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

Before a blood transfusion is started, which check is required?

  1. AThe patient’s identity is checked against the blood product and its paperwork at the bedside
  2. BOne nurse checks the blood product against the order at the nurses’ station
  3. CThe patient signs the blood bag label to confirm their name before it is hung
  4. DThe nurse checks only that the bag number matches the order
2.感染控制与患者安全困难

A patient has a rash, and both smallpox and chickenpox are considered. Which finding suggests smallpox?

  1. ASmall crops of new lesions appearing over several days in a row
  2. BLesions at different stages, most dense on the trunk
  3. CLesions all at the same stage, most dense on the face and limbs
  4. DA rash that is very itchy and starts on the trunk
3.护理学基础中等

哪项措施有助于预防住院患者发生深静脉血栓？

  1. A限制液体摄入
  2. B让患者尽可能长时间卧床
  3. C早期下床活动和下肢运动
  4. D坐着时跷二郎腿
4.护理学基础困难

Before giving a PRN dose of oral morphine, which assessment is most important?

  1. AThe patient's last bowel movement
  2. BThe respiratory rate and level of sedation
  3. CThe patient's weight and height, recorded on admission
  4. DThe patient's blood glucose level
5.微生物学中等

在急性细菌感染中，哪种白细胞是主要的吞噬细胞，也是脓液的主要成分？

  1. AB 淋巴细胞
  2. B嗜碱性粒细胞
  3. C中性粒细胞
  4. D嗜酸性粒细胞
6.微生物学困难

几个人在吃了前一天做好、在室温下放置的炒饭后几小时内呕吐。典型的病原体是什么？

  1. AListeria monocytogenes
  2. BSalmonella Typhi
  3. CBacillus cereus
  4. DClostridium botulinum

3溶液

1.感染控制与患者安全

答案: A · The patient’s identity is checked against the blood product and its paperwork at the bedside

为什么是这个答案

Wrong-patient transfusion can cause a fatal ABO reaction, so the final check is always done at the bedside, with positive patient identification against the product label, compatibility tag and order. Many US hospitals require two qualified people for this check, while UK guidance allows one trained person if positive identification is used. Local policy decides who checks.

答案

A · The patient’s identity is checked against the blood product and its paperwork at the bedside
2.感染控制与患者安全

答案: C · Lesions all at the same stage, most dense on the face and limbs

为什么是这个答案

In smallpox, lesions develop at the same stage in any one area and are densest on the face and extremities. In chickenpox, crops appear at different stages and are densest on the trunk.

答案

C · Lesions all at the same stage, most dense on the face and limbs
3.护理学基础

答案: C · 早期下床活动和下肢运动

为什么是这个答案

早期活动、下肢运动、充足的水分，以及经评估适合时使用弹力袜或抗凝药物，可以减少静脉淤滞和血栓形成的风险。

答案

C · 早期下床活动和下肢运动
4.护理学基础

答案: B · The respiratory rate and level of sedation

为什么是这个答案

Opioids can cause sedation and respiratory depression. Checking breathing and alertness before each dose, as well as the pain score, keeps the patient safe.

答案

B · The respiratory rate and level of sedation
5.微生物学

答案: C · 中性粒细胞

为什么是这个答案

中性粒细胞迅速到达感染部位并吞噬细菌。死亡的中性粒细胞、细菌和组织碎片形成脓液。

答案

C · 中性粒细胞
6.微生物学

答案: C · Bacillus cereus

为什么是这个答案

蜡样芽孢杆菌（Bacillus cereus）的芽孢能耐受煮沸。如果熟米饭在温热状态下放置，细菌会生长并产生耐热的呕吐毒素，因此重新加热并不能使米饭变得安全。

答案

C · Bacillus cereus

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