[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-109-2-medical-surgical-057":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":64},"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-057","nurse-109-2-medical-surgical-057",109,2,57,"一位被診斷為「疑似細菌性肺炎」的病人剛入院，最優先執行下列那一個醫囑？",{"A":14,"B":15,"C":16,"D":17},"給與靜脈輸液 1,000 mL 0.9% Saline","給與抗生素 Ceftriaxone 1 gm IVF 60 minutes","收集尿液標本送尿液分析","收集痰液標本送培養檢驗","D",null,[],"本題考點是疑似細菌性肺炎病人入院醫囑的執行優先順序。考點在於辨識微生物培養檢體必須在給予抗生素「之前」採集，否則抗生素會抑制細菌生長、影響培養與後續藥物敏感試驗結果，故應最優先收集痰液標本送培養，選D。B給予抗生素Ceftriaxone雖然重要，但須在採檢後才給，以免破壞檢體診斷價值。A給予靜脈注射生理食鹽水屬支持性補液，非最優先。C收集尿液送尿液分析與肺炎病原診斷關聯較低。因此先採痰培養再投藥，正解為D。","抗生素治療原則：培養檢體（痰、血液培養）務必在首劑抗生素前採集，但採檢不應過度延誤抗生素給予——嚴重感染或敗血症有「黃金時間」內給藥的要求，臨床上是「快速採檢、緊接投藥」。若已投藥才想起採檢，培養易呈假陰性。此題考的是同時有數個醫囑時的先後邏輯：採檢在前、投藥在後。記憶：「先留檢體再打藥，不然細菌驗不到」。血液培養通常兩套不同部位採集以辨污染。",[24,27,30,32],{"term":25,"count":26},"痰液培養",3,{"term":28,"count":29},"抗生素前採集培養檢體",1,{"term":31,"count":29},"藥物敏感試驗",{"term":33,"count":29},"醫囑執行優先順序",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-109-2-medical-surgical-058","李同學在打籃球時突然感到左胸尖銳疼痛到急診求治，護理師視診發現李同學的左側胸部起伏較小，且氣管偏向右側，聽診發現左側肺部呼吸音減弱、叩診左側肺部出現過度反響音，此時李同學最可能發生下列何種情形？",58,{"webId":40,"stem":41,"number":42,"year":43,"session":29},"nurse-110-1-medical-surgical-074","長期接受血液透析的病人，突然意識改變、出現抽筋及肌肉無力情況，入急診求治，抽血檢查結果：尿素氮／肌酸酐 120 mg\u002FdL／10.6 mg\u002FdL、鉀離子 7.8 mg\u002FdL、鈉離子 135 mg\u002FdL，動脈血液氣體分析結果：pH 7.28、PaO 70 mmHg、PaCO 30 mmHg、 HCO _ 20 mEq\u002FL。下列判斷何者正確？ 2 2 3",74,110,{"webId":45,"stem":46,"number":47,"year":48,"session":29},"nurse-111-1-medical-surgical-008","有關脊髓損傷導致「自主神經反射過度」的敘述，下列何者正確？",8,111,{"webId":50,"stem":51,"number":52,"year":53,"session":29},"nurse-112-1-medical-surgical-046","有關膠帶等黏性產品使用之敘述，下列何者正確？",46,112,{"webId":55,"stem":56,"number":57,"year":58,"session":29},"nurse-113-1-medical-surgical-040","韓小姐的動脈血液氣體分析結果為pH 7.44、PaCO 30 mmHg、HCO - 20 mmHg、PaO 82 mmHg，根據以上數 2           3             2 值，判讀結果下列何者正確？",40,113,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-114-2-medical-surgical-034","急性呼吸窘迫症候群（ARDS）病人產生表面張力素的肺細胞受損，會導致病人出現下列何種問題？",34,114,"2026-09-04",1788510716814]