关门保持安静
  4. D每晚给予镇静剂，使患者留在床上
3.护理学基础中等

While being helped to eat, a patient with dysphagia coughs and their voice sounds wet and gurgly. What should the nurse do?

  1. AFeed more quickly so the meal is finished before they tire
  2. BGive a drink of water to wash the food down
  3. CStop feeding and report for a swallowing assessment
  4. DLie the patient flat to rest
4.护理学基础困难

Which patient should the nurse see first?

  1. AA patient with a pain score of 3/10 whose analgesia is due in an hour
  2. BA postoperative patient with SpO₂ 89% on air and a respiratory rate of 28
  3. CA patient who is waiting for their discharge letter and medicines
  4. DA patient who is asking for help to walk to the toilet now
5.微生物学中等

ELISA 检测的是什么？

  1. A显微镜下细菌的形状
  2. B利用能引起颜色变化的酶检测特异性抗原或抗体
  3. C整个细菌基因组的 DNA 序列
  4. D固体琼脂平板上的细菌生长
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破伤风毒素，它阻断抑制性神经递质
  2. B肉毒毒素，它阻断乙酰胆碱的释放
  3. C运动神经元的病毒感染
  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: C · Ask the patient to explain in their own words how and when to take it

为什么是这个答案

With teach-back, the patient explains the information in their own words, which shows whether the teaching worked. A yes to “Do you understand?” does not confirm understanding.

答案

C · Ask the patient to explain in their own words how and when to take it
2.感染控制与患者安全

答案: B · 低位床、床报警器、定时如厕巡视、夜灯和防滑袜

为什么是这个答案

综合措施最能减少跌倒：低位床、报警器、定时巡视和如厕、良好的照明以及防滑鞋。四侧床栏、常规使用镇静剂和约束都会增加受伤风险。

答案

B · 低位床、床报警器、定时如厕巡视、夜灯和防滑袜
3.护理学基础

答案: C · Stop feeding and report for a swallowing assessment

为什么是这个答案

Coughing, choking and a wet voice during meals suggest food or drink is entering the airway. Feeding stops, the patient sits upright and a speech and language therapist assesses them.

答案

C · Stop feeding and report for a swallowing assessment
4.护理学基础

答案: B · A postoperative patient with SpO₂ 89% on air and a respiratory rate of 28

为什么是这个答案

Low saturation with a high respiratory rate shows a breathing problem that could worsen quickly. The other needs are real but not urgent.

答案

B · A postoperative patient with SpO₂ 89% on air and a respiratory rate of 28
5.微生物学

答案: B · 利用能引起颜色变化的酶检测特异性抗原或抗体

为什么是这个答案

在酶联免疫吸附试验中，与酶相连的抗体结合目标物。加入底物后会产生颜色，从而显示抗原或抗体是否存在。

答案

B · 利用能引起颜色变化的酶检测特异性抗原或抗体
6.微生物学

答案: B · 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

B · 肉毒毒素，它阻断乙酰胆碱的释放

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