[{"data":1,"prerenderedAt":62},["ShallowReactive",2],{"q-nurse-107-2-medical-surgical-014":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":61},"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-107-2-內外科護理學-014","nurse-107-2-medical-surgical-014",107,2,14,"王先生，25 歲，今早突感肚臍周圍疼痛且有噁心、食慾不振的現象，至醫院求診，護理師評估疼痛位置轉移到右下腹，懷疑為急性闌尾炎，下列何項檢查可明確確定病人問題？",{"A":14,"B":15,"C":16,"D":17},"觸診左上腹出現反彈痛","左肩出現輻射痛","閉孔肌徵象（obturator sign）陽性反應","墨菲氏徵象（Murphy's sign）陽性反應","C",null,[],"本題考點是急性闌尾炎的理學檢查徵象。病人由臍周轉移至右下腹痛,伴噁心、食慾不振,典型指向急性闌尾炎;閉孔肌徵象(obturator sign,被動內旋屈曲的髖關節誘發右下腹痛)陽性,反映發炎闌尾刺激閉孔內肌,可支持診斷,故選 C。A 錯誤:闌尾炎的反彈痛應在右下腹(McBurney 點),而非左上腹。B 錯誤:左肩輻射痛多見於脾臟破裂或橫膈刺激(Kehr's sign),與闌尾無關。D 錯誤:墨菲氏徵象(Murphy's sign)陽性是急性膽囊炎的表徵,非闌尾炎。四者中唯 C 的閉孔肌徵象與闌尾發炎相符,故為答案。","闌尾炎的經典徵象群:McBurney 點壓痛與反彈痛、Rovsing sign(壓左下腹引發右下腹痛)、psoas sign(伸展右髖誘痛)、obturator sign(內旋屈髖誘痛),機轉皆為發炎闌尾刺激鄰近肌肉或腹膜。將各徵象「歸位」記憶:Murphy=膽囊、Kehr(左肩痛)=脾\u002F橫膈、McBurney\u002FRovsing\u002Fpsoas\u002Fobturator=闌尾。臨床確診雖多輔以影像(超音波、CT),但理學徵象是本題設定的鑑別線索。",[24,26,28,31],{"term":25,"count":10},"急性闌尾炎",{"term":27,"count":10},"閉孔肌徵象",{"term":29,"count":30},"McBurney點反彈痛",1,{"term":32,"count":30},"墨菲氏徵象(膽囊)",[34,38,43,47,52,57],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-107-2-medical-surgical-015","有關肝硬化主要之合併症，下列何者錯誤？",15,{"webId":39,"stem":40,"number":41,"year":42,"session":30},"nurse-108-1-medical-surgical-031","主要症狀為腹水、下肢水腫及肝脾腫大之瓣膜性心臟病病人，其最可能的瓣膜問題為下列何者？",31,108,{"webId":44,"stem":45,"number":46,"year":42,"session":10},"nurse-108-2-medical-surgical-045","有關燒傷病人的緊急處理措施 5 步驟之敘述，下列何者錯誤？",45,{"webId":48,"stem":49,"number":50,"year":51,"session":30},"nurse-110-1-medical-surgical-003","下列何者為重症肌無力病人最早受到影響的肌肉？",3,110,{"webId":53,"stem":54,"number":55,"year":56,"session":30},"nurse-111-1-medical-surgical-047","有關燒傷深度的敘述，下列何者錯誤？",47,111,{"webId":58,"stem":59,"number":30,"year":60,"session":10},"nurse-112-2-medical-surgical-001","腰椎椎間盤突出接受椎板切除術後之護理指導，下列何者錯誤？",112,"2026-09-04",1788510725012]