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

使用中心静脉导管接头之前，护士应该做什么？

  1. A轻轻吹接头以去除灰尘
  2. B用消毒剂擦洗接头并待其干燥
  3. C用干的无菌纱布快速擦拭
  4. D什么都不用做，因为接头在无菌帽的保护下
2.感染控制与患者安全困难

In a US hospital (CMS rules), a patient keeps pulling at an endotracheal tube, and alternatives have failed. The nurse applies wrist restraints in an emergency. What must happen next?

  1. AObtain a time-limited order for the restraint promptly, following policy
  2. BAsk the provider for a PRN restraint order to use as needed
  3. CKeep the restraints on without an order until the patient is calm
  4. DAsk the family to sign a consent form instead of an order
3.护理学基础中等

A patient says, "I've never seen this tablet before," as the nurse offers it. What should the nurse do?

  1. AGive half the tablet until the doctor visits
  2. BStop and recheck the prescription before giving it
  3. CReassure the patient that the tablet is correct and give it
  4. DLeave the tablet on the table for the patient to take later
4.护理学基础困难

An infusion pump alarms "occlusion". What should the nurse check first?

  1. AThe battery level of the pump
  2. BThe patient's blood glucose level
  3. CThe clamps, the tubing for kinks and the cannula site
  4. DThe fluid prescription chart and the infusion rate written on it
5.微生物学中等

免疫系统的哪一部分产生抗体？

  1. A中性粒细胞
  2. B由 B 淋巴细胞分化而来的浆细胞
  3. C在淋巴结中被激活的细胞毒性 T 细胞
  4. D自然杀伤细胞
6.微生物学困难

一名旅行者从撒哈拉以南非洲回来后发热，怀疑患疟疾。哪一种最可能引起重症和脑型疟疾？

  1. APlasmodium malariae
  2. BPlasmodium vivax
  3. CPlasmodium ovale
  4. DPlasmodium falciparum

3溶液

1.感染控制与患者安全

答案: B · 用消毒剂擦洗接头并待其干燥

为什么是这个答案

用酒精或氯己定等消毒剂“擦洗接头”，并充分摩擦、留足干燥时间，可减少中心静脉导管相关血流感染。干燥时间是消毒的一部分。

答案

B · 用消毒剂擦洗接头并待其干燥
2.感染控制与患者安全

答案: A · Obtain a time-limited order for the restraint promptly, following policy

为什么是这个答案

Under US CMS rules, a nurse may apply a restraint first in an emergency, but an order from a licensed provider must be obtained promptly according to policy. PRN restraint orders are not allowed, and family consent does not replace an order. Other countries use different legal frameworks, but restraint is always a last resort that must be authorized, reviewed and documented.

答案

A · Obtain a time-limited order for the restraint promptly, following policy
3.护理学基础

答案: B · Stop and recheck the prescription before giving it

为什么是这个答案

A patient questioning a medicine may be a sign of an error. The nurse holds the dose, checks the prescription and the drug and explains before giving it.

答案

B · Stop and recheck the prescription before giving it
4.护理学基础

答案: C · The clamps, the tubing for kinks and the cannula site

为什么是这个答案

An occlusion alarm means the flow is blocked, for example by a closed clamp, kinked tubing, a bent arm or a blocked cannula. The nurse checks from the bag to the patient.

答案

C · The clamps, the tubing for kinks and the cannula site
5.微生物学

答案: B · 由 B 淋巴细胞分化而来的浆细胞

为什么是这个答案

被激活的 B 细胞分化为分泌抗体的浆细胞。细胞毒性 T 细胞和 NK 细胞则直接杀伤被感染的细胞。

答案

B · 由 B 淋巴细胞分化而来的浆细胞
6.微生物学

答案: D · Plasmodium falciparum

为什么是这个答案

恶性疟原虫（P. falciparum）可导致极高的原虫血症，并使受感染的红细胞滞留在包括脑在内的小血管中。它在撒哈拉以南非洲很常见，属于医疗急症。

答案

D · Plasmodium falciparum

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