[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-007":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"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-115-2-內外科護理學-007","nurse-115-2-medical-surgical-007",115,2,7,"有關急性膽囊炎的敘述，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"通常伴有發燒、左上腹疼痛等症狀","疼痛處理的藥物首選為 morphine","墨菲氏徵象（Murphy’s sign）為其典型徵象","最常見的發生原因為幽門螺旋桿菌","C",null,[],"本題考點是急性膽囊炎的典型徵象與病因。依理學檢查定義,墨菲氏徵象是按壓右上腹肋緣下方並請病人深吸氣,發炎的膽囊隨膈肌下移碰到檢查者手指而引發疼痛並暫停吸氣,為膽囊炎的特徵性表現,故選 C。A 錯在位置,膽囊位於右上腹,疼痛與壓痛在右上腹並可轉移到右肩或右背,不是左上腹。B 錯在藥理考量,morphine 會引起歐迪氏(Oddi)括約肌收縮而升高膽道壓力、加重疼痛,故傳統教科書以 meperidine 作為疼痛用藥。D 錯在病因,最常見原因是膽結石阻塞膽囊頸或膽囊管;幽門螺旋桿菌與胃、十二指腸潰瘍有關。","膽結石高危險因子可用 5F 記:female(女性)、forty(四十歲以上)、fat(肥胖)、fertile(多次懷孕)、fair(白種人),機轉是膽固醇過飽和與膽囊排空不良。診斷首選腹部超音波,可看到結石、膽囊壁增厚與膽囊周圍積液;膽道阻塞合併感染時出現 Charcot 三徵(右上腹痛、發燒寒顫、黃疸)。與膽結石相關的併發症譜還包括膽道結石造成的膽管炎與膽石性胰臟炎。飲食延伸考點:發炎期禁食或低脂飲食,因脂肪會刺激膽囊收縮素釋放、引發膽囊收縮而加劇疼痛。",[24,27,30,33],{"term":25,"count":26},"墨菲氏徵象",5,{"term":28,"count":29},"急性膽囊炎",4,{"term":31,"count":32},"膽結石病因",1,{"term":34,"count":32},"Oddi 括約肌與 morphine",[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-115-2-medical-surgical-008","有關痔瘡的敘述，下列何者正確？①教導病人手術後一週開始溫水坐浴，促進傷口癒合 ②內痔與外痔的分界線是肛門黏膜與上皮相接的齒狀線（dental line） ③內痔區域是由自主神經所支配、外痔區域則是由體／知覺神經所支配 ④痔瘡切除術後教導病人採仰臥，利用填塞於直腸內的敷料加壓傷口止血",8,{"webId":41,"stem":42,"number":43,"year":44,"session":32},"nurse-106-1-medical-surgical-054","病人移除人工氣道後，出現下列何種現象應做緊急處理？",54,106,{"webId":46,"stem":47,"number":48,"year":44,"session":10},"nurse-106-2-medical-surgical-068","有關腦下垂體前葉分泌之激素，不包括下列何者？",68,{"webId":50,"stem":51,"number":52,"year":53,"session":32},"nurse-108-1-medical-surgical-026","有關心臟衰竭臨床處置之敘述，下列何者錯誤？",26,108,{"webId":55,"stem":56,"number":57,"year":58,"session":32},"nurse-109-1-medical-surgical-070","有關格雷氏病（Grave’s disease）之敘述，下列何者正確？",70,109,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-110-2-medical-surgical-024","有關視網膜剝離病人的術後護理措施，下列何者錯誤？",24,110,"2026-08-06",1787299037005]