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 patient with delirium is at risk of falls and of pulling out lines. Which option is less restrictive than restraints?

  1. AA trained sitter or video monitoring with staff nearby
  2. BA sedative given every few hours as needed
  3. CA vest restraint applied for the whole night
  4. DFour side rails raised and the door closed so the patient stays in bed
2.感染控制与患者安全困难

患者的处方是肼屈嗪（hydralazine），但药房送来的是羟嗪（hydroxyzine）。护士应怎么做？

  1. A给药，因为这两个药名几乎相同
  2. B折中给予羟嗪的半量
  3. C先给药，之后再告知开医嘱者
  4. D不给药，并联系药房取得正确的药物
3.护理学基础中等

What makes "Risk for falls" a risk nursing diagnosis rather than an actual one?

  1. AThe problem can never be prevented
  2. BThe patient has already fallen several times
  3. CThe fall has not happened yet, but risk factors are present
  4. DThe doctor has confirmed the diagnosis with tests and a scan
4.护理学基础困难

A nurse escalated a deteriorating patient, but the doctor has not come after 30 minutes and the patient is getting worse. What should the nurse do?

  1. AEscalate further, for example to a senior doctor or the rapid response team
  2. BWait, since the doctor has already been told
  3. CTreat the patient with drugs from the cupboard without a prescription
  4. DWrite in the notes that the doctor did not come and do nothing else
5.微生物学中等

下列哪一项是科赫法则之一？

  1. A该生物也必须能在健康人体内找到
  2. B该生物必须肉眼可见
  3. C将该生物接种到健康易感宿主体内时，必须引起相同的疾病
  4. D该疾病必须对抗生素有反应
6.微生物学困难

为什么克拉维酸等 β-内酰胺酶抑制剂要与阿莫西林联用？

  1. A它们保护阿莫西林不被破坏它的细菌酶分解
  2. B它们本身通过细胞膜杀死细菌
  3. C它们使阿莫西林对病毒有效
  4. D它们减慢肾脏对阿莫西林的排泄，使其水平升高

3溶液

1.感染控制与患者安全

答案: A · A trained sitter or video monitoring with staff nearby

为什么是这个答案

Close observation by a sitter or video monitoring allows staff to step in quickly, without restricting the patient. It is often combined with reorientation and family presence.

答案

A · A trained sitter or video monitoring with staff nearby
2.感染控制与患者安全

答案: D · 不给药，并联系药房取得正确的药物

为什么是这个答案

肼屈嗪是降压药，而羟嗪是用于止痒和抗焦虑的抗组胺药。给错药属于用药差错。护士应扣留该药，取得正确的药物，并上报配药差错。

答案

D · 不给药，并联系药房取得正确的药物
3.护理学基础

答案: C · The fall has not happened yet, but risk factors are present

为什么是这个答案

A risk diagnosis describes a problem the patient is vulnerable to, based on risk factors, with no signs yet. Care aims to prevent the problem from occurring.

答案

C · The fall has not happened yet, but risk factors are present
4.护理学基础

答案: A · Escalate further, for example to a senior doctor or the rapid response team

为什么是这个答案

If a response is delayed and the patient deteriorates, the nurse follows the escalation policy to the next level and keeps monitoring and supporting ABCDE. Each step is documented.

答案

A · Escalate further, for example to a senior doctor or the rapid response team
5.微生物学

答案: C · 将该生物接种到健康易感宿主体内时，必须引起相同的疾病

为什么是这个答案

科赫法则指出，该微生物必须在每个病例中都能找到，能进行纯培养，能在健康宿主中引起该病，并能从该宿主体内再次分离出来。有些病原体无法培养，因此这些法则有其局限性。

答案

C · 将该生物接种到健康易感宿主体内时，必须引起相同的疾病
6.微生物学

答案: A · 它们保护阿莫西林不被破坏它的细菌酶分解

为什么是这个答案

β-内酰胺酶会水解 β-内酰胺环。克拉维酸与这些酶结合，使阿莫西林对产 β-内酰胺酶的细菌保持活性。

答案

A · 它们保护阿莫西林不被破坏它的细菌酶分解

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