[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-108-2-medical-surgical-075":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"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-108-2-內外科護理學-075","nurse-108-2-medical-surgical-075",108,2,75,"病人發生休克時對肝臟系統之影響不包括下列何者？",{"A":14,"B":15,"C":16,"D":17},"早期出現血中葡萄糖增加","漸進期出現代謝性鹼中毒","漸進期出現乳酸轉換下降","漸進期出現血中葡萄糖下降","B",null,[],"本題考點為休克各期對肝臟與代謝的影響，須找出不會發生者。休克時組織灌流不足、缺氧使無氧糖解增加、乳酸堆積，整體走向代謝性酸中毒而非鹼中毒，故「漸進期出現代謝性鹼中毒」不包括在內，選 B。選項 A 正確，休克早期交感神經興奮與壓力荷爾蒙促進肝醣分解與糖質新生，使血糖上升。選項 C 漸進期因肝細胞缺氧受損、乳酸清除與轉換能力下降。選項 D 漸進期肝醣耗竭與肝功能下降後，血糖可轉為下降。故唯一方向錯誤者為代謝性鹼中毒。","休克代謝軌跡:早期(代償)壓力荷爾蒙(腎上腺素、皮質醇)使血糖↑;進展期組織缺氧→無氧代謝→乳酸堆積→代謝性酸中毒(乳酸性),肝功能受損使乳酸清除↓、糖質新生耗竭致血糖↓。故休克是酸中毒非鹼中毒。判題抓「缺氧+乳酸=代謝性酸中毒」立刻排除鹼中毒選項。",[24,27,29,31,33],{"term":25,"count":26},"休克病生理",1,{"term":28,"count":26},"乳酸性代謝酸中毒",{"term":30,"count":26},"肝臟缺氧損傷",{"term":32,"count":26},"糖質新生耗竭",{"term":34,"count":26},"壓力荷爾蒙升血糖",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-108-2-medical-surgical-076","有關食物中毒之敘述，下列何者錯誤？",76,{"webId":41,"stem":42,"number":43,"year":44,"session":10},"nurse-109-2-medical-surgical-012","有關大腸癌的高危險因子，下列何者錯誤？",12,109,{"webId":46,"stem":47,"number":48,"year":49,"session":26},"nurse-110-1-medical-surgical-026","有關心肌病變（cardiomyopathy）的敘述，下列何者正確？",26,110,{"webId":51,"stem":52,"number":53,"year":54,"session":26},"nurse-111-1-medical-surgical-064","梁太太規律接受血液透析，因腎性貧血服用葉酸，其最恰當的服用時間為何？",64,111,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-112-2-medical-surgical-028","有關心肌梗塞急性期的治療，下列敘述何者正確？①從鼻套管給 10 L\u002Fmin 氧氣 ②給予麻醉性止痛劑止痛，如 morphine ③給予血栓溶解劑治療 ④給予抗凝血劑治療 ⑤補充維生素 K",28,112,{"webId":61,"stem":62,"number":63,"year":64,"session":10},"nurse-113-2-medical-surgical-042","有關腎上腺皮質功能低下症之敘述，下列何者錯誤？",42,113,"2026-09-04",1788510706817]