[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-042":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-042","nurse-115-1-medical-surgical-042",115,1,42,"有關副甲狀腺功能低下之敘述，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"因高血鈣出現沃斯特克氏（Chvostek’s）徵象，導致肌肉痙攣","因低血磷導致手指顫抖","可能會有急性抽搐，導致咬傷舌頭及呼吸道阻塞","因身體出現酸中毒，導致手足抽搐症狀惡化","C",null,[],"本題考點是副甲狀腺功能低下的電解質變化與神經肌肉表現。副甲狀腺素分泌不足時，骨骼釋鈣、腎小管回收鈣與活化維生素D以促進腸道吸鈣的作用都減弱，形成低血鈣與高血磷。低血鈣使神經肌肉興奮性升高，可引起手足抽搐、喉頭與支氣管痙攣，嚴重時全身急性抽搐並可能咬傷舌頭、造成呼吸道阻塞，故C正確。A錯在沃斯特克氏徵象是輕敲顏面神經處引起同側面部肌肉抽動，代表的是低血鈣而非高血鈣。B錯在此症呈高血磷，不是低血磷。D錯在鹼中毒會使鈣與白蛋白結合增加、游離鈣下降而使抽搐惡化，酸中毒反而使游離鈣上升。","副甲狀腺素的三個作用位置決定了所有症狀：骨（釋出鈣）、腎（回收鈣、排出磷）、腸（經活化維生素D吸收鈣）。因此功能低下就是「鈣低磷高」，功能過高則是「鈣高磷低」並伴骨質流失與結石，兩者可用一張對比表一次記牢。低血鈣的兩個經典徵象要分清：沃斯特克氏徵象敲臉頰引起面部抽動，特魯索氏徵象綁血壓壓脈帶加壓後出現手部痙攣（產科手），後者專一性較高。鈣與酸鹼的關係是常考陷阱：血中鈣分為與白蛋白結合型與具生理活性的游離型，鹼中毒使結合增加、游離鈣下降而症狀加重，這也說明為何過度換氣會誘發手足抽搐。臨床常見成因是甲狀腺手術誤傷或誤切副甲狀腺，故甲狀腺術後護理必列低血鈣觀察與床邊備氣管切開設備。",[24,27,29,31,33],{"term":25,"count":26},"副甲狀腺功能低下",7,{"term":28,"count":10},"低血鈣與高血磷",{"term":30,"count":10},"沃斯特克氏徵象",{"term":32,"count":10},"神經肌肉興奮性增加",{"term":34,"count":10},"鹼中毒與游離鈣",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-1-medical-surgical-043","有關嗜鉻細胞瘤切除手術後之護理措施，下列何者錯誤？",43,{"webId":41,"stem":42,"number":43,"year":44,"session":10},"nurse-106-1-medical-surgical-039","人類乳突病毒（HPV）感染與下列何種癌症有關？",39,106,{"webId":46,"stem":47,"number":48,"year":44,"session":49},"nurse-106-2-medical-surgical-053","評估疑似肺栓塞病人時，最可能發現下列何種症狀？",53,2,{"webId":51,"stem":52,"number":53,"year":54,"session":10},"nurse-108-1-medical-surgical-011","下列何者為食道重建術後最嚴重的合併症？",11,108,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-109-1-medical-surgical-055","病人肺部手術後出現呼吸速率加快、粉紅色泡沫狀痰液、持續性咳嗽、呼吸困難和囉音等表徵，最有可能的合併症是下列何者？",55,109,{"webId":61,"stem":62,"number":63,"year":64,"session":49},"nurse-110-2-medical-surgical-009","下列何項指標可以用在術前診斷大腸癌及術後追蹤癌症是否復發？",9,110,"2026-08-06",1787299089035]