[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-1-maternal-pediatric-005":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":63},"產兒科護理學","maternal-pediatric",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":26},"nurse-115-1-產兒科護理學-005","nurse-115-1-maternal-pediatric-005",115,1,5,"林女士 40 歲，目前懷孕 10 週，高興成功懷孕，但也擔心胎兒有染色體問題。有關此期唐氏症遺傳診斷檢查之敘述，下列何者最不適當？",{"A":14,"B":15,"C":16,"D":17},"母血檢測胎兒甲型蛋白、β-hCG、抑制素 A（inhibin A）、雌三醇數值","超音波測量胎兒頸部透明帶厚度","母血檢測β-hCG、妊娠性血漿蛋白 A（PAPP-A）的數值","可以採絨毛膜取樣術做染色體分析篩檢染色體異常","A",null,[],"本題考點在唐氏症篩檢工具與適用週數的配對。母血四指標篩檢(甲型胎兒蛋白、β-hCG、抑制素 A、雌三醇)屬第二孕期篩檢,施行週數約在 15 至 20 週,懷孕 10 週抽血無法得到可解讀的風險值,故此期最不適當,選 A。B 適當,胎兒頸部透明帶厚度的測量窗口在 11 週至 13 週又 6 天,與現在的週數相近可先安排。C 適當,第一孕期母血結合篩檢採妊娠性血漿蛋白 A 與游離 β-hCG,施行時機約在 9 至 13 週。D 適當,絨毛膜取樣術約在 10 至 12 週進行,可取胎盤絨毛直接做胎兒染色體分析,對高齡且有明確焦慮的孕婦是此期可行的診斷方式。","高齡與唐氏症的關聯機轉:女性的卵母細胞自胎兒期即停留在第一次減數分裂前期,長年停滯使紡錘體檢查點與黏合蛋白功能退化,因此隨年齡上升,第一次減數分裂時「同源染色體不分離」的比率增加,形成多一條 21 號染色體的卵子(第二次減數分裂分開的才是姊妹染色分體,兩者不可混稱)。篩檢與診斷要分清:頸部透明帶、第一與第二孕期母血指標、以 cfDNA 為基礎的非侵入性檢測都只給風險值;能確診的是絨毛膜取樣術(約 10 至 12 週)與羊膜穿刺(約 16 至 18 週),兩者皆取得胎兒細胞做核型分析,代價是流產風險。時程口訣:十週取絨毛、十一到十三週看透明帶、十六週後穿羊膜。可延伸複習:唐氏症的臨床表徵與合併心臟缺陷、遺傳諮詢的告知重點。",[24,27,29,31,33],{"term":25,"count":26},"頸部透明帶",2,{"term":28,"count":26},"絨毛膜取樣術",{"term":30,"count":10},"第二孕期四指標篩檢",{"term":32,"count":10},"第一孕期結合篩檢",{"term":34,"count":10},"同源染色體不分離",[36,40,44,48,53,58],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-1-maternal-pediatric-006","懷孕 30 週孕婦抱怨下背痛，可優先教導下列何種運動？",6,{"webId":41,"stem":42,"number":26,"year":43,"session":10},"nurse-106-1-maternal-pediatric-002","有關現今產科照護發展趨勢的敘述，下列何者正確？",106,{"webId":45,"stem":46,"number":47,"year":43,"session":26},"nurse-106-2-maternal-pediatric-016","產婦於第三產程後，依醫囑施打宮縮藥物（Methergine ○ R , Ergonovine）。護理師於下列何種情況需停止給藥？",16,{"webId":49,"stem":50,"number":51,"year":52,"session":26},"nurse-107-2-maternal-pediatric-054","根據兒童及少年福利與權益保障法（2015），醫事人員發現兒童遭受猥褻行為或性交，需於多久時間內通報主管機關？",54,107,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-109-1-maternal-pediatric-018","有關 WHO 的成功母乳哺育十措施中母嬰肌膚接觸之敘述，下列何者錯誤？",18,109,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-110-1-maternal-pediatric-052","有關意識不清的嬰幼兒期病童疼痛評估，下列何者最適當？",52,110,"2026-08-06",1787299089188]