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 is on a ventilator. Which bed position helps to prevent ventilator-associated pneumonia?

  1. ATrendelenburg position
  2. BLying completely flat
  3. CHead of the bed raised about 10 degrees
  4. DHead of the bed raised 30 to 45 degrees
2.感染控制与患者安全困难

A nurse discovers that an insulin infusion was programmed using the wrong drug concentration in the pump library. What should the nurse do first?

  1. AStop the infusion and check the patient’s blood glucose
  2. BReprogram the pump and finish the shift before reporting
  3. CDouble the rate to correct for the error
  4. DLeave it running and check the glucose at the next routine time
3.护理学基础中等

Why do nurses often count the respiratory rate while still appearing to take the pulse?

  1. ACounting breaths is only accurate when the wrist is held
  2. BPatients who know their breathing is watched tend to change it
  3. CThe pulse and breathing rates are always the same number
  4. DIt is not allowed to tell patients that breathing is measured
4.护理学基础困难

A nurse uses SBAR to call a doctor about a breathless patient. Which item belongs under "Background"?

  1. AThe patient has COPD and was admitted two days ago with pneumonia
  2. BHis respiratory rate is 30 and his SpO₂ is 86% on 2 L of oxygen
  3. C"Please come and review him within the next 10 minutes."
  4. D"I am calling about Mr Smith in bed 4, who is very breathless."
5.微生物学中等

哪种细菌引起百日咳？

  1. AHaemophilus influenzae
  2. BBordetella pertussis
  3. CCorynebacterium diphtheriae
  4. DMycoplasma pneumoniae
6.微生物学困难

哪些肝炎病毒主要通过受污染的食物和水传播？

  1. A甲型和戊型肝炎
  2. B乙型和丙型肝炎
  3. C丙型和戊型肝炎
  4. D乙型和丁型肝炎

3溶液

1.感染控制与患者安全

答案: D · Head of the bed raised 30 to 45 degrees

为什么是这个答案

Raising the head of the bed to 30–45 degrees reduces aspiration of oral and gastric secretions into the lungs. It is part of the usual ventilator care bundle, unless contraindicated.

答案

D · Head of the bed raised 30 to 45 degrees
2.感染控制与患者安全

答案: A · Stop the infusion and check the patient’s blood glucose

为什么是这个答案

A concentration error means the dose delivered was wrong. The nurse stops the infusion, assesses the patient including blood glucose, treats as needed, notifies the prescriber and reports the event.

答案

A · Stop the infusion and check the patient’s blood glucose
3.护理学基础

答案: B · Patients who know their breathing is watched tend to change it

为什么是这个答案

Breathing can be changed on purpose, so a patient who is aware of being watched may breathe differently. Counting unobtrusively for a full minute gives a more accurate rate.

答案

B · Patients who know their breathing is watched tend to change it
4.护理学基础

答案: A · The patient has COPD and was admitted two days ago with pneumonia

为什么是这个答案

SBAR is Situation (why you are calling), Background (relevant history), Assessment (your findings) and Recommendation (what you need). Clear structure speeds up the response.

答案

A · The patient has COPD and was admitted two days ago with pneumonia
5.微生物学

答案: B · Bordetella pertussis

为什么是这个答案

百日咳鲍特菌（Bordetella pertussis）引起长时间的阵发性咳嗽，伴有"鸡鸣样"回声。它对幼小婴儿最危险，这就是许多国家为孕妇提供疫苗接种的原因。

答案

B · Bordetella pertussis
6.微生物学

答案: A · 甲型和戊型肝炎

为什么是这个答案

甲型（A）和戊型（E）肝炎经粪-口途径传播。乙型、丙型和丁型通过血液和体液传播，并可引起慢性感染。

答案

A · 甲型和戊型肝炎

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