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

Sputum specimens are ordered to look for acid-fast bacilli (TB). How are they usually collected?

  1. AThree specimens collected after an antiseptic mouthwash
  2. BOne specimen of sputum collected straight after the evening meal, when coughing is easiest
  3. COne saliva sample collected at any convenient time of day
  4. DThree deep-cough specimens collected 8 to 24 hours apart, at least one early in the morning
2.感染控制与患者安全困难

A nurse teaches new parents how to cope with an infant’s crying. Which statement shows a need for further teaching?

  1. A“If I get frustrated, I will put him safely in the crib and take a short break.”
  2. B“If he won’t stop crying, a quick shake will get his attention.”
  3. C“I will check whether he is hungry, wet or too warm.”
  4. D“I can call a friend or family member to help when I am tired.”
3.护理学基础中等

What does the Visual Infusion Phlebitis (VIP) score assess?

  1. AThe patient's eyesight before surgery
  2. BThe risk of an allergic reaction to IV drugs
  3. CThe cannula site for signs of phlebitis
  4. DThe speed of an infusion pump
4.护理学基础困难

A patient describes burning, shooting pain with pins and needles in both feet. Which type of pain is most likely?

  1. AAcute somatic pain
  2. BVisceral pain
  3. CReferred pain
  4. DNeuropathic pain
5.微生物学中等

哪种疫苗含有减毒活病毒？

  1. A破伤风疫苗
  2. BMMR（麻疹、腮腺炎、风疹）疫苗
  3. C乙型肝炎疫苗
  4. D灭活流感注射疫苗
6.微生物学困难

为什么人可以多次得流感，而麻疹通常只得一次？

  1. A流感病毒攻击并破坏感染后形成的记忆细胞
  2. B麻疹病毒没有表面抗原
  3. C麻疹由细菌引起
  4. D流感病毒经常改变其表面抗原

3溶液

1.感染控制与患者安全

答案: D · Three deep-cough specimens collected 8 to 24 hours apart, at least one early in the morning

为什么是这个答案

Several deep-cough sputum samples improve the chance of finding acid-fast bacilli, and early-morning samples contain the most secretions. Saliva is not sputum, and antiseptic mouthwash can affect the result.

答案

D · Three deep-cough specimens collected 8 to 24 hours apart, at least one early in the morning
2.感染控制与患者安全

答案: B · “If he won’t stop crying, a quick shake will get his attention.”

为什么是这个答案

Shaking an infant can cause bleeding in the brain, permanent disability or death. Parents are taught to put the baby down safely and step away if they feel overwhelmed, and to ask for help.

答案

B · “If he won’t stop crying, a quick shake will get his attention.”
3.护理学基础

答案: C · The cannula site for signs of phlebitis

为什么是这个答案

The VIP score grades pain, redness, swelling and hardening along the vein. A rising score tells the nurse when the cannula must be removed.

答案

C · The cannula site for signs of phlebitis
4.护理学基础

答案: D · Neuropathic pain

为什么是这个答案

Neuropathic pain comes from damage to nerves, for example in diabetes, and is often burning, shooting or tingling. It may respond poorly to standard analgesics and need specific drugs.

答案

D · Neuropathic pain
5.微生物学

答案: B · MMR（麻疹、腮腺炎、风疹）疫苗

为什么是这个答案

MMR 含有减毒活病毒，它们会少量复制，产生强大而持久的免疫力。破伤风疫苗是类毒素，乙肝疫苗是亚单位疫苗。

答案

B · MMR（麻疹、腮腺炎、风疹）疫苗
6.微生物学

答案: D · 流感病毒经常改变其表面抗原

为什么是这个答案

流感病毒的血凝素和神经氨酸酶会通过漂移（小突变）和转变（基因重配）而改变，旧抗体可能识别不了新毒株。麻疹病毒抗原稳定。

答案

D · 流感病毒经常改变其表面抗原

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