[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-115-2-psychiatric-community-050":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":64},"精神科與社區衛生護理學","psychiatric-community",{"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-精神科與社區衛生護理學-050","nurse-115-2-psychiatric-community-050",115,2,50,"有關慢性腎臟病飲食衛教指導，下列何者最不適當？",{"A":14,"B":15,"C":16,"D":17},"減少攝取補湯、雞湯或肉湯拌飯等含鉀高的食物","避免攝取動物內臟、麵包、汽水等磷含量高的食物","選擇冬粉、粄條、米苔目等低蛋白澱粉類食物","選擇堅果類、綠豆、麵筋等高生物價值蛋白質","D",null,[],"本題考點在於慢性腎臟病飲食的蛋白質品質與鉀、磷限制原則。高生物價值蛋白質指必需胺基酸種類齊全、比例接近人體需要者,來源為蛋、奶、魚、肉、豆製品;堅果類、綠豆與麵筋屬植物性且必需胺基酸不完整,麵筋缺乏離胺酸,堅果又富含鉀與磷,把它們列為高生物價值蛋白質最不適當,選 D。A 適當,肉湯、雞湯與補湯久熬後鉀離子溶出多,腎功能不佳者排鉀受限應減少攝取。B 適當,動物內臟、加工麵包與可樂汽水含磷或磷酸鹽添加物高。C 適當,冬粉、粄條與米苔目屬低蛋白澱粉,可補足熱量而不增加含氮廢物。","慢性腎臟病飲食可用「低蛋白、高熱量、限磷限鉀限鈉、慎補水」為主軸。低蛋白但需保證品質與熱量:蛋白質限量下若熱量不足,身體會分解自身肌肉蛋白反使尿素氮上升,故以低蛋白澱粉(冬粉、米苔目、藕粉、太白粉、低蛋白米)填補熱量,並讓有限的配額用在高生物價值蛋白質上,以減少含氮廢物堆積。限磷的病生理在於腎小球過濾率下降使磷滯留,刺激副甲狀腺素上升並抑制活性維生素 D 生成,導致腎骨病變與血管鈣化,故除避免內臟、全穀堅果、乳製品與可樂等含磷食物外,常需磷結合劑並隨餐服用。限鉀在於高血鉀可造成心律不整,烹調可先將蔬菜切小以熱水汆燙後撈起再炒、避免菜湯與生菜汁、避免低鈉鹽(以鉀取代鈉)。透析病人則蛋白質需求反而提高,與透析前期原則相反,是常見的對比考點。",[24,27,29,31,33],{"term":25,"count":26},"慢性腎臟病飲食",1,{"term":28,"count":26},"高生物價值蛋白質",{"term":30,"count":26},"低蛋白澱粉",{"term":32,"count":26},"限磷與腎骨病變",{"term":34,"count":26},"限鉀與高血鉀",[36,40,44,49,54,59],{"webId":37,"stem":38,"number":26,"year":39,"session":26},"nurse-106-1-psychiatric-community-001","精神衛生法中規定經專科醫師診斷或鑑定屬嚴重病人者，應置保護人 1 人，專科醫師並應開具診斷證明書交付保護人。保護人應考量嚴重病人利益。條文中的保護人可為下列何人？①監護人 ②同居人 ③配偶 ④父母 ⑤家屬 ⑥心理輔導專家 ⑦法定代理人",106,{"webId":41,"stem":42,"number":43,"year":39,"session":10},"nurse-106-2-psychiatric-community-017","減少阿茲海默症病人之問題行為發生的護理處理，下列何者最適宜？",17,{"webId":45,"stem":46,"number":47,"year":48,"session":26},"nurse-107-1-psychiatric-community-031","下列何種疾患最常與飲食障礙症成為共病？",31,107,{"webId":50,"stem":51,"number":52,"year":53,"session":10},"nurse-108-2-psychiatric-community-069","陳先生早餐吃了蛋製品，餐後有腹瀉、腹痛、噁心、嘔吐及發燒症狀。他最有可能是下列何種細菌引起之食物中毒？",69,108,{"webId":55,"stem":56,"number":57,"year":58,"session":26},"nurse-110-1-psychiatric-community-033","有關復元（recovery）的敘述，下列何者正確？",33,110,{"webId":60,"stem":61,"number":62,"year":63,"session":26},"nurse-111-1-psychiatric-community-067","有關獨居老人預防跌倒的安全議題，下列何者正確？",67,111,"2026-08-06",1787299017323]