[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-003":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"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-003","nurse-115-1-medical-surgical-003",115,1,3,"有關腦膜炎病人接受腰椎穿刺檢查，下列敘述何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"懷疑顱內壓升高時不宜執行腰椎穿刺","腰椎穿刺是將穿刺針由第三與第四腰椎椎間垂直穿入","腦脊髓液分析會出現總蛋白質減少及葡萄糖增加","正常之腦脊髓液壓力為70～180 mmH 2O","C",null,[],"本題考點是腦膜炎的腦脊髓液變化與腰椎穿刺原則。依細菌性腦膜炎的病理,發炎使血腦障壁通透性上升、蛋白質滲出而總蛋白質上升,細菌與大量白血球代謝葡萄糖使糖值下降(常低於血糖的一半),因此 C 的「總蛋白質減少、葡萄糖增加」方向完全相反,為錯誤選項。A 正確:顱內壓升高時抽取腦脊髓液會造成壓力梯度而有腦幹疝脫危險,屬禁忌。B 正確:成人脊髓末端約在第一、二腰椎,故取第三、四腰椎間隙穿刺可避免傷及脊髓。D 正確:腦脊髓液壓力正常值約 70～180 mmH₂O。","腦脊髓液判讀是內外科與感染科的高頻考點,可用一張對照表記:細菌性=外觀混濁、壓力高、白血球以多形核為主、蛋白高、糖低;病毒性=清澈或微濁、白血球以淋巴球為主、蛋白略高、糖正常;結核性與真菌性=淋巴球為主、蛋白明顯高、糖低,且外觀可見纖維網。糖值下降是「有東西在吃糖」的線索,所以細菌與結核會低、病毒不會。穿刺後平躺與補充水分的目的在降低腦脊髓液壓力落差造成的姿勢性頭痛。延伸複習:Kernig 與 Brudzinski 徵象、庫欣氏三徵(血壓升高、心跳變慢、呼吸不規則)代表顱內壓升高。",[24,27,29,31],{"term":25,"count":26},"顱內壓升高",11,{"term":28,"count":10},"細菌性腦膜炎腦脊髓液變化",{"term":30,"count":10},"腰椎穿刺禁忌",{"term":32,"count":10},"腦脊髓液壓力正常值",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-115-1-medical-surgical-004","有關不同類型腦中風發作之比較，下列敘述何者錯誤？",4,{"webId":39,"stem":40,"number":41,"year":9,"session":42},"nurse-115-2-medical-surgical-050","有關休克病人處置後病況改善的表徵，下列何者最適宜？",50,2,{"webId":44,"stem":45,"number":46,"year":47,"session":42},"nurse-106-2-medical-surgical-014","有關罹患膽結石的高風險族群，下列何者錯誤？",14,106,{"webId":49,"stem":50,"number":51,"year":52,"session":42},"nurse-107-2-medical-surgical-052","有關免疫反應之身體屏障的敘述，下列何者錯誤？",52,107,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-109-1-medical-surgical-016","有關胃食道逆流病人之護理指導，下列何者錯誤？",16,109,{"webId":59,"stem":60,"number":41,"year":61,"session":10},"nurse-110-1-medical-surgical-050","有關類風濕性關節炎的醫療處置，下列敘述何者正確？",110,"2026-08-06",1787299088550]