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

Which information must be documented when a patient is restrained?

  1. AOnly whether the family agreed to the restraint
  2. BOnly the name of the nurse who applied it and the unit where it happened
  3. CThe reason, alternatives tried, type of restraint, times and regular assessments
  4. DOnly the time the restraint was put on and the time it was taken off
2.感染控制与患者安全困难

A competent patient at high risk of falls insists on walking to the bathroom alone. What is the best nursing approach?

  1. ARemove the patient’s shoes and walking aid so that they cannot walk alone
  2. BTell the patient that walking alone is against hospital law
  3. CExplain the risks, agree on ways to reduce them, respect the decision and document
  4. DApply wrist restraints so the patient stays in bed
3.护理学基础中等

An IV cannula site is swollen, cool and pale, and the infusion has slowed. What should the nurse do first?

  1. AStop the infusion and remove the cannula
  2. BIncrease the infusion rate to clear the blockage
  3. CFlush the cannula hard with saline
  4. DApply a warm pack and keep the infusion running
4.护理学基础困难

A patient who had a GCS of 15 this morning now opens their eyes only to voice and is confused. What should the nurse do?

  1. ARecord it and recheck at the next routine time
  2. BGive a sedative to calm the confusion
  3. CTreat it as deterioration and escalate urgently
  4. DLet the patient sleep, as they are probably tired
5.微生物学中等

Streptococcus pneumoniae 的主要毒力因子、也是其疫苗的靶点是什么？

  1. A它的芽孢
  2. B它的类霍乱毒素
  3. C它的多糖荚膜
  4. D它的鞭毛
6.微生物学困难

高危型 HPV 如何促成宫颈癌？

  1. A病毒的 E6 和 E7 蛋白使抑癌蛋白 p53 和 Rb 失活
  2. B病毒产生损伤 DNA 的内毒素
  3. C病毒破坏宫颈中的 CD4 T 细胞
  4. D病毒杀死细胞的速度太快，以至于它们被癌细胞取代

3溶液

1.感染控制与患者安全

答案: C · The reason, alternatives tried, type of restraint, times and regular assessments

为什么是这个答案

Restraint documentation includes the behavior that made it necessary, less restrictive measures tried, the order, the type used, the times applied and released, and ongoing checks of circulation, skin, needs and mental state.

答案

C · The reason, alternatives tried, type of restraint, times and regular assessments
2.感染控制与患者安全

答案: C · Explain the risks, agree on ways to reduce them, respect the decision and document

为什么是这个答案

A competent patient can accept a risk. The nurse explains the danger, offers measures such as a low bed, non-slip footwear, a clear path and a call light, respects the choice and documents the discussion.

答案

C · Explain the risks, agree on ways to reduce them, respect the decision and document
3.护理学基础

答案: A · Stop the infusion and remove the cannula

为什么是这个答案

These are signs of infiltration. The infusion is stopped, the cannula removed, the limb elevated and the event documented. A new cannula is sited elsewhere if still needed.

答案

A · Stop the infusion and remove the cannula
4.护理学基础

答案: C · Treat it as deterioration and escalate urgently

为什么是这个答案

The score has dropped to about 13. Any new fall in consciousness or new confusion needs urgent escalation, a full ABCDE assessment and a check of glucose.

答案

C · Treat it as deterioration and escalate urgently
5.微生物学

答案: C · 它的多糖荚膜

为什么是这个答案

荚膜保护 S. pneumoniae 免受吞噬。荚膜型有很多种，肺炎球菌疫苗含有最常见型别的荚膜多糖。

答案

C · 它的多糖荚膜
6.微生物学

答案: A · 病毒的 E6 和 E7 蛋白使抑癌蛋白 p53 和 Rb 失活

为什么是这个答案

E6 促进 p53 的降解，E7 与 Rb 结合，从而解除了对细胞分裂和 DNA 修复的控制。受感染的细胞随后可能在数年间积累突变而癌变。

答案

A · 病毒的 E6 和 E7 蛋白使抑癌蛋白 p53 和 Rb 失活

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