[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-032":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"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":26},"nurse-115-1-內外科護理學-032","nurse-115-1-medical-surgical-032",115,1,32,"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？",{"A":14,"B":15,"C":16,"D":17},"在接下來的 8小時內大量補充液體","進食前須先確認作嘔反射恢復","協助身體躺向健側以利肺擴張","靜脈注射Atropine以減少分泌物","B",null,[],"本題考點是支氣管鏡檢查後的首要安全評估。檢查前會以局部麻醉劑噴喉、抑制咳嗽與作嘔反射以便器械通過，麻醉效果未消退時吞嚥保護機制喪失，此時進食或飲水極易嗆入呼吸道而造成吸入性肺炎，因此依「作嘔反射恢復後才可進食」的原則，選B最適當。A錯在支氣管鏡並未使用需藉水分排出的顯影劑，術後八小時內大量灌水反而增加嗆咳與水分負荷。C錯在此檢查後並無躺向健側以利肺擴張的依據，一般採半坐臥以利呼吸與分泌物排出。D錯在Atropine是檢查前給藥以減少呼吸道分泌物與抑制迷走神經反射，檢查後才注射並無意義。","支氣管鏡後的觀察重點可依併發症排序記憶：出血（尤其做過切片或刷檢者，痰中帶血屬預期，大量鮮血則需警覺）、喉頭水腫與喉痙攣造成的吸氣性哮鳴、氣胸（經支氣管切片後最需注意，表現為突發胸痛與呼吸急促且單側呼吸音減弱）、以及發燒與吸入性肺炎。作嘔反射的測試方式是以壓舌板輕觸咽後壁觀察是否引發嘔吐反射，恢復後先試少量清水再逐步進食。局部麻醉劑抑制反射的機轉與時效解釋了為何檢查後通常需禁食二至四小時，這與上消化道內視鏡的照護邏輯完全相同，可合併記憶為「凡噴喉麻醉的檢查，先驗作嘔反射再開口」。可延伸複習經支氣管切片後的氣胸辨識與胸腔引流指標。",[24,27,30,32,34],{"term":25,"count":26},"吸入性肺炎預防",4,{"term":28,"count":29},"作嘔反射",2,{"term":31,"count":10},"支氣管鏡檢查後護理",{"term":33,"count":10},"局部咽喉麻醉",{"term":35,"count":10},"Atropine 術前給藥",[37,41,46,50,54,59],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-115-1-medical-surgical-033","王先生使用呼吸器，突然呼吸器出現壓力過高警報，下列何者為可能的原因？",33,{"webId":42,"stem":43,"number":44,"year":45,"session":10},"nurse-106-1-medical-surgical-029","有關吸菸對動脈硬化阻塞疾病病人之影響，下列何者錯誤？",29,106,{"webId":47,"stem":48,"number":49,"year":45,"session":29},"nurse-106-2-medical-surgical-043","有關嚴重燒傷病人急性期的疼痛處置，下列何者最適當？",43,{"webId":51,"stem":52,"number":10,"year":53,"session":10},"nurse-108-1-medical-surgical-001","有關測量病人昏迷量表（Glasgow Coma Scale, GCS）之敘述，下列何者錯誤？",108,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-109-1-medical-surgical-045","一位 30 歲女性主訴最近出現皮膚對光敏感、對稱性關節疼痛、口腔潰瘍，另補體 C 3 及 C 4 減少、抗核抗體（ANA）呈現陽性、紅血球沉降速率（ESR）明顯上升、血小板減少，下列何者為其最可能之診斷？",45,109,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-110-1-medical-surgical-079","有關休克初期身體啟動之正常代償機轉，下列何者錯誤？",79,110,"2026-08-06",1787299088898]