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 wants to set up a sterile field in the morning for a procedure that will take place after lunch. What is correct?

  1. ASet it up in the morning and cover it with a clean towel until the procedure starts
  2. BSet it up in the morning and leave it uncovered in an empty room
  3. CSet it up just before the procedure, because a waiting field may become contaminated
  4. DSet it up in the morning and ask a colleague to check it once
2.感染控制与患者安全困难

The laboratory reports that a blood sample labeled with one patient’s name has a blood group different from that patient’s previous result. What is the most likely problem and response?

  1. AA laboratory machine fault, so no action is needed
  2. BThe previous result was wrong, so it is deleted
  3. CA wrong-patient sample, so the test is repeated and the event reported
  4. DA normal change in the patient’s blood group over the years since the last test
3.护理学基础中等

A patient with a weak left leg walks with a stick in the right hand. What is the correct sequence?

  1. AMove the right leg first, then the stick, then the left leg
  2. BMove both legs forward together first, then bring the stick level with them
  3. CMove the stick and the right leg together, then the left leg
  4. DMove the stick and the left leg forward together, then the right leg
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. BRepeat the observations at the next routine time
  3. CAssess the patient straight away
  4. DComplete an incident report
5.微生物学中等

哪种生物是烧伤和囊性纤维化患者感染的常见病原，并能产生绿色色素？

  1. AClostridium tetani
  2. BPseudomonas aeruginosa
  3. CHelicobacter pylori
  4. DStreptococcus pyogenes
6.微生物学困难

血培养阳性，显示成簇的革兰氏阳性球菌。最可能是哪种微生物？

  1. ANeisseria
  2. BStreptococcus
  3. CStaphylococcus
  4. D呈短链状的 Enterococcus

3溶液

1.感染控制与患者安全

答案: C · Set it up just before the procedure, because a waiting field may become contaminated

为什么是这个答案

The longer a sterile field is exposed, the more likely it is to be contaminated, and an unattended field cannot be considered sterile. It is prepared just before use.

答案

C · Set it up just before the procedure, because a waiting field may become contaminated
2.感染控制与患者安全

答案: C · A wrong-patient sample, so the test is repeated and the event reported

为什么是这个答案

A different blood group strongly suggests the sample came from another patient. A new sample is taken with careful bedside identification and labeling, and the event is reported as a serious near miss.

答案

C · A wrong-patient sample, so the test is repeated and the event reported
3.护理学基础

答案: D · Move the stick and the left leg forward together, then the right leg

为什么是这个答案

The stick and the weak leg move together so the stick takes part of the load, then the strong leg steps through.

答案

D · Move the stick and the left leg forward together, then the right leg
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: B · Pseudomonas aeruginosa

为什么是这个答案

铜绿假单胞菌（Pseudomonas aeruginosa）是烧伤、机械通气患者和囊性纤维化患者肺部的机会性病原体。它对许多抗生素天然耐药。

答案

B · Pseudomonas aeruginosa
6.微生物学

答案: C · Staphylococcus

为什么是这个答案

葡萄球菌呈葡萄串状成簇生长；链球菌和肠球菌呈链状或成对。奈瑟菌是革兰氏阴性双球菌。

答案

C · Staphylococcus

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