[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-2-medical-surgical-050":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":64},"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-050","nurse-115-2-medical-surgical-050",115,2,50,"有關休克病人處置後病況改善的表徵，下列何者最適宜？",{"A":14,"B":15,"C":16,"D":17},"心跳速率由 120 次／分降為 60 次／分","65 公斤重的病人，尿量 28 mL\u002F小時","使用 dopamine 收縮壓為 90 mmHg","GCS：E3V3M5 變為 E3V5M6","D",null,[],"本題考點是休克復甦成效的評估,核心在組織灌流是否真正改善。依灌流評估原則,腦部對缺氧最敏感,昏迷指數由 E3V3M5 共 11 分進步為 E3V5M6 共 14 分,語言與運動反應同步改善,代表腦部血流與氧合恢復,故 D 最適宜。A 不適宜,心跳由每分鐘 120 次驟降至 60 次過低,可能反映心輸出量惡化或傳導障礙,不能單純視為代償解除。B 不適宜,尿量須達每小時每公斤 0.5 毫升以上,65 公斤者至少約 32 毫升,28 毫升仍屬腎灌流不足。C 不適宜,收縮壓 90 mmHg 是靠 dopamine 維持,顯示循環尚未穩定而仍依賴升壓藥物。","延伸原理:休克的本質是組織灌流與氧氣供需失衡,血壓只是代償後的表面數字,代償期血壓甚至可維持正常,所以評估要看終端器官指標——腦(意識)、腎(尿量)、皮膚(溫度、顏色、微血管再充填時間)、代謝(乳酸與鹼基缺失)。這也是為何本題把三個看似進步的數字設為錯項:一個是過度變化、一個是仍未達標、一個是藥物撐出來的假象。昏迷指數計算口訣:睜眼 4 分、語言 5 分、運動 6 分,總分 3 到 15,運動反應對預後最具指標性。尿量標準記每小時每公斤 0.5 毫升,換算後再與題目數字比較,是這類題型最快的解法。可連結概念:休克四大分類與各自機轉、乳酸清除率、升壓藥物撤除的評估邏輯。",[24,27,29,31,33],{"term":25,"count":26},"休克組織灌流評估",1,{"term":28,"count":26},"昏迷指數計分",{"term":30,"count":26},"尿量每小時每公斤標準",{"term":32,"count":26},"升壓藥物依賴",{"term":34,"count":26},"終端器官灌流指標",[36,40,44,49,54,59],{"webId":37,"stem":38,"number":26,"year":39,"session":26},"nurse-106-1-medical-surgical-001","有關巴金森氏病治療之敘述，下列何者正確？",106,{"webId":41,"stem":42,"number":43,"year":39,"session":10},"nurse-106-2-medical-surgical-017","有關骨折癒合及治療之敘述，下列何者錯誤？",17,{"webId":45,"stem":46,"number":47,"year":48,"session":26},"nurse-107-1-medical-surgical-031","有關心動週期（Cardiac Cycle）之敘述，下列何者正確？",31,107,{"webId":50,"stem":51,"number":52,"year":53,"session":26},"nurse-108-1-medical-surgical-069","下列何者可評估糖尿病病人過去 3 個月的血糖控制情形？",69,108,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-109-2-medical-surgical-033","有關病人心電圖 VT 之相關處置，下列何者正確？",33,109,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-110-2-medical-surgical-067","有關腎移植後的急性排斥徵候，不包括下列何者？",67,110,"2026-08-06",1787299037404]