[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-108-1-medical-surgical-070":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"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-070","nurse-108-1-medical-surgical-070",108,1,70,"下列何者最可能造成病人出現昏迷、呼吸快而深、血清有效滲透壓 300 mOsm\u002Fkg、血糖值 400 mg\u002FdL 的臨床表徵？",{"A":14,"B":15,"C":16,"D":17},"蘇莫吉效應（Somogyi effect）","急性肝昏迷","糖尿病性酮酸中毒","高血糖高滲透壓狀態","C",null,[],"本題考點在於糖尿病急性高血糖危症的鑑別。病人昏迷、呼吸快而深（Kussmaul 呼吸）、血糖 400 mg\u002FdL 而有效滲透壓僅 300 mOsm\u002Fkg，深快呼吸屬酸血症代償排酸，最符合糖尿病性酮酸中毒（DKA），選 C。（A）錯在蘇莫吉效應是夜間低血糖後反彈的晨間高血糖，不會造成昏迷與深快呼吸。（B）錯在急性肝昏迷源於血氨升高、肝性腦病變，不呈此高血糖圖像。（D）錯在高血糖高滲透壓狀態（HHS）血糖常達 600 mg\u002FdL 以上、有效滲透壓 >320，且無明顯酮酸與深快呼吸，與本題數值不符。","DKA 與 HHS 鑑別是高頻考點。DKA（多見第 1 型）：胰島素絕對缺乏→脂肪分解生酮→代謝性酸中毒→Kussmaul 深快呼吸代償、爛蘋果味（丙酮）、血糖多 250–600、酮體強陽；HHS（多見第 2 型）：仍有少量胰島素抑制生酮，故無明顯酮酸，但血糖極高（>600）、嚴重脫水、滲透壓極高（>320）、意識障礙更重。記憶口訣：「一型酸中毒、二型高滲透；深快吹酮是 DKA」。連結概念：Kussmaul 呼吸、酮體生成、有效滲透壓、脫水程度、胰島素缺乏程度。",[24,27,29,31,33],{"term":25,"count":26},"Kussmaul 呼吸",4,{"term":28,"count":10},"糖尿病性酮酸中毒 DKA",{"term":30,"count":10},"有效滲透壓",{"term":32,"count":10},"高血糖高滲透壓狀態 HHS 鑑別",{"term":34,"count":10},"酮體生成",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-108-1-medical-surgical-071","有關甲狀腺切除後可能發生的合併症，下列何者正確？",71,{"webId":41,"stem":42,"number":43,"year":44,"session":10},"nurse-109-1-medical-surgical-007","有關脊髓損傷造成弛緩型神經性膀胱的排尿訓練，下列何者正確？",7,109,{"webId":46,"stem":47,"number":48,"year":44,"session":49},"nurse-109-2-medical-surgical-021","病人右大腿骨折上石膏 3 個月，拆除石膏時，不會看到下列那種現象？",21,2,{"webId":51,"stem":52,"number":53,"year":54,"session":49},"nurse-110-2-medical-surgical-059","有關以定量吸入器（MDI）方式給藥的敘述，下列何者錯誤？",59,110,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-112-1-medical-surgical-023","有關鼻部手術後的護理指導，下列何者最不適宜？",23,112,{"webId":61,"stem":62,"number":43,"year":63,"session":10},"nurse-113-1-medical-surgical-007","承上題，關於陳先生的護理措施，下列何者正確？①限制水分與蛋白質的攝取 ②每天測量體重與腹圍，記錄輸出入量 ③給與利尿劑後，儘快補充Albumin ④使用Lactulose以減少細菌分解蛋白質所產生大量氨",113,"2026-09-04",1788510710121]