[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-109-1-medical-surgical-006":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":62},"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":25},"nurse-109-1-內外科護理學-006","nurse-109-1-medical-surgical-006",109,1,6,"75 歲老人最近心情抑鬱，對外在環境興趣缺缺，腦部電腦斷層顯示腦組織萎縮、腦溝變大，下列何者為其最可能診斷？",{"A":14,"B":15,"C":16,"D":17},"憂鬱症","譫妄症","阿茲海默氏症","巴金森氏症","C",null,[],"本題考點在於老年認知障礙的鑑別診斷。個案 75 歲、情緒抑鬱、對外在環境興趣缺缺,且腦部電腦斷層顯示瀰漫性腦組織萎縮、腦溝變寬,此影像為阿茲海默氏症(Alzheimer's disease)大腦皮質退化萎縮的典型變化,故最可能診斷為 C。憂鬱症(A)以情緒症狀為主,腦影像通常無明顯萎縮;譫妄症(B)為急性、波動性的意識與注意力障礙,多有誘因且可逆;巴金森氏症(D)以靜止性顫抖、僵硬、動作遲緩等運動症狀為主。考點在於結合臨床表現與腦萎縮影像指向退化性失智。","解題關鍵是「腦組織萎縮、腦溝變大」的影像證據——這是阿茲海默氏症皮質神經退化的典型變化(伴海馬迴萎縮、腦室擴大)。憂鬱症與譫妄多無結構性腦萎縮,譫妄還具急性、波動、可逆的特徵;巴金森氏症以運動症狀為主。要注意老年憂鬱可偽裝成失智(假性失智),但影像上的萎縮會把診斷拉向退化性失智。鑑別口訣:譫妄急又波動可逆、失智慢又進行且結構萎縮、憂鬱以情緒為核心。",[24,26,28,30],{"term":16,"count":25},4,{"term":27,"count":10},"腦萎縮影像",{"term":29,"count":10},"失智症鑑別診斷",{"term":31,"count":10},"譫妄與憂鬱鑑別",[33,37,42,47,52,57],{"webId":34,"stem":35,"number":36,"year":9,"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,{"webId":38,"stem":39,"number":40,"year":9,"session":41},"nurse-109-2-medical-surgical-023","有關鼻竇炎術後的護理措施，下列何者錯誤？",23,2,{"webId":43,"stem":44,"number":45,"year":46,"session":10},"nurse-110-1-medical-surgical-037","有關慢性淋巴性白血病的敘述，下列何者錯誤？",37,110,{"webId":48,"stem":49,"number":50,"year":51,"session":10},"nurse-111-1-medical-surgical-075","有關使用 Spironolactone（Aldactone）藥物指導之敘述，下列何者正確？①須注意鉀離子濃度 ②須注意鎂離子濃度 ③鼓勵多食用柑橘類食物 ④不宜食用芭樂",75,111,{"webId":53,"stem":54,"number":55,"year":56,"session":41},"nurse-112-2-medical-surgical-039","有關化學藥物 cyclophosphamide（Cytoxan）的副作用或毒性，不包括下列何者？",39,112,{"webId":58,"stem":59,"number":60,"year":61,"session":60},"nurse-113-3-medical-surgical-003","墨菲氏徵象（Murphy’s sign）陽性是下列何種疾病的常見特徵？",3,113,"2026-09-04",1788510712366]