[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-2-maternal-pediatric-030":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":65},"產兒科護理學","maternal-pediatric",{"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-115-2-產兒科護理學-030","nurse-115-2-maternal-pediatric-030",115,2,30,"王小弟，足月產，疑似左鎖骨骨折，有關其照護，下列敘述何者最適當？",{"A":14,"B":15,"C":16,"D":17},"採平躺或右側臥姿勢，勿趴睡","以石膏固定，須注意末梢循環","給予左手被動運動，避免攣縮","維持肩部外展、外旋之姿勢","A",null,[],"本題考點在於新生兒鎖骨骨折的固定與擺位原則。此類骨折多能自行癒合,護理重點在減少患側牽拉與受壓,故採平躺或健側也就是右側臥、避免趴睡壓迫左鎖骨,選 A。B 錯在新生兒鎖骨骨折不以石膏處理,必要時僅將患側上臂輕貼胸壁固定即可。C 錯在急性期患肢須制動,被動運動會增加疼痛與骨折端移位風險。D 錯在維持肩部外展、外旋會拉扯骨折處,正確方向是讓患肢內收貼近軀幹、肘部屈曲。","延伸病生理:新生兒鎖骨骨折多因肩難產、巨嬰或產程中肩部受壓所致,是最常見的產傷性骨折;典型徵象為患側活動減少、Moro 反射不對稱、觸摸有骨摩擦聲與局部腫脹壓痛,約兩到三週後在癒合處可摸到骨性隆凸,這個隆凸屬正常骨癒合過程。鑑別重點是臂神經叢損傷(Erb 麻痺),後者為神經受牽拉造成上肢無力與姿勢異常,而非骨骼斷裂,兩者可同時發生,因此考題常放在一起。護理原則可歸納為制動、支托、減痛與觀察,穿脫衣物時先穿患側、先脫健側。可連結概念:肩難產與產傷、Moro 反射評估、新生兒骨骼癒合速度快的特性。",[24,26,29,31,33],{"term":25,"count":10},"新生兒鎖骨骨折",{"term":27,"count":28},"產傷照護",1,{"term":30,"count":28},"患肢制動與擺位",{"term":32,"count":28},"Moro 反射不對稱",{"term":34,"count":28},"臂神經叢損傷鑑別",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-2-maternal-pediatric-031","有關健康兒童各階段已完成發展的動作敘述，下列何者較不適當？",31,{"webId":41,"stem":42,"number":43,"year":44,"session":28},"nurse-106-1-maternal-pediatric-077","小華，7 歲，搭乘母親的摩托車上學途中，被轎車撞傷，頭部嚴重撞傷，轉入兒科加護病房，現昏迷指數 3 分，給予疼痛刺激時，手臂和腳均呈僵直和內轉的姿勢，有關這些症狀及受傷部位的描述，下列何者正確？",77,106,{"webId":46,"stem":47,"number":48,"year":49,"session":28},"nurse-107-1-maternal-pediatric-011","王女士以陰道產娩出一足月男嬰，其第一、五分鐘的 Apgar scores 分別為 7 分和 8 分，新生兒即刻護理已完成，王女士正在進行會陰縫合，有關首次親子互動之時機，下列何者最適當？",11,107,{"webId":51,"stem":52,"number":53,"year":54,"session":28},"nurse-108-1-maternal-pediatric-049","婷婷，14 歲，泌尿道感染三度入院，下列護理指導何者較不適當？",49,108,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-109-2-maternal-pediatric-013","初產婦廖女士進入產房待產，足月且孕期無其他併發症，目前每 5 分鐘子宮收縮一次，每次約收縮 30 秒，沒有破水，陰道有粉色分泌物，內診發現其子宮頸變薄 80%且已擴張 3 公分，station 0。廖女士詢問是否可以下床走動，下列回應何者較適切？",13,109,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-110-2-maternal-pediatric-047","有關兒童虐待的敘述，下列何者錯誤？",47,110,"2026-08-06",1787299007168]