[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-108-2-fundamental-nursing-039":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":34,"lastmod":63},"基本護理學與護理行政","fundamental-nursing","基本護理學(包括護理原理、護理技術)與護理行政",{"id":8,"webId":9,"year":10,"session":11,"subject":4,"number":12,"stem":13,"options":14,"answer":19,"answerNote":20,"images":21,"explanation":22,"explanationDeep":23,"topics":24,"freq":27},"nurse-108-2-基本護理學與護理行政-039","nurse-108-2-fundamental-nursing-039",108,2,39,"下列何種臥位不適合意識不清病人口鼻腔分泌物之引流？",{"A":15,"B":16,"C":17,"D":18},"俯臥","側臥","仰臥","辛氏臥位","C",null,[],"本題考點為意識不清病人促進口鼻腔分泌物引流的臥位選擇。仰臥時頭頸後仰、分泌物易積聚咽喉並倒流入氣道,不利引流且增加吸入(aspiration)風險,故「仰臥」最不適合,選C。A俯臥、B側臥、D辛氏臥位(Sims,半俯臥)都能藉重力使口鼻腔分泌物順勢向外流出、保持呼吸道通暢,適合意識不清者。意識不清病人因咳嗽與吞嚥反射減弱,更需仰賴重力引流與側臥,避免仰臥造成分泌物滯留、舌後墜阻塞氣道。","意識不清或術後未清醒者的體位安全原則:採側臥或半俯臥(辛氏臥位),使分泌物與嘔吐物順重力由口角流出,防吸入性肺炎與窒息;同時避免舌根後墜堵塞咽喉。仰臥的風險:舌後墜、分泌物積聚、若嘔吐易逆流入肺。復甦姿勢(recovery position)即側臥概念的延伸。對照:引流分泌物時常見的姿勢引流(postural drainage)亦是藉重力清除肺部分泌物。口訣:「昏迷病人側臥保命,仰臥防舌墜與吸入」。",[25,28,31,32],{"term":26,"count":27},"吸入性肺炎預防",4,{"term":29,"count":30},"意識不清體位",1,{"term":18,"count":30},{"term":33,"count":30},"分泌物引流",[35,39,44,48,53,58],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-108-2-fundamental-nursing-040","雙手尺骨骨折的病人，手術後 6 小時未解尿，觸診膀胱鼓脹，下列何者是最適當的獨立性護理功能？",40,{"webId":40,"stem":41,"number":42,"year":43,"session":30},"nurse-109-1-fundamental-nursing-056","有關體溫變化的敘述，下列何者錯誤？",56,109,{"webId":45,"stem":46,"number":47,"year":43,"session":11},"nurse-109-2-fundamental-nursing-070","依據 Marquis 和 Huston（2011）創造激勵氛圍的策略，下列何者錯誤？",70,{"webId":49,"stem":50,"number":51,"year":52,"session":30},"nurse-111-1-fundamental-nursing-028","古先生，腳踝扭傷，護理師給予冷敷其腳踝。30 分鐘後，古先生主訴其肢體出現發紅的現象，此現象是屬於何種效應？",28,111,{"webId":54,"stem":55,"number":56,"year":57,"session":30},"nurse-112-1-fundamental-nursing-072","依據 Keeney（1994）建議的最佳的問題解決方案，下列敘述何者最適宜？",72,112,{"webId":59,"stem":60,"number":61,"year":62,"session":11},"nurse-113-2-fundamental-nursing-006","護理師首次照護王先生，先查閱其病歷資料，進入病室後向王先生自我介紹，隨後運用會談方式了解其昨天晚上睡不好的原因，並提供情緒的安撫。王先生感謝地說：「謝謝您這麼關心我，我現在感覺好多了。」有關治療性人際關係過程的敘述，下列何者錯誤？",6,113,"2026-09-04",1788510705853]