[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-042":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"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-042","nurse-115-2-medical-surgical-042",115,2,42,"有關急性腎盂腎炎病人的敘述，下列何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"詢問病人是否有泌尿道結石、泌尿道感染和糖尿病的病史","觀察有無肋骨脊柱角疼痛、發燒、頻尿、尿液混濁及尿臭味","鼓勵按時服用抗生素、止痛劑和大量攝液，以改善疼痛和細菌感染","為了解有無腎衰竭發生，需監測紅血球沉降率和 C 反應蛋白數值","D",null,[],"本題考點是急性腎盂腎炎的評估重點與檢驗判讀。依其病理,細菌多由下泌尿道上行侵犯腎盂與腎實質,若要了解有無腎功能損傷或腎衰竭,應監測血中尿素氮、肌酸酐、腎絲球過濾率估算值、尿量與電解質;紅血球沉降速率與 C 反應蛋白僅反映發炎活性,無法判斷腎功能是否衰退,故 D 錯誤。A 正確,泌尿道結石、反覆感染與糖尿病都是上行性感染的重要危險因子。B 正確,肋骨脊柱角疼痛合併發燒、寒顫、頻尿與尿液混濁惡臭是典型表現。C 正確,足量足療程抗生素、止痛與充分水分攝取有助控制感染並緩解症狀。","延伸原理:上下泌尿道感染的分界就在有無全身性徵象。單純下泌尿道感染以頻尿、急尿、解尿疼痛為主而少發燒;腎盂腎炎因侵犯腎實質而出現高燒、寒顫、腰側疼痛與全身無力,並可能菌血症,所以治療療程明顯較長。肋骨脊柱角敲擊痛是床邊區辨的關鍵理學檢查。檢驗分工口訣:發炎看 C 反應蛋白與紅血球沉降速率,感染定位看尿液鏡檢與尿液培養,腎功能看尿素氮與肌酸酐。充分水分攝取的機轉是增加尿量沖刷細菌並降低尿液濃度,但若已有腎衰竭或體液過多則需依醫療計畫調整。可連結概念:尿液培養採檢原則、抗生素完成療程的重要性、慢性腎盂腎炎與腎功能不全的關係。",[24,27,30,32,34],{"term":25,"count":26},"急性腎盂腎炎",3,{"term":28,"count":29},"肋骨脊柱角疼痛",1,{"term":31,"count":29},"腎功能指標尿素氮與肌酸酐",{"term":33,"count":29},"發炎指標的判讀限制",{"term":35,"count":29},"上行性泌尿道感染危險因子",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-115-2-medical-surgical-043","有關抗利尿不當症候群（SIADH）的臨床表徵，下列何者正確？①血鈉 128 mEq\u002FL ②尿鈉 40 mEq\u002FL ③尿比重 1.050 ④血漿滲透壓 350 mOsmo\u002Fkg ⑤尿液滲透壓 50 mOsmo\u002Fkg",43,{"webId":42,"stem":43,"number":44,"year":45,"session":10},"nurse-106-2-medical-surgical-009","有關肝硬化病人會出現手掌紅斑之原因，下列何者正確？",9,106,{"webId":47,"stem":48,"number":49,"year":50,"session":29},"nurse-107-1-medical-surgical-023","有關鼻部手術後病人護理措施及指導之敘述，下列何者錯誤？",23,107,{"webId":52,"stem":53,"number":54,"year":55,"session":29},"nurse-108-1-medical-surgical-061","下列何者是男性較常出現的尿失禁型態？",61,108,{"webId":57,"stem":58,"number":59,"year":60,"session":10},"nurse-109-2-medical-surgical-025","有關白內障之敘述，下列何者錯誤？",25,109,{"webId":62,"stem":63,"number":64,"year":65,"session":10},"nurse-110-2-medical-surgical-059","有關以定量吸入器（MDI）方式給藥的敘述，下列何者錯誤？",59,110,"2026-08-06",1787299037320]