[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-034":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":37,"lastmod":66},"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-034","nurse-115-2-medical-surgical-034",115,2,34,"張力性氣胸是指空氣滯留在以下那個部位無出口，造成吸氣時空氣進入，吐氣時卻無法排出，而產生單向瓣膜效應（one-way valve effect）？",{"A":14,"B":15,"C":16,"D":17},"縱膈腔","肋膜腔","肺實質","橫膈膜","B",null,[],"本題考點是張力性氣胸的單向瓣膜機轉發生部位。依胸腔生理,肋膜腔是肺臟與胸壁之間的密閉潛在空間,平時維持負壓使肺得以貼附擴張;當胸壁或肺表面破裂形成單向瓣膜,吸氣時空氣被吸入肋膜腔、吐氣時卻無法排出,腔內壓由負轉正並持續累積,導致患側肺完全塌陷、縱膈腔被推向對側並壓迫大血管使靜脈回流下降,故答案為 B。A 錯,縱膈腔是被張力推移的受害構造,不是空氣蓄積的起點。C 錯,氣體積在肺實質屬肺氣腫或氣囊病變,不會形成腔內壓進行性升高。D 錯,橫膈膜是肌肉構造,並非可積氣的腔室。","延伸病生理:張力性氣胸是同時具備呼吸與循環雙重威脅的急症,除了通氣面積喪失造成低血氧,更關鍵的是正壓壓迫上下腔靜脈使回心血量驟減,因此可出現血壓下降與頸靜脈膨脹,屬阻塞性休克的典型原因之一。辨識重點對照:患側呼吸音消失或減弱、患側叩診鼓音、氣管與心尖搏動偏向對側,合稱張力性氣胸三大理學徵象。與單純氣胸的差別在於壓力是否進行性累積,前者可自行吸收,後者不減壓則持續惡化。減壓原理即在打斷單向瓣膜、讓積氣有出口。可連結概念:自發性氣胸危險因子、開放性氣胸與縱膈腔擺盪、胸腔穿刺與水下引流原理。",[24,27,30,32,35],{"term":25,"count":26},"張力性氣胸",4,{"term":28,"count":29},"阻塞性休克",3,{"term":31,"count":10},"縱膈腔移位",{"term":33,"count":34},"肋膜腔負壓",1,{"term":36,"count":34},"單向瓣膜效應",[38,42,46,51,56,61],{"webId":39,"stem":40,"number":41,"year":9,"session":10},"nurse-115-2-medical-surgical-035","有關肺栓塞病人護理措施之敘述，下列何者最不適當？",35,{"webId":43,"stem":44,"number":34,"year":45,"session":10},"nurse-106-2-medical-surgical-001","林先生因頭部外傷需要裝置顱內壓監測系統的敘述，下列何者錯誤？",106,{"webId":47,"stem":48,"number":49,"year":50,"session":34},"nurse-107-1-medical-surgical-015","有關肝癌病人接受動脈栓塞療法（Transcatheter Arterial Embolization, TAE）之敘述，下列何者正確？",15,107,{"webId":52,"stem":53,"number":54,"year":55,"session":34},"nurse-108-1-medical-surgical-053","有關連枷胸的敘述，下列何者正確？",53,108,{"webId":57,"stem":58,"number":59,"year":60,"session":10},"nurse-109-2-medical-surgical-017","有關刺激胃液分泌的因素，下列何者正確？",17,109,{"webId":62,"stem":63,"number":64,"year":65,"session":10},"nurse-110-2-medical-surgical-051","下列何者不屬於第Ⅰ型過敏反應？",51,110,"2026-08-06",1787299037237]