一位從安養設施轉入的88歲女性，其骶骨有一處第4期壓瘡，且感染了抗甲氧西林金黃色葡萄球菌 (MRSA)。她已被適當安置於接觸隔離病房內。一名外科住院醫師準備進入病房，為該傷口進行用力的灌洗與清創。除了執行手部衛生外，該醫師在執行程序前必須穿戴哪些個人防護裝備 (PPE)？
An 88-year-old female transferred from a nursing facility has a stage 4 sacral pressure ulcer infected with Methicillin-resistant Staphylococcus aureus (MRSA). She is appropriately placed in contact isolation. A surgical resident prepares to enter the room to vigorously irrigate and debride the wound. Aside from performing hand hygiene, what personal protective equipment (PPE) must the resident don before executing the procedure?
- AGloves and a disposable gown only, conforming strictly to standard contact precaution guidelines.僅戴手套和一次性隔離衣，嚴格遵守標準接觸隔離指引
- BSterile surgical gloves, shoe covers, and a bouffant scrub cap specifically designed for operating room sterility.無菌手術手套、鞋套及專為手術室無菌設計的一次性圓帽
- CA fit-tested N95 respirator mask and gloves to prevent inhaling airborne MRSA flakes from the wound bed.經密合測試的N95呼吸器口罩和手套，以防止吸入傷口床中空氣傳播的MRSA碎片
- DGloves, a gown, a surgical mask, and eye protection (goggles or a face shield).✓ 正解手套、隔離衣、外科口罩及眼部防護（護目鏡或面罩）
本題測驗標準防護（Standard Precautions）與接觸隔離（Contact Precautions）的彈性運用。MRSA 屬於接觸傳染範疇，因此進入病房「必須」穿戴拋棄式隔離衣（Gown）與手套（Gloves）。然而，護理原則要求從業者必須根據「當下手術或預期暴露風險性質」來升級裝備。當執行傷口「灌洗與清創（Irrigate and debride）」時，會高度預期產生血液體液的飛濺（Sprays / Splashes）。因此，防禦者必須額外佩戴面罩/護目鏡與普通外科口罩，以保護眼睛與口鼻的脆弱黏膜。選項A僅涵蓋接觸防護，不足以應付本來會被飛濺濺到的臉部黏膜。選項C錯誤，MRSA 極罕見為空氣傳染途徑，無需佩戴因空氣傳播設定的 N95 口罩。選項B的無菌裝備與鞋套屬於手術室規範，在病室內執行的清創並不要求全套手術室頭套或鞋套，這無法替代防噴濺護目鏡的本質需求。
Contact precautions require gloves and a gown to prevent transmission of MRSA. However, because irrigation and debridement involve potential splashing of bodily fluids, additional protection for mucous membranes is necessary. Therefore, a surgical mask and eye protection must be added to the standard contact precautions.
針對接觸防護加掛飛濺防護的原則在兩地毫無差別。此題是考試常見陷阱：刻意給你 MRSA（想到 Gown + Gloves），卻藏了一個 Irrigate （想到噴濺而必須加上面罩）的動詞。