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

How does a nurse add a sterile gauze pack to a sterile field that is already set up?

  1. AReach across the field with clean gloves to place the item
  2. BOpen the wrapper away from the field and drop the item on it without reaching over
  3. CTip the item onto the field and push it into place with the wrapper
  4. DPlace the whole wrapped pack on the field and open it there with sterile gloves
2.感染控制与患者安全困难

Ten minutes into a red blood cell transfusion, the patient reports chills and low back pain and has a new fever. What should the nurse do first?

  1. AGive an antipyretic and continue the transfusion
  2. BSlow the transfusion and recheck vital signs in 15 minutes
  3. CStop the transfusion
  4. DCall the blood bank and let the transfusion continue
3.护理学基础中等

Why should insulin injection sites be rotated?

  1. ABecause each site can only be used once
  2. BTo prevent lumpy fatty swelling that affects absorption
  3. CTo make the insulin work more quickly with each injection
  4. DTo stop the patient getting used to the needle
4.护理学基础困难

Aspirate from a newly placed nasogastric tube has a pH of 7. What should the nurse do?

  1. AFlush the tube with water and start the feed
  2. BNot use the tube and follow policy, which may mean a chest X-ray
  3. CStart the feed, as a pH of 7 confirms that the tube is in the stomach
  4. DPush air down the tube and listen over the stomach
5.微生物学中等

霍乱引起大量"米泔水样"腹泻。最重要的治疗是什么？

  1. A停止一切口服液体摄入，让肠道休息和恢复
  2. B通过口服或静脉补液补充液体和盐分
  3. C抗病毒药物
  4. D抗真菌药物
6.微生物学困难

一名青少年出现发热、颈项强直和压之不褪色的紫色皮疹。脑脊液中发现革兰氏阴性双球菌。最可能的病原体是什么？

  1. AListeria monocytogenes
  2. BEscherichia coli
  3. CNeisseria meningitidis
  4. DStreptococcus pneumoniae

3溶液

1.感染控制与患者安全

答案: B · Open the wrapper away from the field and drop the item on it without reaching over

为什么是这个答案

The nurse opens the package so the sterile item can be dropped onto the field from a short height, without the wrapper or arms crossing over the sterile area. The item must land well inside the non-sterile border.

答案

B · Open the wrapper away from the field and drop the item on it without reaching over
2.感染控制与患者安全

答案: C · Stop the transfusion

为什么是这个答案

These signs suggest an acute transfusion reaction, possibly hemolytic. The nurse stops the transfusion at once, keeps the IV open with normal saline through new tubing, assesses the patient and notifies the provider and blood bank.

答案

C · Stop the transfusion
3.护理学基础

答案: B · To prevent lumpy fatty swelling that affects absorption

为什么是这个答案

Injecting in the same place causes lipohypertrophy, which makes absorption unpredictable. Patients rotate within an area and check sites for lumps.

答案

B · To prevent lumpy fatty swelling that affects absorption
4.护理学基础

答案: B · Not use the tube and follow policy, which may mean a chest X-ray

为什么是这个答案

A low pH supports gastric placement (1–5.5 in UK guidance; 5 or below is typical in US guidance). A pH of 7 does not rule out the lungs, so nothing is put down the tube until position is confirmed, usually by X-ray. The "whoosh" air test is unreliable.

答案

B · Not use the tube and follow policy, which may mean a chest X-ray
5.微生物学

答案: B · 通过口服或静脉补液补充液体和盐分

为什么是这个答案

霍乱毒素使肠道细胞分泌大量水和盐。迅速补液能挽救大多数生命；抗生素只能缩短病程。

答案

B · 通过口服或静脉补液补充液体和盐分
6.微生物学

答案: C · Neisseria meningitidis

为什么是这个答案

脑膜炎奈瑟菌（Neisseria meningitidis）是一种革兰氏阴性双球菌，可引起脑膜炎和伴瘀点或紫癜样皮疹的败血症。需要紧急使用抗生素，密切接触者可能需要预防性用药。

答案

C · Neisseria meningitidis

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