[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-109-1-medical-surgical-015":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":63},"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":10},"nurse-109-1-內外科護理學-015","nurse-109-1-medical-surgical-015",109,1,15,"肝穿刺切片檢查時，為避免橫膈穿孔與肝臟撕裂傷，教導病人當針頭插入肝臟時應採取的動作，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"用力深呼吸","張開嘴巴說「啊」","數個深呼吸後，深吸氣並摒住呼吸","數個深呼吸後，深吐氣並摒住呼吸","D",null,[],"本題考點在於肝穿刺切片時的呼吸配合以固定橫膈與肝臟位置。肝臟位於右上腹橫膈下方，隨呼吸上下移動；針頭插入瞬間須讓橫膈上抬、肝臟固定不動，方法是「數個深呼吸後，深吐氣（吐盡）並摒住呼吸」，因吐氣末橫膈上升到最高、肝臟相對穩定，可避免橫膈穿孔與肝撕裂，故選D。選項A用力深呼吸會使橫膈下降、肝臟隨之移動增加撕裂風險；選項B張嘴說啊用於評估或聲門開放，與固定肝臟無關；選項C深吸氣摒住會使橫膈下移、肝臟下降，與所需方向相反。故正確為深吐氣後摒息。","關鍵在橫膈與肝臟隨呼吸的相對位移：吸氣橫膈收縮下降、肝下移；吐氣橫膈鬆弛上升、肝上移並固定。切片針多由右側肋間進入，故須避開肝隨呼吸的活動範圍。術後平臥並右側臥壓迫穿刺點止血，密切監測出血與氣胸徵象。此考點常與胸腔穿刺（吐氣摒息）互相對照記憶。",[24,26,28,30],{"term":25,"count":10},"肝穿刺切片",{"term":27,"count":10},"橫膈與肝臟呼吸位移",{"term":29,"count":10},"深吐氣摒住呼吸",{"term":31,"count":10},"橫膈穿孔預防",[33,37,42,47,52,57],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-109-1-medical-surgical-016","有關胃食道逆流病人之護理指導，下列何者錯誤？",16,{"webId":38,"stem":39,"number":40,"year":9,"session":41},"nurse-109-2-medical-surgical-032","有關抗心律不整藥物，下列何者屬於鈉離子通道阻斷劑？",32,2,{"webId":43,"stem":44,"number":45,"year":46,"session":10},"nurse-110-1-medical-surgical-046","有關燒傷病人居家照護的護理指導，下列何者錯誤？",46,110,{"webId":48,"stem":49,"number":50,"year":51,"session":41},"nurse-111-2-medical-surgical-004","有關誘發腦下垂體中風原因的敘述，下列何者正確？",4,111,{"webId":53,"stem":54,"number":55,"year":56,"session":41},"nurse-112-2-medical-surgical-048","有關類風濕性關節炎藥物治療之敘述，下列何者錯誤？",48,112,{"webId":58,"stem":59,"number":60,"year":61,"session":62},"nurse-113-3-medical-surgical-012","承上題，有關此類病人的護理措施，下列何者最適宜？",12,113,3,"2026-09-04",1788510712439]