[{"data":1,"prerenderedAt":62},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-019":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":61},"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-019","nurse-115-2-medical-surgical-019",115,2,19,"下列何種心律不整，可以使用按摩頸動脈竇的方式來使心律恢復正常？",{"A":14,"B":15,"C":16,"D":17},"心室纖維顫動","心室早期收縮","心室搏動過速","陣發性心室心搏過速","D",null,[],"本題考點是迷走神經刺激手法適用的心律不整類型。按摩頸動脈竇經壓力感受器反射提高迷走神經張力,使房室結傳導減慢、不反應期延長,可終止折返環路經過房室結的陣發性上心室性心搏過速。A 心室纖維顫動是心室多處雜亂放電、無有效心輸出,需立即電擊去顫;B 心室早期收縮為單發異位搏動,並非持續性快速心律;C 心室搏動過速起源於房室結以下,不受迷走神經調控。D 的官方用字「陣發性心室心搏過速」並不精確,依機轉真正適用的是陣發性上心室性心搏過速;但四個選項中只有 D 描述突發突止、可被迷走神經手法終止的陣發性類型,故為最適答案。","陣發性上心室性心搏過速最常見的機轉是房室結迴旋性心搏過速(AVNRT),折返環路由房室結的快徑與慢徑構成。頸動脈竇按摩或伐氏操作(Valsalva)提高迷走神經張力,乙醯膽鹼作用於房室結的蕈毒鹼受體,使傳導變慢、不反應期延長,折返環路一旦被打斷心律即回復,無效時再以腺苷(adenosine)短暫阻斷房室結。真正起源於心室的快速心律(心室搏動過速、心室纖維顫動)不靠房室結維持折返,迷走神經操作無效,屬電擊去顫或心臟整流的範疇。考選部公布的題本上,四個選項確實都印作「心室」,D 的用字因此不夠精確,依機轉應寫成陣發性上心室性心搏過速;作答時抓住「陣發性、突發突止、可被迷走操作終止」這組特徵,即可在四選項中定位到 D。對比記憶:上心室起源者 QRS 波窄、多為折返機轉,可被迷走操作或腺苷終止;心室起源者 QRS 波寬,處置走電擊路線。延伸可連結頸動脈竇按摩在頸動脈雜音或中風病史者屬禁忌的考點。",[24,27,29,31],{"term":25,"count":26},"壓力感受器反射與迷走神經張力",1,{"term":28,"count":26},"房室結折返機轉",{"term":30,"count":26},"陣發性上心室性心搏過速",{"term":32,"count":26},"心室性心律不整的電擊處置",[34,38,43,47,52,56],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-115-2-medical-surgical-020","有關下肢深部靜脈栓塞之症狀與評估，下列何者正確？",20,{"webId":39,"stem":40,"number":41,"year":42,"session":26},"nurse-106-1-medical-surgical-066","關於膀胱癌的敘述，下列何者錯誤？",66,106,{"webId":44,"stem":45,"number":46,"year":42,"session":10},"nurse-106-2-medical-surgical-080","有關體溫過低病人採取回溫措施期間的支持性處置，下列何者錯誤？",80,{"webId":48,"stem":49,"number":50,"year":51,"session":26},"nurse-108-1-medical-surgical-038","有關良性腫瘤的特徵，下列何者錯誤？",38,108,{"webId":53,"stem":54,"number":10,"year":55,"session":10},"nurse-109-2-medical-surgical-002","有關頭部外傷病人經手術取出顱內血腫並於腦室內放置顱內壓監測器（ICP monitoring device）之敘述，下列何者錯誤？",109,{"webId":57,"stem":58,"number":59,"year":60,"session":10},"nurse-110-2-medical-surgical-036","有關 BUN 與 Serum Creatinite 比值的敘述，下列何者正確？",36,110,"2026-08-06",1787299037097]