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 cleans an IV pump with a disinfectant wipe. What must happen for the disinfectant to work?

  1. AThe wipe is used on many pumps to save product
  2. BThe surface is wiped once lightly without pressure
  3. CThe surface stays wet for the contact time on the product label
  4. DThe surface is dried with a clean towel right after wiping
2.感染控制与患者安全困难

A responsive 6-month-old infant is choking and cannot cry or cough. What should the rescuer do?

  1. ADo a blind finger sweep of the mouth
  2. BTurn the infant upside down and shake gently
  3. CGive abdominal thrusts as for an adult
  4. DGive back blows and chest thrusts in turn
3.护理学基础中等

接受管饲的患者应采取什么体位以降低误吸风险？

  1. A床头抬高约 30–45 度
  2. B头低位
  3. C俯卧位
  4. D完全平卧
4.护理学基础困难

Why must a needlestick injury be reported straight away rather than at the end of the shift?

  1. APost-exposure prophylaxis works best when it is started as soon as possible
  2. BThe injury must be documented within ten minutes for the report to be valid
  3. CThe source patient will be discharged soon
  4. DReporting late means the nurse has to pay for the tests
5.微生物学中等

什么是内毒素？

  1. A只在人体细胞内产生的毒素
  2. B革兰氏阳性菌分泌到周围组织中的蛋白质毒素
  3. C革兰氏阴性菌外膜中的脂多糖
  4. D潮湿建筑中真菌产生的毒素
6.微生物学困难

一名旅行者从撒哈拉以南非洲回来后发热，怀疑患疟疾。哪一种最可能引起重症和脑型疟疾？

  1. APlasmodium ovale
  2. BPlasmodium vivax
  3. CPlasmodium falciparum
  4. DPlasmodium malariae

3溶液

1.感染控制与患者安全

答案: C · The surface stays wet for the contact time on the product label

为什么是这个答案

Each disinfectant has a contact (dwell) time during which the surface must stay visibly wet. Drying it early or spreading one wipe over many items reduces its effect.

答案

C · The surface stays wet for the contact time on the product label
2.感染控制与患者安全

答案: D · Give back blows and chest thrusts in turn

为什么是这个答案

For infants under one year, the rescuer alternates sets of back blows with chest thrusts, with the head lower than the chest. Abdominal thrusts are not used in infants, and blind finger sweeps can push the object further in.

答案

D · Give back blows and chest thrusts in turn
3.护理学基础

答案: A · 床头抬高约 30–45 度

为什么是这个答案

在喂养期间及之后抬高床头，有助于防止反流和误吸入肺。

答案

A · 床头抬高约 30–45 度
4.护理学基础

答案: A · Post-exposure prophylaxis works best when it is started as soon as possible

为什么是这个答案

After a high-risk exposure, for example to HIV or hepatitis B, preventive treatment is most effective when started early. Prompt reporting also allows the source patient to be assessed.

答案

A · Post-exposure prophylaxis works best when it is started as soon as possible
5.微生物学

答案: C · 革兰氏阴性菌外膜中的脂多糖

为什么是这个答案

内毒素是脂多糖中的类脂 A。它引发伴有发热的强烈免疫反应，大量时可导致感染性休克。

答案

C · 革兰氏阴性菌外膜中的脂多糖
6.微生物学

答案: C · Plasmodium falciparum

为什么是这个答案

恶性疟原虫（P. falciparum）可导致极高的原虫血症，并使受感染的红细胞滞留在包括脑在内的小血管中。它在撒哈拉以南非洲很常见，属于医疗急症。

答案

C · Plasmodium falciparum

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