[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-024":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":62},"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":10},"nurse-115-2-內外科護理學-024","nurse-115-2-medical-surgical-024",115,2,24,"一位癌症病人檢查及評估結果如下：血壓 105\u002F65 mmHg，呼吸 20 次／分，心電圖顯示正常竇性心律，鉀離子 4.1 mmol\u002FL，尿酸 5.5 mg\u002FdL，血鈣 9.2 mg\u002FdL，蹠反射強直，無水腫症狀。病人最可能罹患下列何種腫瘤急症？",{"A":14,"B":15,"C":16,"D":17},"上腔靜脈症候群","脊髓壓迫症候群","腫瘤溶解症候群","心臟急症","B",null,[],"本題考點是四大腫瘤急症的數據鑑別。依檢查值判讀,血壓 105\u002F65 mmHg 與正常竇性心律不支持心包填塞等心臟急症;鉀離子 4.1 mmol\u002FL、尿酸 5.5 mg\u002FdL、血鈣 9.2 mg\u002FdL 全在正常範圍,不符腫瘤溶解症候群的高血鉀、高尿酸、高血磷與低血鈣型態;沒有臉部、頸部與上肢水腫或頸靜脈擴張,也不支持上腔靜脈症候群。唯一的異常線索是蹠反射強直,屬上運動神經元徵象,反映脊髓因腫瘤壓迫而傳導路徑受損,故選 B。脊髓壓迫的其他表現包括背痛、感覺異常、肌力減弱與大小便功能改變。","四大腫瘤急症可用特徵組合快速分流:脊髓壓迫症候群多來自乳癌、肺癌、攝護腺癌與多發性骨髓瘤的骨轉移,以胸椎最常見,背痛常是最早也最容易被忽略的症狀,神經學檢查出現反射異常、肌力下降與感覺平面即屬警訊,愈早以類固醇降低水腫並接受放射治療,保存行走功能的機會愈大。腫瘤溶解症候群發生於大量腫瘤細胞快速崩解後,記憶口訣是三高一低(高血鉀、高尿酸、高血磷、低血鈣)並可致急性腎損傷與心律不整。上腔靜脈症候群表現為顏面與上肢腫脹、頸胸壁靜脈擴張、平躺時呼吸困難加重。心臟急症則以低血壓、心音遙遠與頸靜脈擴張為主。",[24,26,29,30],{"term":25,"count":10},"上運動神經元徵象",{"term":27,"count":28},"腫瘤急症鑑別",1,{"term":15,"count":28},{"term":31,"count":28},"腫瘤溶解症候群檢驗值",[33,37,42,47,52,57],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-115-2-medical-surgical-025","有關化學治療藥物滲漏之處理方式，下列何者最不適當？",25,{"webId":38,"stem":39,"number":40,"year":41,"session":28},"nurse-106-1-medical-surgical-071","唐女士，口腔癌術後狀況穩定，胰島素注射一天 4 次，鼻胃管灌食一天 6 餐，消化良好，空腹指尖血糖約 100～140 mg\u002FdL，手術前糖化血色素（HbA1c）為 9.5%。唐女士表示「我住院開刀前糖尿病是以口服藥控制，而且血糖控制很好的，我一定要注射胰島素嗎？」護理師的回答，下列何者最適切？",71,106,{"webId":43,"stem":44,"number":45,"year":46,"session":28},"nurse-107-1-medical-surgical-005","江小姐因頸椎滑脫須使用床頭式骨骼牽引 Gardner-Wells Tongs traction 讓頸椎復位，下列敘述何者正確？",5,107,{"webId":48,"stem":49,"number":50,"year":51,"session":28},"nurse-108-1-medical-surgical-043","有關燒傷病人達到體液復甦目標之指標，下列何者正確？",43,108,{"webId":53,"stem":54,"number":55,"year":56,"session":10},"nurse-109-2-medical-surgical-007","王小姐進行經蝶骨腦下垂體切除術，術後發現鼻部有水樣液體流出之護理措施，下列何者正確？",7,109,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-110-2-medical-surgical-041","有關頭頸部放射線治療的敘述，下列何者錯誤？",41,110,"2026-08-06",1787299037152]