[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-109-2-medical-surgical-052":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"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-109-2-內外科護理學-052","nurse-109-2-medical-surgical-052",109,2,52,"有關吸入性肺炎之臨床症狀，下列何者須立即處理？",{"A":14,"B":15,"C":16,"D":17},"咳出帶血絲（blood-tinged）的痰","聽診後側肺底出現些許的爆裂音（crackles）","經兩天的靜脈注射抗生素治療後，仍發燒至 38.6 o C","調高給氧的流速，周邊血氧仍繼續下降且低於 90%","D",null,[],"本題考點是吸入性肺炎病人症狀的優先處置判斷。考點在於辨識依生命維持（ABC）原則，氣體交換惡化最為危急：D所述已調高給氧流速、周邊血氧仍持續下降且低於90%，代表低血氧與呼吸衰竭惡化，須立即處理，故選D。A咳出帶血絲痰是肺部發炎常見表現，非立即危及生命。B後側肺底些許爆裂音為肺炎典型聽診所見，屬預期症狀。C經兩天靜脈抗生素仍發燒至38.6°C反映感染尚在，需追蹤評估但非分秒必爭。相較之下，持續且對供氧無反應的低血氧最需優先介入，故D正確。","臨床優先順序判斷用ABC（Airway-Breathing-Circulation）與「威脅生命者優先」：SpO₂\u003C90%約對應PaO₂\u003C60mmHg，屬呼吸衰竭門檻，且對提高氧流速無反應，提示嚴重分流或惡化，須評估是否需更高階呼吸支持。相對地，發燒、血絲痰、局部爆裂音屬病程可預期、可延後處理的表現。記憶：「先救喘不過氣（缺氧惡化）、再處理發燒感染」。吸入性肺炎好發於吞嚥障礙、意識不清者，右下肺葉較常受累。",[24,26,28,31],{"term":25,"count":10},"低血氧與呼吸衰竭",{"term":27,"count":10},"吸入性肺炎",{"term":29,"count":30},"ABC處置優先順序",1,{"term":32,"count":30},"SpO2\u003C90%臨界值",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-109-2-medical-surgical-053","有關張力性氣胸（tension pneumothorax）的臨床表徵，下列何者正確？",53,{"webId":39,"stem":40,"number":41,"year":42,"session":30},"nurse-110-1-medical-surgical-069","有關嗜鉻細胞瘤的敘述，下列何者錯誤？",69,110,{"webId":44,"stem":45,"number":46,"year":47,"session":30},"nurse-111-1-medical-surgical-003","有關腰椎椎間盤突出的敘述，下列何者錯誤？",3,111,{"webId":49,"stem":50,"number":51,"year":52,"session":30},"nurse-112-1-medical-surgical-041","有關良性腫瘤及惡性腫瘤之敘述，下列何者正確？",41,112,{"webId":54,"stem":55,"number":56,"year":57,"session":30},"nurse-113-1-medical-surgical-035","有關肺炎鏈球菌肺炎病人之臨床表徵，下列敘述何者最不適當？",35,113,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-114-2-medical-surgical-029","有關第一型單純疱疹之敘述，下列何者正確？①容易再度復發 ②感染痊癒後會潛伏於神經根節 ③由水痘病毒感染後所引起的 ④多感染於會陰部",29,114,"2026-09-04",1788510716774]