[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-109-2-medical-surgical-038":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"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":26},"nurse-109-2-內外科護理學-038","nurse-109-2-medical-surgical-038",109,2,38,"醫師告知王先生罹患多發性骨髓瘤，王先生問護理師這是什麼病，下列何者是護理師最適當的回覆？",{"A":14,"B":15,"C":16,"D":17},"不正常的白血球過度增生","骨髓中的漿細胞惡性分化且過度增生","不正常的紅血球過度增生","不正常的淋巴球過度增生","B",null,[],"本題考點是多發性骨髓瘤（multiple myeloma）的本質。考點在於辨識此病是骨髓中「漿細胞（plasma cell）」發生惡性分化並過度增生，漿細胞由B淋巴球分化而來、專責製造抗體，惡性增生後產生大量單株免疫球蛋白，故選B。A不正常白血球過度增生指的是白血病。C不正常紅血球過度增生指真性紅血球增多症。D不正常淋巴球過度增生對應淋巴性白血病或淋巴瘤，而非漿細胞。護理師面對病人提問時，最準確的回覆是點出漿細胞惡性增生此一核心，故B為最適當。","病生理：惡性漿細胞分泌大量單株免疫球蛋白（M蛋白），並活化蝕骨細胞造成溶骨性病變。典型表現以「CRAB」記憶——C高血鈣（hyperCalcemia）、R腎功能不全（Renal）、A貧血（Anemia）、B骨骼病變（Bone lesion）。實驗室可見血中M-spike、尿中Bence Jones蛋白。護理重點：骨痛與病理性骨折防護、水分維持以保護腎臟、感染預防（正常抗體不足）。與白血病、淋巴瘤同屬血液惡性但細胞來源不同是常考鑑別點。",[24,27,29,32],{"term":25,"count":26},"多發性骨髓瘤",4,{"term":28,"count":10},"單株免疫球蛋白",{"term":30,"count":31},"漿細胞惡性增生",1,{"term":33,"count":31},"CRAB表現",[35,39,44,48,53,58],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-109-2-medical-surgical-039","有關放射線治療癌症之敘述，下列何者正確？",39,{"webId":40,"stem":41,"number":42,"year":43,"session":31},"nurse-110-1-medical-surgical-055","下列何者不是闌尾炎的徵象？",55,110,{"webId":45,"stem":46,"number":47,"year":43,"session":10},"nurse-110-2-medical-surgical-069","有關甲狀腺素製劑使用原則與注意事項，下列何者錯誤？",69,{"webId":49,"stem":50,"number":51,"year":52,"session":31},"nurse-112-1-medical-surgical-027","有關裝置植入式自動心律轉換去顫器（AICD）病人居家護理指導之敘述，下列何者錯誤？",27,112,{"webId":54,"stem":55,"number":56,"year":57,"session":31},"nurse-113-1-medical-surgical-021","針對接受trastuzumab（Herceptin®）治療的癌症病人之護理，下列何者正確？①靜脈滴注給藥 ②空腹口服給藥 ③監測丘疹、手足症候群 ④監測心臟功能",21,113,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-114-2-medical-surgical-015","病人左耳聽力正常，右耳有聽力障礙，以韋伯試驗（Weber test）發現右耳比較大聲，再以任內試驗（Rinne test）發現左耳空氣傳導＞骨傳導、右耳空氣傳導≦骨傳導，下列何者是病人右耳最可能的病變位置？ ①外耳 ②中耳 ③內耳 ④耳蝸神經",15,114,"2026-09-04",1788510716627]