[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-108-1-medical-surgical-040":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":65},"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":26},"nurse-108-1-內外科護理學-040","nurse-108-1-medical-surgical-040",108,1,40,"維生素 B 12 缺乏造成的惡性貧血，可透過下列何種試驗或檢查進行鑑別？",{"A":14,"B":15,"C":16,"D":17},"直接庫姆氏試驗（direct Coombs’ test）","間接庫姆氏試驗（indirect Coombs’ test）","席林試驗（Schilling’s test）","尿液本斯-瓊司氏蛋白檢查（Bence-Jones protein）","C",null,[],"本題考點為維生素B12缺乏所致惡性貧血的鑑別檢查。依機轉，惡性貧血源於內在因子缺乏使B12吸收障礙，席林試驗（Schilling's test）以口服放射標記B12並測其尿中排出，可判斷吸收缺陷是否因缺乏內在因子，故選C。A直接與B間接庫姆氏試驗用於偵測自體免疫溶血性貧血的抗體；D本斯-瓊司氏蛋白檢查用於多發性骨髓瘤。故惡性貧血的專屬鑑別為席林試驗。","惡性貧血屬巨球性貧血，因胃壁細胞萎縮或自體免疫破壞導致內在因子不足、B12無法在迴腸末端吸收。席林試驗步驟：先給放射B12再測尿排出，第二階段補充內在因子後若吸收改善即證實病因。臨床亦可驗抗內在因子抗體。記憶：Coombs查溶血、Bence-Jones查骨髓瘤、Schilling查B12吸收。",[24,27,30,33],{"term":25,"count":26},"內在因子",5,{"term":28,"count":29},"惡性貧血",4,{"term":31,"count":32},"維生素B12",3,{"term":34,"count":35},"席林試驗",2,[37,41,45,50,55,60],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-108-1-medical-surgical-041","王太太 50 歲，診斷為急性白血病，入院行高劑量 Ara-C 化學治療後，白血球 3,500\u002Fcumm、嗜中性球為 13%，下列敘述何者正確？",41,{"webId":42,"stem":43,"number":44,"year":9,"session":35},"nurse-108-2-medical-surgical-057","有關呼吸困難之徵象，下列何者最不常見？",57,{"webId":46,"stem":47,"number":48,"year":49,"session":10},"nurse-109-1-medical-surgical-071","有關高血磷病人的護理指導，下列何者正確？①少吃堅果類與糙米飯 ②多補充維生素 D ③監測小便量與肝功能 ④注意下床活動安全 ⑤服用磷結合劑",71,109,{"webId":51,"stem":52,"number":53,"year":54,"session":35},"nurse-110-2-medical-surgical-029","有關心臟血管系統檢查評估的敘述，下列何者錯誤？",29,110,{"webId":56,"stem":57,"number":58,"year":59,"session":35},"nurse-111-2-medical-surgical-073","有關甲狀腺功能亢進病人的飲食指導，下列何者正確？",73,111,{"webId":61,"stem":62,"number":63,"year":64,"session":32},"nurse-112-3-medical-surgical-027","病人剛接受骨髓移植 2 週，主訴右上腹痛，評估有黃疸、腹水，下列何者是病人最有可能發生的問題？",27,112,"2026-09-04",1788510709852]