[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-109-2-medical-surgical-033":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"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":26},"nurse-109-2-內外科護理學-033","nurse-109-2-medical-surgical-033",109,2,33,"有關病人心電圖 VT 之相關處置，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"有意識的情況下，實施去纖維震顫術，應選擇同步心臟電氣轉換術（synchronized cardioversion）","無脈搏的情況下，實施去纖維震顫術前，應先注射麻醉鎮靜劑","有脈搏的情況下，實施去纖維震顫術，可直接使用 100 焦耳","心電圖從 VT 變 Vf 時，應停止實施去纖維震顫術，改心肺復甦術","A",null,[],"本題考點是心室頻脈（VT）電擊治療的適應症區分。考點在於辨識「有脈搏」與「無脈搏」VT的處置差異：依高級心臟救命術（ACLS），有脈搏（有意識）的VT仍有心輸出，須用「同步心臟電氣轉換術」，讓電擊對準R波、避開T波以免誘發VF，故選A。B錯在無脈搏VT等同VF，屬立即去顫指徵，救命為先不可為打鎮靜劑而延遲。C錯在有脈搏VT應採同步整流而非直接高能量去顫，能量也非固定100焦耳直上。D錯在心律由VT惡化為VF時，VF正是去顫（defibrillation）的明確指徵，應立即電擊而非停止。","關鍵對比：同步整流（synchronized cardioversion）偵測R波才放電，用於有脈搏的VT、心房顫動、心房撲動等；非同步去顫（defibrillation）隨時放電，用於VF與無脈搏VT。若對有脈搏VT誤用非同步電擊，可能落在T波「易損期」引發R-on-T而誘發VF。記憶口訣：「有脈搏對R波（同步）、沒脈搏隨便電（去顫）」。無脈搏VT與VF的救命鏈相同：CPR＋盡早去顫＋腎上腺素，鎮靜只用於「清醒且血流動力學尚穩」需整流者。",[24,27,29,31],{"term":25,"count":26},"同步心臟電氣轉換術",1,{"term":28,"count":26},"去纖維震顫術",{"term":30,"count":26},"無脈搏VT等同VF",{"term":32,"count":26},"R-on-T現象",[34,38,43,47,52,57],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-109-2-medical-surgical-034","心衰竭病人之心電圖持續出現明顯 U 波，在給予藥物時，應注意下列何種藥物可能有中毒的危險？",34,{"webId":39,"stem":40,"number":41,"year":42,"session":26},"nurse-110-1-medical-surgical-050","有關類風濕性關節炎的醫療處置，下列敘述何者正確？",50,110,{"webId":44,"stem":45,"number":46,"year":42,"session":10},"nurse-110-2-medical-surgical-064","下列何種疾病的常見臨床症狀不包括血尿？",64,{"webId":48,"stem":49,"number":50,"year":51,"session":26},"nurse-112-1-medical-surgical-022","一位高度數近視的病人，主訴眼前突然出現一群浮動的黑點，而且有部分視野缺失，下列建議何者不適宜？",22,112,{"webId":53,"stem":54,"number":55,"year":56,"session":26},"nurse-113-1-medical-surgical-016","有關心肌炎病人的護理指導，下列何者不適宜？",16,113,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-114-2-medical-surgical-010","王先生，170 cm，88 Kg，從事搬運工，因腹股溝疝氣接受手術治療，有關疝氣手術後護理指導，下列何者正確？①傷口處熱敷，以減輕疼痛與腫脹 ②不需要特別減重以免營養不良 ③陰囊應給與支托後再下床 ④平時應多吃蔬果以預防便秘 ⑤出院後可立即上班從事搬運工作",10,114,"2026-09-04",1788510716578]