[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-115-1-psychiatric-community-049":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":62},"精神科與社區衛生護理學","psychiatric-community",{"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-精神科與社區衛生護理學-049","nurse-115-1-psychiatric-community-049",115,1,49,"有關糖尿病的足部護理，衛生護理師應建議個案避免下列那些習慣？①穿拖鞋外出   ②每日用溫水泡腳10分鐘   ③睡覺時用電毯或熱水袋保暖足部   ④使用中性肥皂清洗足部",{"A":14,"B":15,"C":16,"D":17},"①②","②③","①③","②④","C",null,[],"本題考點是糖尿病足部衛教中「機轉明確有害」與「有條件可行」的區辨。周邊神經病變使痛覺與溫覺遲鈍,合併周邊動脈疾病則癒合能力下降;①穿拖鞋外出時腳趾與足背缺乏包覆,踢傷擦傷後常因感覺喪失而延遲發現;③電毯或熱水袋緊貼皮膚,溫覺遲鈍者無法及時察覺過熱,容易造成低溫燙傷。兩者都是明確的外傷與燙傷風險,故選 C。④以中性肥皂清洗足部是標準做法,不需避免。②每日用溫水泡腳 10 分鐘則屬相對比較的關鍵:在事先測水溫、時間不長、結束後將趾縫徹底擦乾的前提下,常見衛教多把它視為可接受的清潔行為,各版教材寬嚴標準不一,本題並未把它列入應避免的習慣。","糖尿病足的病生理有三條線:感覺神經病變使保護性痛覺與溫覺喪失、運動神經病變造成足內在肌萎縮與爪狀趾而改變壓力分布、自主神經病變使汗腺分泌減少導致皮膚乾裂;再疊加周邊動脈疾病的灌流不足,小傷口就可能演變成慢性潰瘍。評估上常用 10 公克 Semmes-Weinstein 單纖維測保護性感覺、音叉測震動覺。①③之所以屬機轉明確的風險:拖鞋外露的腳趾與足背失去防護,踢撞割傷在痛覺喪失下常被延遲發現;電毯與熱水袋屬持續性低溫熱源,溫覺遲鈍者無法回饋撤離,四十幾度即可造成低溫燙傷。②則要據實理解其爭議:長時間浸泡確實可能使角質軟化(maceration)而形成感染入口,水溫未測也有燙傷風險,因此部分教材主張「以溫水清洗而不浸泡」;但在先測水溫、控制在 10 分鐘內、事後把趾縫徹底擦乾的條件下,溫水泡腳仍是不少衛教材料採用的清潔方式,兩種寫法並存。這一題把泡腳歸在清潔行為那一側,與①③這類外傷、燙傷風險並列時採相對比較,取①③即可,不必把「一律不可浸泡」當成鐵則來套用。延伸可連結糖尿病足潰瘍的 Wagner 分級與剪趾甲平剪的衛教要點。",[24,26,28,30],{"term":25,"count":10},"糖尿病周邊神經病變",{"term":27,"count":10},"低溫燙傷機轉",{"term":29,"count":10},"周邊動脈疾病與傷口癒合",{"term":31,"count":10},"足部清潔衛教與角質浸軟",[33,37,42,47,52,57],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-115-1-psychiatric-community-050","有關代謝症候群及其健康照護的敘述，下列何者最適當？",50,{"webId":38,"stem":39,"number":40,"year":41,"session":10},"nurse-106-1-psychiatric-community-046","下列何者為我國「傳染病防治法」中規定之第一類法定傳染病？",46,106,{"webId":43,"stem":44,"number":45,"year":41,"session":46},"nurse-106-2-psychiatric-community-060","有關慢性病的特性，下列何者錯誤？",60,2,{"webId":48,"stem":49,"number":50,"year":51,"session":46},"nurse-108-2-psychiatric-community-018","王先生為躁症病人，情緒高昂、易怒，容易受病友影響而生氣，下列對於王先生活動的安排，何者較適切？",18,108,{"webId":53,"stem":54,"number":55,"year":56,"session":46},"nurse-109-2-psychiatric-community-062","有關卡加立的家庭評估模式（Calgary family assessment model），其中家庭內在結構的評估項目，下列何者錯誤？",62,109,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-111-1-psychiatric-community-016","林先生因為雙相情緒障礙症（Bipolar Disorder）躁症發作住院，主要治療藥物為鋰鹽、carbamazepine （Tegretol ® ）。護理師發現林先生顯得倦怠、無力，緊急抽血鋰鹽濃度為 0.8 mEq\u002FL、Na 為 120 mEq\u002FL。下列何項護理措施最適當？",16,111,"2026-08-06",1787299090229]