[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-030":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"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-030","nurse-115-1-medical-surgical-030",115,1,30,"有關類風濕性關節炎藥物治療之敘述，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"Aspirin能改變疾病的過程或防止關節的破壞","選擇性COX-2抑制劑適用於有腸胃道潰瘍病史的高危險病人","疾病調節抗風濕藥（DMARDs）為第一線用藥","抗瘧疾藥物（奎寧類）主要副作用在聽力損傷","B","第30題答Ｂ或Ｃ或BC者均給分",[],"本題考點是類風濕性關節炎用藥的分類與適用對象。選擇性COX-2抑制劑只抑制發炎組織中誘導型的COX-2，保留COX-1所負責的胃黏膜保護機制，因此胃腸黏膜傷害低於傳統非類固醇抗發炎藥，較適合有腸胃道潰瘍病史的高危險病人，故選B。A錯在Aspirin屬非類固醇抗發炎藥，只能緩解疼痛與發炎，無法改變病程或阻止關節破壞。C依傳統護理教科書分線，非類固醇抗發炎藥為第一線、疾病調節抗風濕藥為第二線慢作用藥而被判錯，惟現行風濕科指引主張早期使用，屬教科書與臨床觀點落差。D錯在奎寧類主要毒性為視網膜病變，聽力損傷屬胺基醣類抗生素。","類風濕性關節炎用藥可依「治不治病根」分兩類：非類固醇抗發炎藥與類固醇只壓制症狀與發炎，屬症狀緩解治療；疾病調節抗風濕藥（如 methotrexate、hydroxychloroquine、sulfasalazine）與生物製劑才能延緩關節破壞，屬病程調節，共通特性是作用慢，需數週至數月才見效，因此常與非類固醇抗發炎藥短期橋接。副作用配對是高頻考點，可整理成口訣：奎寧類看眼睛（視網膜）、methotrexate 看肝與骨髓（並需補葉酸）、sulfasalazine 看皮疹與血球、生物製劑看感染與結核復發、胺基醣類抗生素才是耳與腎毒性。選擇性 COX-2 抑制劑雖護胃，卻因抑制血管內皮的前列環素而增加心血管事件風險，故有心血管疾病者反而不宜，這是B選項背後常被追問的另一面。",[24,27,29,31,33],{"term":25,"count":26},"非類固醇抗發炎藥",3,{"term":28,"count":10},"選擇性 COX-2 抑制劑",{"term":30,"count":10},"COX-1 與胃黏膜保護",{"term":32,"count":10},"疾病調節抗風濕藥",{"term":34,"count":10},"奎寧類視網膜毒性",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-1-medical-surgical-031","有關全身性紅斑性狼瘡（SLE）之臨床表徵，下列敘述何者錯誤？",31,{"webId":41,"stem":42,"number":43,"year":44,"session":10},"nurse-106-1-medical-surgical-027","有關病人接受經皮穿腔冠狀動脈血管成形術（PTCA）處置之敘述，下列何者錯誤？",27,106,{"webId":46,"stem":47,"number":48,"year":44,"session":49},"nurse-106-2-medical-surgical-041","有關腫瘤溶解症候群的處置，下列何者錯誤？",41,2,{"webId":51,"stem":52,"number":53,"year":54,"session":49},"nurse-107-2-medical-surgical-079","護理師為一位跌倒的老先生施行基本救命術時，應以下列何種方式打開其呼吸道？",79,107,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-109-1-medical-surgical-043","有關化學性灼傷的處置，下列何者錯誤？",43,109,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-110-1-medical-surgical-077","依據「臺灣急診檢傷與急迫度分級量表」（TTAS），病人出現中樞性疼痛程度為 4～7 分，級數應為下列何者？",77,110,"2026-08-06",1787299088863]