[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-107-1-medical-surgical-027":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":62},"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-107-1-內外科護理學-027","nurse-107-1-medical-surgical-027",107,1,27,"有關發生蘇莫吉效應（Somogyi effect）之敘述，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"是一種反彈性低血糖症狀","由於晚餐前注射胰島素過少所引起","治療方式應採逐漸增加胰島素劑量","常發生在使用高劑量胰島素之後","D",null,[],"本題考點為蘇莫吉效應的成因與處置。依蘇莫吉效應是夜間胰島素劑量「過高」造成半夜低血糖，身體釋放升糖荷爾蒙反彈使清晨血糖升高，故常發生於使用高劑量胰島素之後，D正確。A它引起的是反彈性「高血糖」而非低血糖，錯;B成因是胰島素過多而非過少，錯;C正確處置應「減少」睡前胰島素劑量並可加宵夜，而非逐漸增加，錯，故此三者皆與機轉相反。","清晨高血糖有兩種機轉,鑑別攸關處置方向相反。蘇莫吉效應:夜間胰島素過量→約凌晨 2-3 點低血糖→反調節荷爾蒙(升糖素、腎上腺素、皮質醇、生長激素)過度分泌→晨間反彈高血糖;處置是「減量」胰島素或加睡前點心。黎明現象(Dawn phenomenon):清晨生長激素與皮質醇自然上升致胰島素阻抗,無夜間低血糖;處置是「增量」或調整給藥時間。辨別靠監測凌晨 3 點血糖:低者為 Somogyi,正常或偏高者為 Dawn。口訣:Somogyi「先低後高、越打越糟、該減量」。",[24,26,28,30],{"term":25,"count":10},"蘇莫吉效應",{"term":27,"count":10},"反彈性高血糖",{"term":29,"count":10},"夜間胰島素過量",{"term":31,"count":10},"黎明現象鑑別",[33,37,42,47,52,57],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-107-1-medical-surgical-028","有關風濕熱與風濕性心臟病之敘述，下列何者錯誤？",28,{"webId":38,"stem":39,"number":40,"year":9,"session":41},"nurse-107-2-medical-surgical-044","有關腫瘤溶解症候群之敘述，下列何者正確？①高血鉀症 ②高血鈣症 ③要補充大量水分 ④使用 kayexalate 可降低鈉離子 ⑤allopurinol 可降尿酸",44,2,{"webId":43,"stem":44,"number":45,"year":46,"session":10},"nurse-108-1-medical-surgical-058","慢性阻塞性肺部疾病病人最早出現的肺功能變化為下列何者？",58,108,{"webId":48,"stem":49,"number":50,"year":51,"session":41},"nurse-109-2-medical-surgical-016","病人主訴「餓的時候疼痛，常常半夜痛醒」，下列何者為其最大可能之診斷？",16,109,{"webId":53,"stem":54,"number":55,"year":56,"session":41},"nurse-110-2-medical-surgical-060","急性腎衰竭病人血清鉀為 7.2 mEq\u002FL，下列處置何者正確？①靜脈注射中長效胰島素及 5%葡萄糖溶液 ②口服或灌腸給予 Kayexalate ③靜脈注射重碳酸鈉 ④鼓勵多食用香蕉、柳丁",60,110,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-112-1-medical-surgical-014","有關慢性胃炎之敘述，下列何者錯誤？",14,112,"2026-09-04",1788510702674]