[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-029":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":64},"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":10},"nurse-115-1-內外科護理學-029","nurse-115-1-medical-surgical-029",115,1,29,"吳太太因腫瘤接受化學治療，口腔出現疱疹性齒齦口腔炎（herpetic gingivostomatitis），下列敘述何者正確？",{"A":14,"B":15,"C":16,"D":17},"由單純性疱疹第一型病毒（HSV-I）感染所致","抗濾過性病毒藥物，如Acyclovir，於症狀嚴重時使用，以免副作用產生","患處水泡可擠壓排除液體後應立即清潔乾淨","進食後待口腔潰瘍處不痛後再進行口腔護理","A",null,[],"本題考點是疱疹性齒齦口腔炎的致病原與口腔照護原則。此症由單純性疱疹病毒第一型感染引起，病毒平時潛伏於三叉神經節，當化學治療造成免疫功能抑制時再度活化，於齒齦與口腔黏膜形成成簇小水泡與疼痛性潰瘍，故A正確。B錯在給藥時機，抗病毒藥Acyclovir須在病灶剛出現的早期投予才能有效抑制病毒複製，等症狀嚴重才用療效大打折扣。C錯在擠壓水泡會破壞黏膜屏障、使病毒與細菌向周圍擴散並延緩癒合，水泡應保持完整。D錯在口腔護理須定時執行並在進食前先緩解疼痛，若等到不痛才做，食物殘渣與細菌早已在潰瘍處堆積。","HSV-1 與 HSV-2 的區別是常考對比：前者主要造成腰部以上、口唇與口腔病灶，後者以生殖器為主，但兩者部位可交叉。病毒具「潛伏—再活化」特性，誘發因子包括發燒、紫外線曝曬、壓力與免疫抑制，因此接受化學治療、器官移植或愛滋病患者的病灶範圍更廣、癒合更慢。Acyclovir 屬核苷類似物，需經病毒自身的胸腺核苷激酶磷酸化才具活性，只作用在被感染的細胞，這正是它選擇性高、副作用相對輕的原因，也說明「怕副作用而延後給藥」在藥理上並不合理。化學治療期口腔炎照護的核心是餐前後與睡前定時清潔、使用軟毛牙刷與不含酒精的漱口水、進食前先用局部麻醉或止痛藥控制疼痛以維持營養攝取。可延伸對照口腔念珠菌感染的白色偽膜與抗黴菌藥物。",[24,26,28,30,32],{"term":25,"count":10},"單純性疱疹病毒第一型",{"term":27,"count":10},"病毒潛伏與再活化",{"term":29,"count":10},"Acyclovir 早期給藥",{"term":31,"count":10},"化學治療口腔黏膜炎",{"term":33,"count":10},"口腔護理原則",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-115-1-medical-surgical-030","有關類風濕性關節炎藥物治療之敘述，下列何者正確？",30,{"webId":40,"stem":41,"number":42,"year":43,"session":10},"nurse-106-1-medical-surgical-026","有關心因性休克造成之血流動力學變化，下列何者正確？",26,106,{"webId":45,"stem":46,"number":47,"year":43,"session":48},"nurse-106-2-medical-surgical-040","有關造成大量凝血活酶釋入血液中，導致凝血因子全面活化，促使全身血管內凝血之情況，下列何者錯誤？",40,2,{"webId":50,"stem":51,"number":52,"year":53,"session":48},"nurse-107-2-medical-surgical-078","有關敗血症治療之敘述，下列何者錯誤？",78,107,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-109-1-medical-surgical-042","有關足癬的敘述，下列何者錯誤？",42,109,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-110-1-medical-surgical-076","有關第一期心腦肺甦醒術（cardiopulmonary cerebral resuscitation; CPCR）的執行步驟，下列何者最優先？",76,110,"2026-08-06",1787299088855]