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

An adult with hepatitis A is incontinent of stool. Which precautions are used?

  1. AA protective environment with filtered air
  2. BAirborne precautions in a negative-pressure room with the door closed
  3. CContact precautions in addition to standard precautions
  4. DDroplet precautions with a surgical mask
2.感染控制与患者安全困难

A patient takes medicines prescribed by several providers. Which advice best reduces the risk of medication errors at home?

  1. AOnly tell each provider about the drugs they prescribed
  2. BKeep each provider’s medicines in separate bags
  3. CStop taking any medicine that seems to repeat another one, without asking anyone
  4. DKeep one up-to-date list of all medicines and use one pharmacy where possible
3.护理学基础中等

A patient's hearing aid keeps whistling. What is the most likely cause?

  1. AIt is not fitted properly in the ear
  2. BThe patient's hearing has improved
  3. CThe volume is turned right down
  4. DThe battery is completely flat
4.护理学基础困难

While counting an apical pulse, the nurse finds the rhythm is irregularly irregular and the radial rate is lower than the apical rate. Which rhythm is most likely?

  1. ASinus tachycardia
  2. BAtrial fibrillation
  3. CSinus bradycardia
  4. DNormal sinus rhythm
5.微生物学中等

下列哪一项是科赫法则之一？

  1. A将该生物接种到健康易感宿主体内时，必须引起相同的疾病
  2. B该生物必须肉眼可见
  3. C该疾病必须对抗生素有反应
  4. D该生物也必须能在健康人体内找到
6.微生物学困难

HIV 等逆转录病毒如何把自己的基因组复制到宿主 DNA 中？

  1. A核糖体把病毒 RNA 翻译成 DNA
  2. B宿主 DNA 聚合酶在没有帮助的情况下复制 RNA
  3. C逆转录酶以病毒 RNA 为模板合成 DNA，整合酶将其插入
  4. D宿主 RNA 聚合酶直接复制病毒 DNA

3溶液

1.感染控制与患者安全

答案: C · Contact precautions in addition to standard precautions

为什么是这个答案

Hepatitis A spreads through fecal contamination. For a patient who is incontinent or in diapers, contact precautions are added to standard precautions to prevent spread on hands and surfaces.

答案

C · Contact precautions in addition to standard precautions
2.感染控制与患者安全

答案: D · Keep one up-to-date list of all medicines and use one pharmacy where possible

为什么是这个答案

A single complete medication list and one pharmacy allow interactions and duplicates to be detected. The list, including over-the-counter drugs and supplements, is shown at every visit.

答案

D · Keep one up-to-date list of all medicines and use one pharmacy where possible
3.护理学基础

答案: A · It is not fitted properly in the ear

为什么是这个答案

Whistling is feedback, usually from a poor fit, earwax or a damaged tube. Refitting the aid or checking for wax usually solves it; a flat battery makes it silent.

答案

A · It is not fitted properly in the ear
4.护理学基础

答案: B · Atrial fibrillation

为什么是这个答案

Atrial fibrillation gives an irregularly irregular pulse, and some beats are too weak to be felt at the wrist, causing a pulse deficit. It should be reported and confirmed with an ECG.

答案

B · Atrial fibrillation
5.微生物学

答案: A · 将该生物接种到健康易感宿主体内时，必须引起相同的疾病

为什么是这个答案

科赫法则指出，该微生物必须在每个病例中都能找到，能进行纯培养，能在健康宿主中引起该病，并能从该宿主体内再次分离出来。有些病原体无法培养，因此这些法则有其局限性。

答案

A · 将该生物接种到健康易感宿主体内时，必须引起相同的疾病
6.微生物学

答案: C · 逆转录酶以病毒 RNA 为模板合成 DNA，整合酶将其插入

为什么是这个答案

逆转录酶把 RNA 基因组转变为 DNA，整合酶再把它作为前病毒插入宿主基因组。这两种酶都是药物靶点。

答案

C · 逆转录酶以病毒 RNA 为模板合成 DNA，整合酶将其插入

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