[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-107-2-fundamental-nursing-044":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":35,"lastmod":64},"基本護理學與護理行政","fundamental-nursing","基本護理學(包括護理原理、護理技術)與護理行政",{"id":8,"webId":9,"year":10,"session":11,"subject":4,"number":12,"stem":13,"options":14,"answer":19,"answerNote":20,"images":21,"explanation":22,"explanationDeep":23,"topics":24,"freq":27},"nurse-107-2-基本護理學與護理行政-044","nurse-107-2-fundamental-nursing-044",107,2,44,"長期臥床者在床上使用便盆時，易使用伐耳沙伐氏操作（Valsalva’s maneuver）用力排便，此時心血管系統會呈現何種改變？①胸內壓上升 ②靜脈血快速大量流回心臟 ③血壓下降 ④心輸出量減少",{"A":15,"B":16,"C":17,"D":18},"①②","②③","③④","①④","D",null,[],"本題考點在伐耳沙伐氏操作（Valsalva maneuver）對心血管的即時影響。依其機轉，用力憋氣排便時聲門緊閉、腹肌與胸腔用力，使胸內壓上升（①對）；升高的胸內壓壓迫腔靜脈，靜脈血回流心臟減少而非增加（②錯），前負荷下降使每搏輸出量與心輸出量減少（④對），故選 D①④。③「血壓下降」在此考題採用力當下胸內壓上升、壓迫主動脈使血壓短暫上升的簡化觀點，與③敘述相反，故不選。整體因回流減少導致心輸出量降低，是本題核心。","完整 Valsalva 分四期：第一期用力初起胸內壓上升、血壓短暫上升；第二期持續用力、靜脈回流與心輸出量下降、血壓回落並反射性心搏加快；第三期放鬆瞬間壓力驟降；第四期回流大量湧回、血壓過衝並反射性心搏變慢。臨床危險在「放鬆瞬間」的心搏過緩，心臟病或顱內壓高者應避免用力排便，故常給軟便劑。國考多採簡化版（胸內壓升→回流減→心輸出量減）作答，遇分期細節題再區分。",[25,28,31,33],{"term":26,"count":27},"心輸出量",3,{"term":29,"count":30},"伐耳沙伐氏操作",1,{"term":32,"count":30},"胸內壓與靜脈回流",{"term":34,"count":30},"前負荷與每搏輸出量",[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-107-2-fundamental-nursing-045","每次灌食前，必須反抽胃內溶液之主要目的是在預防灌食造成下列何種情況？",45,{"webId":41,"stem":42,"number":43,"year":44,"session":30},"nurse-108-1-fundamental-nursing-061","下列何者對管理學大師彼得杜拉克（Peter F. Drucker）所倡導的目標管理（management by objectives）之敘述最為適切？",61,108,{"webId":46,"stem":47,"number":48,"year":44,"session":11},"nurse-108-2-fundamental-nursing-075","下列何者為直接成本？",75,{"webId":50,"stem":51,"number":52,"year":53,"session":30},"nurse-110-1-fundamental-nursing-033","執行背部護理之開始與結束時，最常採用下列何種按摩法？",33,110,{"webId":55,"stem":56,"number":57,"year":58,"session":30},"nurse-111-1-fundamental-nursing-077","有關造成醫院危機的外在因素，下列何者錯誤？",77,111,{"webId":60,"stem":61,"number":62,"year":63,"session":11},"nurse-112-2-fundamental-nursing-031","病人解出黏液便，下列護理師的解釋何者較為適當？",31,112,"2026-09-04",1788510724535]