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 technique is used for suctioning a tracheostomy in hospital?

  1. ANo gloves at all, because the airway already contains bacteria
  2. BSterile technique, with a sterile catheter and sterile glove
  3. CClean technique, with the catheter rinsed in tap water
  4. DClean technique, reusing the catheter during the shift
2.感染控制与患者安全困难

Before the wound is closed, the sponge count does not match the starting count. What should happen?

  1. AClose the wound to avoid a long anesthetic and recount the sponges after surgery
  2. BChange the count on the record so that it matches, then close the wound as planned
  3. CTell the surgeon and team, search for the item, and image the patient per policy if it is not found
  4. DAssume that the first count was wrong and continue
3.护理学基础中等

A patient is found on the floor beside the bed. What should the nurse do first?

  1. AComplete the incident report first, then go back to assess the patient fully
  2. BLift the patient straight back into bed
  3. CAsk the patient to stand up on their own
  4. DCheck responsiveness and look for injuries before moving them
4.护理学基础困难

Which statement about the use of physical restraint is correct?

  1. AIt is a last resort, uses the least restrictive option and needs regular checks
  2. BIt is the best way to stop older patients from falling
  3. CIt can be used whenever a patient is confused, without further assessment
  4. DIt never needs to be documented if it is used only overnight
5.微生物学中等

在诊断实验室中，PCR 的作用是什么？

  1. A使细菌在琼脂平板上生长得更快
  2. B给细菌染色以便观察
  3. C它测量患者血清样本中特定抗体的水平
  4. D大量复制特定的 DNA 序列以便检测
6.微生物学困难

19世纪60年代，约瑟夫·李斯特减少了术后感染。他的主要创新是什么？

  1. A在每次手术前用蒸汽高压灭菌器对所有手术器械灭菌
  2. B每次手术后都给予磺胺类抗生素
  3. C给外科医生接种葡萄球菌疫苗
  4. D用石炭酸（苯酚）作为伤口和器械的消毒剂

3溶液

1.感染控制与患者安全

答案: B · Sterile technique, with a sterile catheter and sterile glove

为什么是这个答案

In hospital, tracheal suctioning uses sterile technique to avoid introducing organisms into the lower airway. Clean technique may be taught for long-term home care, according to policy.

答案

B · Sterile technique, with a sterile catheter and sterile glove
2.感染控制与患者安全

答案: C · Tell the surgeon and team, search for the item, and image the patient per policy if it is not found

为什么是这个答案

A count discrepancy is reported to the whole team at once. Closure waits while the field, wound and room are searched, and an x-ray is taken per policy if the item is still missing.

答案

C · Tell the surgeon and team, search for the item, and image the patient per policy if it is not found
3.护理学基础

答案: D · Check responsiveness and look for injuries before moving them

为什么是这个答案

The nurse first calls for help and assesses the patient, including for head and hip injury. The patient is moved only when safe, using proper equipment, and the doctor is informed.

答案

D · Check responsiveness and look for injuries before moving them
4.护理学基础

答案: A · It is a last resort, uses the least restrictive option and needs regular checks

为什么是这个答案

Restraint carries risks such as injury, distress and pressure damage. It is used only when alternatives have failed, in the least restrictive form, for the shortest time, with monitoring and documentation.

答案

A · It is a last resort, uses the least restrictive option and needs regular checks
5.微生物学

答案: D · 大量复制特定的 DNA 序列以便检测

为什么是这个答案

聚合酶链反应能把目标序列扩增数百万倍，可以检测难以培养的病原体；RNA 病毒需先转化为 DNA（RT-PCR）。

答案

D · 大量复制特定的 DNA 序列以便检测
6.微生物学

答案: D · 用石炭酸（苯酚）作为伤口和器械的消毒剂

为什么是这个答案

李斯特把石炭酸用于伤口、敷料和器械，大大减少了术后感染，由此开创了抗菌外科。

答案

D · 用石炭酸（苯酚）作为伤口和器械的消毒剂

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