[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-108-1-medical-surgical-058":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":64},"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-058","nurse-108-1-medical-surgical-058",108,1,58,"慢性阻塞性肺部疾病病人最早出現的肺功能變化為下列何者？",{"A":14,"B":15,"C":16,"D":17},"用力呼氣時間延長","肺活量降低","肺餘容積上升","用力呼氣第一秒容積下降","D",null,[],"本題考點在於慢性阻塞性肺疾病（COPD）最早出現的肺功能異常。COPD 屬阻塞性通氣障礙，最早且最敏感的變化是呼氣氣流受阻，表現為用力呼氣第一秒容積（FEV1）下降及 FEV1／FVC 比值降低，故選 D。（A）用力呼氣時間延長雖也反映阻塞，但屬較粗略的臨床觀察，非最早量化到的指標，且它其實是 FEV1 下降的同一現象的定性描述。（B）錯在肺活量降低較晚出現，且較屬限制性變化。（C）錯在肺餘容積上升（氣體滯留、過度充氣）為疾病進展後才明顯的變化，非最早。故最早、最敏感者為 FEV1 下降。","阻塞性 vs 限制性判讀口訣：「阻塞看比值（FEV1\u002FFVC 降）、限制看容積（TLC、VC 降）」。COPD 因小氣道發炎狹窄與彈性回縮喪失，呼氣時氣道提早塌陷、氣流受阻，故最先反映在 FEV1 與 FEV1\u002FFVC。隨病程進展才出現氣體滯留使肺餘容積（RV）與功能餘量（FRC）上升、肺過度充氣（桶狀胸）。連結概念：FEV1\u002FFVC 比值、氣道提早塌陷、肺餘容積、過度充氣。",[24,27,30,32,34],{"term":25,"count":26},"慢性阻塞性肺疾病",3,{"term":28,"count":29},"FEV1\u002FFVC 比值",2,{"term":31,"count":29},"阻塞性通氣障礙",{"term":33,"count":10},"用力呼氣第一秒容積 FEV1",{"term":35,"count":10},"氣道提早塌陷",[37,41,45,50,55,60],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-108-1-medical-surgical-059","下列何者不會出現少尿現象？",59,{"webId":42,"stem":43,"number":44,"year":9,"session":29},"nurse-108-2-medical-surgical-075","病人發生休克時對肝臟系統之影響不包括下列何者？",75,{"webId":46,"stem":47,"number":48,"year":49,"session":29},"nurse-109-2-medical-surgical-009","有關闌尾炎身體評估檢查的結果，下列何者正確？①墨菲氏徵象（Murphy’s sign） ②麥氏點（McBurney’s point）壓痛 ③普氏徵象（Psoas sign） ④閉孔肌徵象（obturator sign）",9,109,{"webId":51,"stem":52,"number":53,"year":54,"session":29},"nurse-110-2-medical-surgical-047","有關燒傷病人敷料應用的敘述，下列何者錯誤？",47,110,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-112-1-medical-surgical-011","有關升結腸造瘻的敘述，下列何者正確？",11,112,{"webId":61,"stem":62,"number":63,"year":59,"session":26},"nurse-112-3-medical-surgical-045","有關胰臟所製造的激素與作用，下列敘述何者錯誤？",45,"2026-09-04",1788510710032]