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

A nurse’s hands are dry and cracked from frequent hand hygiene. What is the best approach?

  1. AUse any lotion from home, whatever its contents
  2. BStop hand hygiene until the skin heals
  3. CUse the hand lotion approved by the facility to keep the skin intact
  4. DWear gloves all day instead of cleaning the hands between patients
2.感染控制与患者安全困难

An audit shows poor hand hygiene compliance on a ward. Which plan is most likely to improve it?

  1. ARemoving all sinks so staff must use hand rub
  2. BDisciplining staff who are seen not cleaning their hands, with no other change
  3. CA combined approach with education, hand rub at every bedside, regular audits and feedback
  4. DA single poster about hand hygiene placed in the staff room
3.护理学基础中等

Teaching a patient how to inject insulin mainly involves which domain of learning?

  1. APsychomotor
  2. BSpiritual
  3. CAffective
  4. DCognitive
4.护理学基础困难

During a sterile dressing change, the nurse's sterile glove touches the bed rail. What should the nurse do?

  1. ACarry on, as the bed rail was cleaned that morning
  2. BRemove the gloves, perform hand hygiene and put on new sterile gloves
  3. CPut a second pair of sterile gloves over the first pair
  4. DWipe the glove with an alcohol swab and carry on with the dressing change
5.微生物学中等

什么是内毒素？

  1. A只在人体细胞内产生的毒素
  2. B革兰氏阴性菌外膜中的脂多糖
  3. C潮湿建筑中真菌产生的毒素
  4. D革兰氏阳性菌分泌到周围组织中的蛋白质毒素
6.微生物学困难

为什么在感染后的最初几周 HIV 抗体检测可能呈阴性？

  1. A病毒在最初几周只藏在红细胞中
  2. B抗体被检测试剂破坏
  3. CHIV 根本不会引起抗体产生
  4. D机体尚未产生足以检测到的抗体

3溶液

1.感染控制与患者安全

答案: C · Use the hand lotion approved by the facility to keep the skin intact

为什么是这个答案

Cracked skin is harder to clean and harbors more organisms. Facility-approved lotions help keep the skin healthy without reducing the effect of hand antiseptics such as chlorhexidine.

答案

C · Use the hand lotion approved by the facility to keep the skin intact
2.感染控制与患者安全

答案: C · A combined approach with education, hand rub at every bedside, regular audits and feedback

为什么是这个答案

Multimodal strategies, such as easy access to hand rub at the point of care, training, reminders, audits with feedback and leadership support, improve hand hygiene more than single actions.

答案

C · A combined approach with education, hand rub at every bedside, regular audits and feedback
3.护理学基础

答案: A · Psychomotor

为什么是这个答案

The psychomotor domain covers physical skills, the cognitive domain covers knowledge and the affective domain covers attitudes and feelings. Skills are learned by demonstration and practice.

答案

A · Psychomotor
4.护理学基础

答案: B · Remove the gloves, perform hand hygiene and put on new sterile gloves

为什么是这个答案

A sterile glove that touches a non-sterile surface is contaminated and must be replaced. Cleaning it or covering it does not restore sterility.

答案

B · Remove the gloves, perform hand hygiene and put on new sterile gloves
5.微生物学

答案: B · 革兰氏阴性菌外膜中的脂多糖

为什么是这个答案

内毒素是脂多糖中的类脂 A。它引发伴有发热的强烈免疫反应，大量时可导致感染性休克。

答案

B · 革兰氏阴性菌外膜中的脂多糖
6.微生物学

答案: D · 机体尚未产生足以检测到的抗体

为什么是这个答案

抗体需要数周才会出现。同时检测 p24 抗原的联合检测或病毒 RNA 检测可以缩短这一窗口期。

答案

D · 机体尚未产生足以检测到的抗体

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