護理師在內外科病房照護一組病人。下列哪些病人應被安排在單人隔離病房？（選所有適合的）
A nurse is caring for a group of clients on a medical-surgical unit. Which client should be placed in a private room? (Select all that apply.)
- AA client with Neisseria meningitidis pneumonia✓ 正解患有腦膜炎雙球菌肺炎的病人
- BA client with a large pressure injury infected with Methicillin-resistant Staphylococcus aureus (MRSA)✓ 正解患有被耐甲氧西林金黃色葡萄球菌（MRSA）感染的大面積壓瘡的病人
- CA client with Herpes Zoster (shingles) that is localized and covered患有局限性且已覆蓋的帶狀皰疹（疱疹）的病人
- DA client with laboratory-confirmed Disseminated Herpes Zoster✓ 正解實驗室確診為播散性帶狀皰疹的病人
- EA client with Vancomycin-resistant Enterococci (VRE) in a surgical wound✓ 正解手術傷口中有萬古黴素耐腸球菌（VRE）的病人
單人病房的安排主要基於隔離類別：飛沫、空氣或加強型接觸隔離。選項 A（腦膜炎雙球菌肺炎）需飛沫隔離，必須單人房或同病種合住。選項 B（大面積傷口感染 MRSA）與選項 E（傷口 VRE）均需接觸隔離，特別是當傷口分泌物無法被完全覆蓋或病人衛生習慣差時，應優先入住單人房。選項 D（瀰漫性帶狀皰疹）極其關鍵，它需要空氣與接觸雙重隔離，必須進入負壓單人房。至於選項 C（局限性且已覆蓋的帶狀皰疹），在標準預防下可住多人房，除非是免疫低下區域。核心概念是評估病原體的傳播途徑及病人排出病原的量（如分泌物、排泄物）。
Assignment to a private room is based primarily on the category of isolation required: droplet, airborne, or enhanced contact precautions. Option A (Neisseria meningitidis pneumonia) requires droplet precautions, which mandate a private room or cohorting with patients who have the same infection. Options B (large wound infected with MRSA) and E (surgical wound with VRE) both require contact precautions, and a private room should be prioritized—especially when wound drainage cannot be fully contained or when the patient has poor hygiene. Option D (disseminated herpes zoster) is particularly critical: it requires both airborne and contact precautions, mandating placement in a negative-pressure private room. Option C (localized herpes zoster that is covered) can be managed in a shared room under standard precautions, unless the area houses immunocompromised patients. The core concept is to assess the pathogen's route of transmission and the amount of pathogen shed (e.g., in secretions or excreta).
美國 NCLEX 考題非常強調隔離類別的細微差異（如分散式 vs 局限式皰疹）。台灣臨床在多人病房中，有時會用圍簾隔開接觸隔離病人，但在美國標準與考試邏輯中，這被視為不足，必須強調 Private room（或同病種 Cohorting）。