[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-031":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":66},"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-031","nurse-115-1-medical-surgical-031",115,1,31,"有關全身性紅斑性狼瘡（SLE）之臨床表徵，下列敘述何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"關節症狀包括發炎、疼痛、腫脹、僵硬等","心肺症狀，如心包炎、肋膜炎的發生，對病人預後影響很大","中樞神經不受侵犯，不必擔心病人認知問題","腎功能下降，應限制蛋白質、水分、鹽分的攝取","C",null,[],"本題考點是全身性紅斑性狼瘡的多器官侵犯範圍。狼瘡屬自體免疫疾病，自體抗體與免疫複合體可沉積於包含中樞神經在內的各器官，形成神經精神性狼瘡，出現頭痛、癲癇、腦血管病變、情緒與精神症狀以及記憶與認知功能障礙，故C所稱「中樞神經不受侵犯、不必擔心認知問題」為錯誤敘述。A正確，對稱性小關節發炎、疼痛、腫脹與晨間僵硬是最常見的初始表現。B正確，心包炎與肋膜炎代表漿膜與心肺受累，與腎臟侵犯同屬影響預後的重要因素。D正確，出現狼瘡腎炎、腎功能下降時，飲食須限制蛋白質、水分與鹽分以減輕腎臟負擔。","狼瘡的病生理核心是第三型過敏反應：抗核抗體、抗雙股DNA抗體與抗原形成免疫複合體，沉積在血管壁與基底膜後活化補體、引來白血球而造成血管炎，因此症狀「哪裡有小血管就可能哪裡發病」，這正是它多器官表現的來源。抗雙股DNA抗體效價與補體 C3、C4 下降通常反映疾病活動度與腎臟侵犯，是追蹤重點。診斷準則可用臉、口、關節、腎、腦、血、漿膜與抗體來記；預後最主要取決於狼瘡腎炎與神經精神侵犯，其次為感染與長期類固醇的併發症。護理指導的重點是避免陽光紫外線曝曬與感染，因兩者都會誘發急性發作；停藥自行減量也是常見復發原因。可延伸對照類風濕性關節炎的關節破壞性差異，狼瘡關節炎多不造成骨侵蝕與變形。",[24,27,30,32,34],{"term":25,"count":26},"全身性紅斑性狼瘡",12,{"term":28,"count":29},"免疫複合體沉積",4,{"term":31,"count":10},"神經精神性狼瘡",{"term":33,"count":10},"狼瘡腎炎飲食限制",{"term":35,"count":10},"漿膜炎與預後",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-115-1-medical-surgical-032","王先生剛接受支氣管鏡檢查後返回病室，下列護理措施何者最適當？",32,{"webId":42,"stem":43,"number":44,"year":45,"session":10},"nurse-106-1-medical-surgical-028","張先生，64 歲，因呼吸喘、下肢水腫至急診求治，診斷為心衰竭，病人出現下列那些表徵表示最可能有急性肺水腫？①心搏過緩 ②高燒 ③端坐呼吸 ④帶有泡沫的痰",28,106,{"webId":47,"stem":48,"number":49,"year":45,"session":50},"nurse-106-2-medical-surgical-042","有關一氧化碳中毒的臨床表徵，下列何者正確？",42,2,{"webId":52,"stem":53,"number":54,"year":55,"session":50},"nurse-107-2-medical-surgical-080","有關血中賀爾蒙於休克代償機轉中之變化，下列何者錯誤？",80,107,{"webId":57,"stem":58,"number":59,"year":60,"session":10},"nurse-109-1-medical-surgical-044","有關過敏性休克之敘述，下列何者錯誤？",44,109,{"webId":62,"stem":63,"number":64,"year":65,"session":10},"nurse-110-1-medical-surgical-078","有關敗血性休克引發瀰漫性血管內凝血（DIC）之敘述，下列何者正確？",78,110,"2026-08-06",1787299088892]