[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-016":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":63},"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-016","nurse-115-2-medical-surgical-016",115,2,16,"有關 B 型利鈉胜肽（B-type Natriuretic peptide）檢查的敘述，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"可用來偵測心肌壞死狀態","是一個會造成血管收縮的賀爾蒙","前質是心房肥厚時所釋放出來的物質","此物質具有降低心臟的前後負荷功能","D",null,[],"本題考點是 B 型利鈉胜肽(BNP)的來源與生理作用。依內分泌生理,心室壁受到牽張(心衰竭時心室容積與壓力上升)會分泌 BNP,其作用是促進腎臟排鈉排水並使周邊血管擴張,因而同時降低心臟的前負荷與後負荷,故選 D。A 錯在檢驗定位,偵測心肌壞死靠 troponin I\u002FT 與 CK-MB,BNP 反映的是心室負荷與心衰竭嚴重度。B 錯在作用方向,BNP 造成血管擴張而非收縮,恰與腎素-血管收縮素-醛固酮系統相反。C 錯在來源,前質 proBNP 由心室分泌,由心房肥厚牽張所釋放的是 ANP,兩者不可混淆。","臨床判讀延伸:BNP 與 NT-proBNP 常用於急性呼吸困難的鑑別,數值很低大致可排除心衰竭,數值愈高與心衰竭嚴重度、住院與預後相關;干擾因素要知道——腎功能不良、高齡、心房顫動會使數值偏高,肥胖病人則偏低,故不能只看單一數字。名稱來源是最初自豬腦分離而稱 brain natriuretic peptide,實際主要來自心室,這個歷史命名常成為選項陷阱。藥理連結:sacubitril 抑制分解利鈉胜肽的腦酶,延長 BNP 的排鈉與血管擴張作用,與 valsartan 合用形成心衰竭治療的新一線組合。",[24,27,30,32],{"term":25,"count":26},"前負荷與後負荷",3,{"term":28,"count":29},"B 型利鈉胜肽",1,{"term":31,"count":29},"心室壁牽張",{"term":33,"count":29},"ANP 與 BNP 來源差異",[35,39,44,48,53,58],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-115-2-medical-surgical-017","心臟衰竭功能性分級第 4 級（NYHA Fc IV），最可能出現下列何種活動功能限制？",17,{"webId":40,"stem":41,"number":42,"year":43,"session":29},"nurse-106-1-medical-surgical-063","王先生兩星期前因喉頭發炎、發燒就醫，近日出現血尿再次就醫，發現尿液中出現 RBC、WBC、蛋白質及圓柱體；血中 BUN 及肌酸酐值上升。下列何者為其最可能之診斷？",63,106,{"webId":45,"stem":46,"number":47,"year":43,"session":10},"nurse-106-2-medical-surgical-077","針對心臟衰竭病人的評估結果，下列何者最需要護理師密切觀察？",77,{"webId":49,"stem":50,"number":51,"year":52,"session":29},"nurse-108-1-medical-surgical-035","汪小姐，血小板數目為 40,000\u002Fmm 3 ，下列敘述何者正確？①非常容易引起自發性出血 ②避免使用 Aspirin 或 Heparin ③肌肉注射的給藥方式最佳 ④給與軟便藥物可減少排便腸黏膜受傷",35,108,{"webId":54,"stem":55,"number":56,"year":57,"session":29},"nurse-109-1-medical-surgical-079","當支氣管擴張症病人出現下列何種狀況需盡速就醫？",79,109,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-110-2-medical-surgical-033","評估時請病人快速彎曲足背，如果出現小腿疼痛，表示為下列何種徵象？",33,110,"2026-08-06",1787299037080]