[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-1-maternal-pediatric-024":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":64},"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-024","nurse-115-1-maternal-pediatric-024",115,1,24,"進入青春期的 17 歲少女一直無月經來潮，其可能原因為何？",{"A":14,"B":15,"C":16,"D":17},"甲狀腺機能異常","骨盆腔感染","多囊性卵巢症候群","巧克力囊腫","A",null,[],"本題考點是原發性無月經的可能病因判斷。依原發性無月經的定義,年滿 16 歲仍未有初經即屬此類,常見成因是下視丘、腦下垂體與卵巢軸的內分泌異常;甲狀腺機能異常會改變甲狀腺釋素與泌乳素的分泌,並干擾促性腺激素釋放素的脈衝節律,使卵巢週期無法啟動,故 A 是可能原因。B 骨盆腔感染主要造成下腹痛、異常分泌物與輸卵管沾黏所致的不孕,不會使初經始終未到。C 多囊性卵巢症候群的典型表現是月經稀少、週期不規則或次發性無月經,並伴多毛與體重上升,較少呈現從未有過月經。D 巧克力囊腫源於子宮內膜異位,前提是已有月經與經血逆流,無法解釋從未初經。","先把兩個定義切乾淨:原發性無月經指年滿 16 歲仍無初經(或 14 歲無初經且無第二性徵發育);次發性無月經指原本有規律月經,連續停止 3 個週期或 6 個月以上。病因思考可沿著「軸」由上而下排:中樞層面有下視丘功能性抑制(過度運動、極低體重、壓力)、腦下垂體腫瘤與高泌乳素;內分泌層面有甲狀腺與腎上腺疾病;卵巢層面有卵巢功能不全與染色體異常(如透納氏症);最下游則是解剖出口問題,例如穆勒氏管發育不全、陰道橫膈或處女膜閉鎖,後者常表現為週期性下腹痛卻無經血流出。甲狀腺之所以能造成無月經,是因為甲狀腺素影響性荷爾蒙結合球蛋白濃度與雌性素代謝,甲狀腺低下時升高的甲狀腺釋素還會刺激泌乳素分泌,而泌乳素上升會抑制促性腺激素釋放素。評估方向包括第二性徵發育程度、生長曲線、體重與運動史、泌乳素與甲狀腺功能檢驗、骨盆超音波確認子宮卵巢是否存在。",[24,27,29,31,33],{"term":25,"count":26},"子宮內膜異位症",3,{"term":16,"count":28},2,{"term":30,"count":10},"原發性無月經定義",{"term":32,"count":10},"下視丘腦下垂體卵巢軸",{"term":34,"count":10},"甲狀腺功能異常",[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-1-maternal-pediatric-025","有關卵巢癌的致病因素，下列敘述何者錯誤？",25,{"webId":41,"stem":42,"number":43,"year":44,"session":10},"nurse-106-1-maternal-pediatric-021","黃女士，G 2 P 2 ，陰道產後 6 小時尚未排尿，她表示：「我從生產到現在只喝一點水，沒什麼尿液感」，下列護理處置何者最適宜？",21,106,{"webId":46,"stem":47,"number":48,"year":44,"session":28},"nurse-106-2-maternal-pediatric-035","下列何者為罹患乳癌的高危險群？①長期使用雌激素及黃體激素 ②母乳親餵 ③維持身體質量指數（BMI）於 23 ④從未懷孕",35,{"webId":50,"stem":51,"number":52,"year":53,"session":28},"nurse-107-2-maternal-pediatric-073","陳小弟，8 個月大，體重 7 公斤。心臟手術後第一天，下列何者為異常表徵？",73,107,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-109-1-maternal-pediatric-037","有關陰道感染的護理措施，下列何者正確？",37,109,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-110-1-maternal-pediatric-071","林小弟，9 歲，因為急性腎絲球腎炎（acute glomerulonephritis）而入院治療，有關此疾病之護理照護，下列敘述何者錯誤？",71,110,"2026-08-06",1787299089396]