[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-106-2-medical-surgical-047":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":10},"nurse-106-2-內外科護理學-047","nurse-106-2-medical-surgical-047",106,2,47,"有關發生急性溶血性輸血反應處置之敘述，下列何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"密切監測生命徵象","輸血不能中斷","收集血液及尿液標本送檢","記錄輸出入量","B",null,[],"本題考點為急性溶血性輸血反應的緊急處置。此反應多因 ABO 血型不合,受血者抗體攻擊供血紅血球引發溶血,可致休克與急性腎衰竭,故第一步必須「立即停止輸血」以阻斷抗原繼續進入。B 稱『輸血不能中斷』與此原則完全相反,為錯誤選項,選 B。A 密切監測生命徵象以掌握休克徵象,正確;C 收集血液與尿液標本送檢以確認溶血與比對血型,正確;D 記錄輸出入量以監測腎功能與尿量變化,正確。發生疑似反應時應停血、保留靜脈管路改打生理食鹽水,故選 B。","輸血反應第一動作永遠是『STOP the transfusion』,保留 IV line 換 0.9% NS 維持通路與利尿,再通報血庫核對。急性溶血屬 type II 過敏(IgG\u002FIgM 對紅血球抗原),最凶險為 DIC 與急性腎小管壞死,故要監測尿量、尿色(血紅素尿呈紅棕)並送檢標本。口訣:『反應一來先關血,換鹽水、報血庫、驗血尿』。",[24,26,28,31,33],{"term":25,"count":10},"急性溶血性輸血反應",{"term":27,"count":10},"輸出入量監測",{"term":29,"count":30},"ABO 血型不合",1,{"term":32,"count":30},"停止輸血",{"term":34,"count":30},"急性腎小管壞死",[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-106-2-medical-surgical-048","有關過敏性疾病的實驗室檢查，下列何者錯誤？",48,{"webId":41,"stem":42,"number":43,"year":44,"session":30},"nurse-107-1-medical-surgical-064","有關急性腎絲球腎炎之敘述，下列何者錯誤？",64,107,{"webId":46,"stem":47,"number":48,"year":44,"session":10},"nurse-107-2-medical-surgical-078","有關敗血症治療之敘述，下列何者錯誤？",78,{"webId":50,"stem":51,"number":52,"year":53,"session":30},"nurse-109-1-medical-surgical-036","有關靜脈導管 Port-A 之敘述，下列何者正確？①放置 Port-A 人工血管，須採全身麻醉方式 ②Port-A 導管可由腋靜脈放置到鎖骨下靜脈 ③注射起泡性藥物時，應測試是否有回血 ④注射藥物時，使用一般空針 90 度插入，以免發生外滲",36,109,{"webId":55,"stem":56,"number":57,"year":58,"session":30},"nurse-110-1-medical-surgical-080","下列何者不屬於傳染病的護理評估項目？",80,110,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-111-2-medical-surgical-034","奇脈（paradoxical pulse）是指下列何種情況？",34,111,"2026-09-04",1788510698697]