一位疑似肺結核的病人被安置在空氣傳染隔離病室（負壓病室）。護理師每次進入病室都必須配戴哪一項個人防護裝備？
A client with suspected pulmonary tuberculosis is placed in an airborne infection isolation room. Which item of personal protective equipment must the nurse wear every time the nurse enters the room?
- AA surgical mask covering the nose and mouth覆蓋口鼻的外科口罩
- BA fit-tested N95 or higher-level respirator經密合度測試的 N95 或更高等級呼吸防護具正確答案
- CA disposable gown and gloves拋棄式隔離衣與手套
- DA face shield or goggles面罩或護目鏡
- B經密合度測試的 N95 或更高等級呼吸防護具
正確答案是 B。結核桿菌經直徑 1–5 微米的飛沫核在空氣中長時間懸浮傳播，因此採空氣傳染防護：病人安置於負壓隔離病室（每小時 6–12 次換氣、排氣至戶外或經 HEPA 過濾）、病室門保持關閉，所有進入者都必須配戴經密合度測試（fit-tested）的 N95 或更高等級呼吸防護具（動力空氣淨化呼吸防護具 PAPR 亦可），且在進入前戴妥、離開後才取下。A：外科口罩無法有效過濾飛沫核，只在病人必須離開病室運送時由病人配戴以減少飛沫散出。C、D：隔離衣、手套、面罩或護目鏡屬標準防護，僅在預期接觸血液、體液或可能噴濺（如抽痰、誘發咳痰）時加用，不是每次進入病室的必需品。來源：CDC, Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings（2005）；CDC, Guideline for Isolation Precautions（2007）。
- A覆蓋口鼻的外科口罩
錯誤。外科口罩無法過濾結核桿菌的飛沫核，僅在病人離開病室運送時由病人配戴，不能作為護理師的空氣傳染防護。
- B · 正確答案經密合度測試的 N95 或更高等級呼吸防護具
正確。結核病採空氣傳染防護，每次進入負壓病室都必須配戴經密合度測試的 N95 或更高等級呼吸防護具。
- C拋棄式隔離衣與手套
錯誤。隔離衣與手套屬標準防護，只在預期接觸血液或體液時加用，不是結核病每次進入病室的必需裝備。
- D面罩或護目鏡
錯誤。面罩或護目鏡在可能噴濺（如抽痰、誘發咳痰）時才依標準防護加用，並非空氣傳染防護的常規必需品。
美國 OSHA 規定使用 N95 者必須每年進行密合度測試並有書面呼吸防護計畫；台灣疾病管制署同樣要求結核病照護配戴 N95 並建議密合度測試，但各院執行頻率與查核強度不一。
English explanation
Option B is correct. Mycobacterium tuberculosis is spread by droplet nuclei 1 to 5 microns in diameter that remain suspended in the air for long periods, so airborne precautions are required: the client is placed in a negative-pressure airborne infection isolation room with 6 to 12 air changes per hour and air exhausted outdoors or through a HEPA filter, the door is kept closed, and everyone entering wears a fit-tested N95 or higher-level respirator (a powered air-purifying respirator is also acceptable), donned before entering and removed only after leaving. Option A is incorrect because a surgical mask does not filter droplet nuclei; it is worn by the client, not the nurse, only when the client must leave the room for transport. Options C and D are incorrect because gowns, gloves, face shields, and goggles are standard precautions added only when contact with blood or body fluids or splashing is anticipated, such as during suctioning or sputum induction; they are not required for every entry. Source: CDC, Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings (2005); CDC, Guideline for Isolation Precautions (2007).