[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-2-maternal-pediatric-041":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":63},"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":26},"nurse-115-2-產兒科護理學-041","nurse-115-2-maternal-pediatric-041",115,2,41,"12 歲病童，診斷為風濕性心臟病（rheumatic heart disease），下列症狀何者較不會出現？",{"A":14,"B":15,"C":16,"D":17},"皮下結節","邊緣性紅斑","結膜炎","心雜音","C",null,[],"本題考點在於風濕熱與風濕性心臟病的 Jones 診斷準則。主要表現包括心肌炎(常以心雜音呈現)、遷移性多發性關節炎、舞蹈症、邊緣性紅斑與皮下結節;結膜炎並不在其中,故較不會出現,選 C。A 皮下結節為骨突處的無痛性硬結,屬主要表現之一。B 邊緣性紅斑為軀幹與四肢近端的環狀、不癢紅斑,亦屬主要表現。D 心雜音源於瓣膜受損,以二尖瓣最常受累,是日後形成風濕性心臟病的關鍵。非化膿性結膜炎則是川崎病的典型特徵,兩者不可混淆。","延伸架構:Jones 準則需具備前驅 A 群鏈球菌感染證據,例如 ASO 效價上升或咽喉培養陽性,再加上兩項主要表現,或一項主要加兩項次要表現。次要表現包含發燒、關節痛、發炎指標 ESR 與 CRP 上升、心電圖 PR 間期延長。五項主要表現可用心臟、關節、舞蹈症、紅斑、結節五個關鍵詞記憶。病生理上是鏈球菌 M 蛋白與人體心肌、瓣膜組織的抗原相似,引發交叉反應的自體免疫傷害,屬第二型過敏反應概念,因此傷害發生在感染後兩到四週而非急性期。川崎病則以持續高燒、雙側非化膿性結膜炎、草莓舌與嘴唇乾裂、多形性皮疹、頸部淋巴結腫大、手足硬腫脫皮為六大特徵,冠狀動脈病變是主要併發症,拿來與風濕熱做對比表最省力。可連結概念:長效 penicillin 續發性預防、二尖瓣狹窄與逆流、鏈球菌咽喉炎治療。",[24,27,28,29,31],{"term":25,"count":26},"Jones 診斷準則",1,{"term":15,"count":26},{"term":14,"count":26},{"term":30,"count":26},"風濕性心臟病瓣膜受損",{"term":32,"count":26},"川崎病結膜炎鑑別",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-115-2-maternal-pediatric-042","小力，4 歲，診斷為重度 β 型海洋性貧血，居家使用注射型排鐵劑（desferal），下列敘述何者不適當？",42,{"webId":39,"stem":40,"number":41,"year":42,"session":10},"nurse-106-2-maternal-pediatric-008","有關無壓力試驗（Non-stress test）的敘述，下列何者正確？",8,106,{"webId":44,"stem":45,"number":46,"year":47,"session":26},"nurse-107-1-maternal-pediatric-022","有關陰道生產後評估結果的敘述，下列何者為異常現象？",22,107,{"webId":49,"stem":50,"number":51,"year":52,"session":26},"nurse-108-1-maternal-pediatric-060","宏宏，8 個月大，因支氣管炎住院接受治療，服用口服藥物的護理指導，下列何者正確？",60,108,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-109-2-maternal-pediatric-024","有關產後婦女生理復舊變化之敘述，下列何者正確？",24,109,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-110-2-maternal-pediatric-058","新生兒經母子垂直感染後天免疫缺乏症候群（AIDS），有關護理措施之敘述，下列何者錯誤？",58,110,"2026-08-06",1787299007325]