[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-107-2-maternal-pediatric-046":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":62},"產兒科護理學","maternal-pediatric",{"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-107-2-產兒科護理學-046","nurse-107-2-maternal-pediatric-046",107,2,46,"鐮狀細胞貧血（sickle cell anemia）病童不會出現下列何項臨床表徵？",{"A":14,"B":15,"C":16,"D":17},"顱骨變大、顴骨隆起","末端肢體腫脹與疼痛","視網膜病變以致失明","肝、脾腫大","A",null,[],"本題考點在鐮狀細胞貧血(sickle cell anemia)與海洋性貧血臨床表徵的鑑別。顱骨變大、顴骨隆起(頭顱增厚、面容改變)是慢性溶血致骨髓大量代償增生的表現,典型見於重型海洋性貧血,並非鐮狀細胞貧血的特徵,故 A 為不會出現者。B 正確,鐮狀紅血球阻塞末梢微血管造成手足腫脹疼痛(手足症候群);C 正確,反覆血管阻塞可致視網膜病變甚至失明;D 正確,溶血與脾臟捕捉鐮狀細胞造成肝脾腫大。故不會出現者為 A。","鐮狀細胞貧血因血紅素 β 鏈第 6 位麩胺酸被纈胺酸取代(HbS),缺氧時聚合使紅血球變鐮刀狀,引發血管阻塞危象:疼痛、手足症候群、脾梗塞、急性胸症候群、視網膜病變。對比海洋性貧血為血紅素鏈合成不足,無效造血致骨髓增生而出現顴骨突、額骨隆的地中海面容與 X 光「毛髮豎立狀」顱骨。兩者都溶血,骨骼面容改變是鑑別關鍵。",[24,26,29,31],{"term":25,"count":10},"鐮狀細胞貧血",{"term":27,"count":28},"血管阻塞危象",1,{"term":30,"count":28},"海洋性貧血面容鑑別",{"term":32,"count":28},"手足症候群",[34,38,43,47,52,57],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-107-2-maternal-pediatric-047","小玉，罹患先天性甲狀腺功能低下（congenital hypothyroidism），長期服用甲狀腺藥物，下列何者不是甲狀腺毒性反應之症狀？",47,{"webId":39,"stem":40,"number":41,"year":42,"session":28},"nurse-108-1-maternal-pediatric-063","有關新生兒罹患先天性梅毒的敘述，下列何者錯誤？",63,108,{"webId":44,"stem":45,"number":46,"year":42,"session":10},"nurse-108-2-maternal-pediatric-077","王小弟，3 歲，罹患腎病症候群（nephrotic syndrome），目前服用 prednisolone 治療。護理師在安排與王小弟同住的病童時，下列何者適宜？",77,{"webId":48,"stem":49,"number":50,"year":51,"session":28},"nurse-110-1-maternal-pediatric-035","下列何者不是多囊性卵巢疾病之臨床表徵？",35,110,{"webId":53,"stem":54,"number":55,"year":56,"session":28},"nurse-111-1-maternal-pediatric-079","有關成骨不全（osteogenesis imperfecta）病變的護理措施，下列敘述何者錯誤？",79,111,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-112-2-maternal-pediatric-033","有關比夏計分法（Bishop’s score）之敘述，下列何者正確？",33,112,"2026-09-04",1788510726073]