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 contact precautions must be taken to another department for a test. What is correct?

  1. AHave the patient wear an N95 respirator during transport
  2. BCover wounds, give the patient a clean gown and tell the receiving department
  3. CPut the patient in a separate elevator with the doors open
  4. DCancel the test until the precautions are no longer needed, however urgent it is
2.感染控制与患者安全困难

A nurse floated to an unfamiliar unit is asked to manage a device they have never been trained to use. What should the nurse do?

  1. ADo it anyway, using only the device manual and the instructions on the screen
  2. BTell the charge nurse and ask for help or a change of assignment
  3. CLeave the device untouched and not tell anyone
  4. DAsk the patient or the family to explain how the device works
3.护理学基础中等

A patient shouts at the nurse that nobody has told them when their operation will be. What is the best first response?

  1. AStay calm, listen and acknowledge their frustration
  2. BWalk away until the patient calms down by themselves
  3. CArgue back that the staff are very busy
  4. DTell the patient to stop shouting or leave the ward
4.护理学基础困难

A healthcare assistant (nursing assistant) has recorded a blood pressure of 82/50 mmHg during routine observations but did not report it. What should the registered nurse do first?

  1. ATalk to the healthcare assistant about reporting
  2. BComplete an incident report
  3. CAssess the patient straight away
  4. DRepeat the observations at the next routine time
5.微生物学中等

晚期 HIV 感染者发生耶氏肺孢子菌（Pneumocystis jirovecii）肺炎，属于：

  1. A媒介传播感染
  2. B人畜共患感染
  3. C机会性感染
  4. D食源性感染
6.微生物学困难

一名医务人员的血液检测结果为抗-HBs（乙型肝炎表面抗体）阳性，HBsAg 和抗-HBc 阴性。这最可能意味着什么？

  1. A慢性乙型肝炎感染
  2. B既往自然感染且已清除
  3. C现症急性乙型肝炎感染
  4. D接种乙肝疫苗获得的免疫

3溶液

1.感染控制与患者安全

答案: B · Cover wounds, give the patient a clean gown and tell the receiving department

为什么是这个答案

Transport is limited to what is necessary. Infected areas are contained or covered, the patient wears a clean gown, the receiving area is informed and equipment is cleaned afterwards.

答案

B · Cover wounds, give the patient a clean gown and tell the receiving department
2.感染控制与患者安全

答案: B · Tell the charge nurse and ask for help or a change of assignment

为什么是这个答案

Accepting a task beyond one’s competence puts the patient at risk. The nurse explains the limit to the charge nurse, who can arrange help, training or reassignment.

答案

B · Tell the charge nurse and ask for help or a change of assignment
3.护理学基础

答案: A · Stay calm, listen and acknowledge their frustration

为什么是这个答案

Listening calmly and acknowledging feelings often de-escalates anger. The nurse then finds out the answer or explains what will happen next. Staff safety is maintained throughout.

答案

A · Stay calm, listen and acknowledge their frustration
4.护理学基础

答案: C · Assess the patient straight away

为什么是这个答案

A low blood pressure may mean deterioration, so the nurse assesses the patient at once and escalates if needed. Feedback to the assistant and reporting follow afterwards.

答案

C · Assess the patient straight away
5.微生物学

答案: C · 机会性感染

为什么是这个答案

机会性感染利用的是减弱的免疫系统。在 HIV 感染中，当 CD4 计数降到较低水平时，这类感染就会变得常见。

答案

C · 机会性感染
6.微生物学

答案: D · 接种乙肝疫苗获得的免疫

为什么是这个答案

疫苗含有 HBsAg，因此接种者产生抗-HBs，但不产生抗-HBc。既往自然感染会同时产生抗-HBs 和抗-HBc，而持续感染则表现为 HBsAg 阳性。

答案

D · 接种乙肝疫苗获得的免疫

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