[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-027":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":65},"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-027","nurse-115-1-medical-surgical-027",115,1,27,"王先生常年受過敏所苦，想要知道那種過敏原引起過敏反應，下列何項診斷檢查最合適？",{"A":14,"B":15,"C":16,"D":17},"伍氏燈檢查（Wood’s light test）","免疫螢光試驗（immunofluorescence test）","刮畫試驗（scratch test）","皮膚切片檢查（skin biopsy）","C",null,[],"本題考點是各項皮膚診斷檢查的用途辨識。要找出「究竟哪一種過敏原」引起反應，需靠皮膚過敏原測試，刮畫試驗將可疑過敏原置於刮畫的表皮上，觀察十五至二十分鐘內是否出現膨疹與紅暈，可一次比對多種過敏原並找出致敏物質，故選C。A的伍氏燈是以紫外光照射觀察病灶螢光，用於篩檢黴菌感染與色素性病變，無法辨識過敏原。B的免疫螢光試驗是以螢光標記抗體偵測組織中免疫球蛋白或補體沉積，主要用於自體免疫水泡性皮膚病的診斷。D的皮膚切片是取組織作病理判讀，能呈現發炎型態與腫瘤細胞，但看不出是哪一個過敏原致敏。","刮畫試驗與針刺試驗同屬第一型（IgE 媒介）立即型過敏反應測試，原理是過敏原與皮膚肥大細胞表面的專一性 IgE 結合後釋出組織胺，造成局部膨疹；判讀時必須同時設組織胺為陽性對照、生理食鹽水為陰性對照，否則抗組織胺類藥物未停用會出現假陰性。與之對比的是貼布試驗，那是第四型延遲型過敏反應測試，用於接觸性皮膚炎，需貼四十八小時後再判讀，兩者的機轉與時間尺度完全不同，是常見的混淆點。抽血檢驗特異性 IgE 則適用於嚴重皮膚病灶無法做皮膚試驗、或不能停抗組織胺的情況。記憶法：「刮／針＝立即型看膨疹；貼布＝延遲型看濕疹」；「伍氏燈＝照黴菌看螢光；免疫螢光＝找抗體沉積；切片＝看組織」。",[24,27,30,32,34],{"term":25,"count":26},"第一型過敏反應",7,{"term":28,"count":29},"伍氏燈檢查",2,{"term":31,"count":10},"刮畫試驗",{"term":33,"count":10},"IgE 媒介",{"term":35,"count":10},"免疫螢光試驗",[37,41,46,50,55,60],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-115-1-medical-surgical-028","長期臥床病人採仰臥姿勢時，下列何者是皮膚壓力性損傷較不常發生的部位？",28,{"webId":42,"stem":43,"number":44,"year":45,"session":10},"nurse-106-1-medical-surgical-024","使用 Beta 腎上腺素阻斷劑治療青光眼之敘述，下列何者錯誤？",24,106,{"webId":47,"stem":48,"number":49,"year":45,"session":29},"nurse-106-2-medical-surgical-038","下列何種疾病有 90%的病人體內可發現費城染色體（Philadelphia chromosome）？",38,{"webId":51,"stem":52,"number":53,"year":54,"session":29},"nurse-107-2-medical-surgical-076","下列何種荷爾蒙分泌過多會導致肢端肥大症？",76,107,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-109-1-medical-surgical-040","下列何種皮膚疾病是由自體免疫系統所引起，會出現急性炎症反應但不具傳染性？",40,109,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-110-1-medical-surgical-074","長期接受血液透析的病人，突然意識改變、出現抽筋及肌肉無力情況，入急診求治，抽血檢查結果：尿素氮／肌酸酐 120 mg\u002FdL／10.6 mg\u002FdL、鉀離子 7.8 mg\u002FdL、鈉離子 135 mg\u002FdL，動脈血液氣體分析結果：pH 7.28、PaO 70 mmHg、PaCO 30 mmHg、 HCO _ 20 mEq\u002FL。下列判斷何者正確？ 2 2 3",74,110,"2026-08-06",1787299088831]