[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-108-1-medical-surgical-041":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":66},"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-041","nurse-108-1-medical-surgical-041",108,1,41,"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？",{"A":14,"B":15,"C":16,"D":17},"王太太屬輕度白血球低下，應提供居家照護護理指導後辦理出院","王太太正處於嗜中性白血球低下（neutropenia）的階段","王太太沒有發燒、呼吸急促或解尿困難等症狀，表示未感染，出院後自行觀察即可","王太太的口腔黏膜、肛門黏膜和侵入性導管置入處不可能會發生感染","B",null,[],"本題考點在於用嗜中性球絕對值（ANC）判讀骨髓抑制程度。ANC＝白血球總數×嗜中性球百分比，故本題 3,500×13%≒455／μL。依教科書分級，ANC 低於 500／μL 屬嚴重嗜中性白血球低下，感染風險最高，選 B。（A）錯在此為嚴重而非輕度低下，屬保護隔離對象，不可貿然出院。（C）錯在嗜中性球極低時發炎反應被抑制，感染早期可無發燒等典型症狀，不能以無症狀判定未感染。（D）錯在口腔、肛門黏膜與導管置入處正是黏膜屏障破損、常見的感染門戶，並非不可能感染。","ANC 分級可記為「一千警戒、五百嚴重、一百極危」：500–1000／μL 中度、低於 500／μL 嚴重、低於 100／μL 極重度。高劑量 Ara-C（cytarabine）抑制骨髓造血幹細胞，使成熟顆粒球生成停滯，故白血球看似仍有 3,500，但真正抗菌的嗜中性球比例極低，總數才是關鍵。發炎的紅腫熱痛需靠嗜中性球聚集產生，低下時感染徵象被掩蓋，發燒可能是唯一線索，故臨床以發熱性嗜中性白血球低下（febrile neutropenia）為警訊。連結概念：保護性隔離、黏膜炎、造血生長因子 G-CSF。",[24,27,30,32,34],{"term":25,"count":26},"骨髓抑制",8,{"term":28,"count":29},"發熱性嗜中性球低下",2,{"term":31,"count":10},"嗜中性球絕對值 ANC",{"term":33,"count":10},"嗜中性白血球低下 neutropenia",{"term":35,"count":10},"Ara-C 化學治療",[37,41,45,50,55,60],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-108-1-medical-surgical-042","有關非何杰金氏淋巴瘤之治療，下列何者正確？",42,{"webId":42,"stem":43,"number":44,"year":9,"session":29},"nurse-108-2-medical-surgical-058","成人在正常飲水狀況下，日間平均解尿次數超過 8 次之現象，下列何者正確？",58,{"webId":46,"stem":47,"number":48,"year":49,"session":10},"nurse-109-1-medical-surgical-072","有關執行胸外心臟按壓的敘述，下列何者正確？",72,109,{"webId":51,"stem":52,"number":53,"year":54,"session":29},"nurse-110-2-medical-surgical-030","有關心電圖的敘述，下列何者錯誤？",30,110,{"webId":56,"stem":57,"number":58,"year":59,"session":29},"nurse-111-2-medical-surgical-074","有關糖化血色素的敘述，下列何者正確？",74,111,{"webId":61,"stem":62,"number":63,"year":64,"session":65},"nurse-112-3-medical-surgical-028","有關頭頸部放射治療對口腔造成的影響，下列處置何者正確？",28,112,3,"2026-09-04",1788510709862]