[{"data":1,"prerenderedAt":48},["ShallowReactive",2],{"q-nurse-107-2-fundamental-nursing-041":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":24},"基本護理學與護理行政","fundamental-nursing","基本護理學(包括護理原理、護理技術)與護理行政",{"id":8,"webId":9,"year":10,"session":11,"subject":4,"number":12,"stem":13,"options":14,"answer":19,"answerNote":20,"images":21,"explanation":22,"freq":23},"nurse-107-2-基本護理學與護理行政-041","nurse-107-2-fundamental-nursing-041",107,2,41,"李太太，80 歲，身高 160 公分，體重 82 公斤，有糖尿病二十多年，以降血糖藥物控制；近日因左腳疼痛，大拇趾已有壞疽發黑情形，無法下床走路，整天臥床休息，有腹瀉情形，故予以包尿布；今早護理師發現李太太的薦骨處有一處 1 × 2 cm 2 的皮膚呈發紅、腫脹和起水泡情形。下列何者不是造成李太太產生壓瘡的危險因子？",{"A":15,"B":16,"C":17,"D":18},"年齡","肥胖","糖尿病","水腫","D",null,[],"本題考點在壓瘡（壓力性損傷）危險因子的辨識。依 Braden 壓瘡危險因子架構，組織耐受度與壓力暴露是兩大主軸：李太太高齡 80 歲（皮膚變薄、修復慢）、肥胖（BMI 約 32，骨突承受壓力大）、糖尿病二十多年（末梢循環與感覺變差、傷口不易癒合），再加上臥床不動與腹瀉包尿布造成潮濕，都是題幹可對應的危險因子。反觀 D「水腫」，題幹並未描述李太太有水腫表現，就本案例而言不成立，故選 D。A 年齡、B 肥胖、C 糖尿病皆能在病史中找到依據，均為真實存在的危險因子，故非本題所選。",1,[25,29,32,36,40,44],{"webId":26,"stem":27,"number":23,"year":28,"session":23},"nurse-106-1-fundamental-nursing-001","下列何者為預防院內感染最經濟有效的方法？",106,{"webId":30,"stem":31,"number":11,"year":28,"session":23},"nurse-106-1-fundamental-nursing-002","下列那一種健康問題會導致體溫過高？",{"webId":33,"stem":34,"number":35,"year":28,"session":23},"nurse-106-1-fundamental-nursing-003","王先生因腦血管損傷住院中，下列何種灌注溶液不適合王先生使用？",3,{"webId":37,"stem":38,"number":39,"year":28,"session":23},"nurse-106-1-fundamental-nursing-004","醫囑為 Acetaminophen 1 tab q6h p.r.n. if BT≧39℃之含義，下列敘述何者正確？",4,{"webId":41,"stem":42,"number":43,"year":28,"session":23},"nurse-106-1-fundamental-nursing-005","測量 H5N1 流感病毒感染病人生命徵象時，下列何項防護設備較不必要？",5,{"webId":45,"stem":46,"number":47,"year":28,"session":23},"nurse-106-1-fundamental-nursing-006","林小姐因中風導致右側肢體偏癱，住院期間有關病人之安全，下列敘述何者錯誤？",6,1783840750285]