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 with a fentanyl skin patch wants to use a heating pad on the area. What should the nurse teach?

  1. AHeat makes the patch last longer, so fewer patches are needed each month
  2. BAvoid heat on or near the patch, because it increases how fast the drug is absorbed
  3. CHeat only matters if the patch is on the chest
  4. DHeat is fine to use, because it helps the patch stick better to the skin
2.感染控制与患者安全困难

A patient on an anticoagulant falls and hits their head but says they feel fine. What should the nurse do?

  1. ANotify the provider and start neurological observations, because a brain bleed may develop
  2. BHelp the patient back to bed and do nothing more if they feel fine
  3. CWait until the next day to see if a headache develops
  4. DGive the next anticoagulant dose early to prevent clots from forming after the fall
3.护理学基础中等

How long should each pass of oropharyngeal or tracheal suction usually last?

  1. AAbout 30–45 seconds
  2. BAbout one minute
  3. CAs long as secretions keep coming
  4. DNo more than about 10–15 seconds
4.护理学基础困难

For a patient at risk of pressure ulcers, why is the head of the bed usually kept at 30 degrees or less if their condition allows?

  1. ALower angles stop the patient from getting out of bed
  2. BLower angles increase blood flow to the heels
  3. CHigher angles make the patient slide down, causing shear over the sacrum
  4. DHigher angles always cause breathing problems in patients who are bedbound
5.微生物学中等

mRNA 疫苗如何产生免疫力？

  1. AmRNA 被永久插入人类 DNA
  2. BmRNA 含有减毒活病毒
  3. CmRNA 在血液中直接杀死病毒
  4. D人体细胞利用 mRNA 合成一种病毒蛋白，免疫系统学会识别它
6.微生物学困难

朊病毒与所有其他病原体不同，是因为它们：

  1. A只能感染细菌
  2. B只含 RNA，基因组周围没有蛋白质外壳
  3. C不含核酸，由错误折叠的蛋白质构成
  4. D能被普通烹饪和消毒杀灭

3溶液

1.感染控制与患者安全

答案: B · Avoid heat on or near the patch, because it increases how fast the drug is absorbed

为什么是这个答案

Heat from heating pads, electric blankets, hot tubs or fever increases fentanyl absorption and can cause an overdose. Patients are taught to avoid heat over the patch.

答案

B · Avoid heat on or near the patch, because it increases how fast the drug is absorbed
2.感染控制与患者安全

答案: A · Notify the provider and start neurological observations, because a brain bleed may develop

为什么是这个答案

Head injury in a patient on anticoagulants can cause bleeding inside the skull that shows signs later. The provider is told at once, imaging may be needed and neurological checks are done closely.

答案

A · Notify the provider and start neurological observations, because a brain bleed may develop
3.护理学基础

答案: D · No more than about 10–15 seconds

为什么是这个答案

Suction removes oxygen as well as secretions. Keeping passes short, oxygenating as needed and watching SpO₂ reduces hypoxia and airway trauma.

答案

D · No more than about 10–15 seconds
4.护理学基础

答案: C · Higher angles make the patient slide down, causing shear over the sacrum

为什么是这个答案

When the head is raised high, the body tends to slide while the skin stays still, distorting the tissues over the sacrum. Keeping the angle low, where safe, reduces this shear.

答案

C · Higher angles make the patient slide down, causing shear over the sacrum
5.微生物学

答案: D · 人体细胞利用 mRNA 合成一种病毒蛋白，免疫系统学会识别它

为什么是这个答案

mRNA 被细胞翻译成一种抗原，例如冠状病毒的刺突蛋白，免疫系统对其产生应答。mRNA 随后被降解，不会进入细胞核。

答案

D · 人体细胞利用 mRNA 合成一种病毒蛋白，免疫系统学会识别它
6.微生物学

答案: C · 不含核酸，由错误折叠的蛋白质构成

为什么是这个答案

朊病毒是错误折叠的蛋白质，能诱导正常蛋白质也发生错误折叠。它们不含 DNA 或 RNA，对常规灭菌非常耐受。

答案

C · 不含核酸，由错误折叠的蛋白质构成

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