[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-002":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":62},"內外科護理學","medical-surgical",{"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-內外科護理學-002","nurse-115-1-medical-surgical-002",115,1,2,"有關重症肌無力之敘述，下列何者正確？①屬於自體免疫疾病，體內產生攻擊Ach接受器的抗體           ② 第一型僅侵犯眼肌，造成複視和眼瞼下垂          ③四肢肌肉的無力發生在遠端和下肢且為不對稱   ④當侵犯肋間肌，通氣容積會減少，嚴重呼吸困難致死",{"A":14,"B":15,"C":16,"D":17},"①②③","①②④","①③④","②③④","B",null,[],"本題考點是重症肌無力的免疫病理與臨床分型。依其病理機轉,體內產生對抗神經肌肉接合處乙醯膽鹼(Ach)接受器的自體抗體,使接受器數目減少而訊號傳遞失效,①正確;依 Osserman 分類,第一型為單純眼肌型,表現複視與眼瞼下垂,②正確;當病變侵犯肋間肌與橫膈,通氣容積下降可導致肌無力危機而呼吸衰竭死亡,④正確,故選 B。③敘述方向錯誤:此病的無力以近端肌群為主、呈對稱分布,且典型從眼外肌、顏面與咽喉肌開始,而非遠端且不對稱的下肢無力,遠端不對稱型無力更符合周邊神經病變的表現。","病生理的核心是突觸後膜受損,故重複使用後肌力愈差、休息後回復,是「晨輕暮重」的來源;診斷可用抗 AChR 抗體、重複神經電刺激顯示波幅遞減,以及 Tensilon 試驗。藥理上以膽鹼酶抑制劑(如 pyridostigmine)提高突觸間隙 Ach 濃度為主。好記的對比:重症肌無力=突觸後、近端與眼肌先受累、活動後變差;Guillain-Barré 症候群=周邊髓鞘,由下肢遠端往上對稱進展;Eaton-Lambert 症候群=突觸前鈣通道抗體,活動後反而短暫改善。延伸複習:肌無力危機與膽鹼性危機的鑑別、胸腺切除與胸腺瘤的關聯。",[24,27,30,32],{"term":25,"count":26},"重症肌無力",7,{"term":28,"count":29},"神經肌肉接合處",4,{"term":31,"count":10},"乙醯膽鹼接受器抗體",{"term":33,"count":10},"Osserman 分類",[35,39,43,48,53,58],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-115-1-medical-surgical-003","有關腦膜炎病人接受腰椎穿刺檢查，下列敘述何者錯誤？",3,{"webId":40,"stem":41,"number":42,"year":9,"session":11},"nurse-115-2-medical-surgical-049","有關中心導管組合式照護之敘述，下列何者錯誤？",49,{"webId":44,"stem":45,"number":46,"year":47,"session":11},"nurse-106-2-medical-surgical-013","分泌胃酸之部位，下列何者正確？",13,106,{"webId":49,"stem":50,"number":51,"year":52,"session":11},"nurse-107-2-medical-surgical-051","一位 23 歲女性主訴最近食慾不振、疲倦、發燒及體重減輕，經身體評估發現口腔潰瘍、左右膝關節有壓痛、腫脹，另抗核性抗體（ANA）呈現陽性，下列何者為其最可能之診斷？",51,107,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-109-1-medical-surgical-015","肝穿刺切片檢查時，為避免橫膈穿孔與肝臟撕裂傷，教導病人當針頭插入肝臟時應採取的動作，下列何者正確？",15,109,{"webId":59,"stem":60,"number":42,"year":61,"session":10},"nurse-110-1-medical-surgical-049","有關心臟衰竭合併肺水腫病人之護理措施及其原理的敘述，下列何者正確？",110,"2026-08-06",1787299088537]