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 on oxygen is being taken to another department by wheelchair. What should the nurse check first?

  1. AThat the cylinder is placed on the patient’s lap
  2. BThat the portable cylinder has enough oxygen for the whole trip
  3. CThat the cylinder is the largest size available
  4. DThat the oxygen is turned off during the transfer to save the supply in the tank
2.感染控制与患者安全困难

A patient on oxygen needs an MRI scan. Which plan is safe?

  1. ALeave the steel cylinder on the patient’s bed during the scan
  2. BUse only MRI-safe equipment, and never take a standard steel oxygen cylinder into the scanner room
  3. CTake the usual steel cylinder into the room if it is tightly strapped to the trolley frame
  4. DRemove the oxygen for the scan without telling anyone
3.护理学基础中等

What is a portable bladder scanner used for?

  1. ADetecting kidney stones
  2. BMeasuring how much urine is in the bladder without a catheter
  3. CChecking the urine for blood and protein
  4. DTaking a sterile sample of urine for culture without a catheter
4.护理学基础困难

Why are a patient's observations checked about 15 minutes after a blood transfusion starts?

  1. AIt is the time the blood takes to warm up
  2. BSerious reactions often happen early in a transfusion
  3. CIt is only for record-keeping purposes
  4. DReactions only ever occur after the transfusion ends
5.微生物学中等

刚地弓形虫（Toxoplasma gondii）在妊娠期具有风险。哪项建议可以减少接触？

  1. A避免食用所有水果和蔬菜
  2. B避免接触狗
  3. C避免清理猫砂，避免食用未煮熟的肉
  4. D避免去游泳池和所有其他公共浴场
6.微生物学困难

一份尿液标本在麦康凯琼脂上长出了粉红色菌落。这说明了什么？

  1. A该生物是真菌
  2. B该生物不发酵乳糖，因此很可能是沙门氏菌
  3. C该生物是革兰氏阳性球菌
  4. D该生物可能是能发酵乳糖的革兰氏阴性杆菌

3溶液

1.感染控制与患者安全

答案: B · That the portable cylinder has enough oxygen for the whole trip

为什么是这个答案

The nurse checks the cylinder gauge and makes sure there is enough oxygen for the trip and possible delays. The cylinder is secured in a holder on the chair, not on the patient’s lap.

答案

B · That the portable cylinder has enough oxygen for the whole trip
2.感染控制与患者安全

答案: B · Use only MRI-safe equipment, and never take a standard steel oxygen cylinder into the scanner room

为什么是这个答案

Steel oxygen cylinders can become projectiles in an MRI room and cause fatal injuries. Only equipment labeled MRI-safe is used, and the patient’s oxygen needs are planned with the MRI team.

答案

B · Use only MRI-safe equipment, and never take a standard steel oxygen cylinder into the scanner room
3.护理学基础

答案: B · Measuring how much urine is in the bladder without a catheter

为什么是这个答案

A bladder scanner uses ultrasound to estimate bladder volume, for example after a patient has voided. It helps detect retention and avoids unnecessary catheterisation.

答案

B · Measuring how much urine is in the bladder without a catheter
4.护理学基础

答案: B · Serious reactions often happen early in a transfusion

为什么是这个答案

Severe reactions, such as ABO incompatibility and anaphylaxis, often appear soon after starting. Observations before, at about 15 minutes and at the end, plus close watching, allow early action.

答案

B · Serious reactions often happen early in a transfusion
5.微生物学

答案: C · 避免清理猫砂，避免食用未煮熟的肉

为什么是这个答案

弓形虫卵囊随猫粪便排出，包囊存在于未煮熟的肉中。妊娠期感染可损害胎儿的大脑和眼睛。

答案

C · 避免清理猫砂，避免食用未煮熟的肉
6.微生物学

答案: D · 该生物可能是能发酵乳糖的革兰氏阴性杆菌

为什么是这个答案

麦康凯琼脂含有抑制革兰氏阳性菌的胆盐和结晶紫（选择性），以及乳糖和 pH 指示剂（鉴别性）。E. coli 等乳糖发酵菌产酸而呈粉红色。

答案

D · 该生物可能是能发酵乳糖的革兰氏阴性杆菌

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