[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-109-2-medical-surgical-073":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-073","nurse-109-2-medical-surgical-073",109,2,73,"下列何者為高血糖高滲透壓狀態（HHS）病人出現脫水的最常見原因？",{"A":14,"B":15,"C":16,"D":17},"噁心、嘔吐","缺乏抗利尿激素","腎臟無法濃縮尿液","高血糖造成滲透壓性利尿","D",null,[],"本題考點是高血糖高滲透壓狀態（HHS）病人脫水的主因。HHS血糖常極度升高，超過腎糖閾後葡萄糖大量進入尿液，形成滲透壓性利尿，帶走大量水分與電解質而造成嚴重脫水，故選項D為正解。選項A噁心、嘔吐雖會流失體液，但非HHS脫水的最主要機轉；選項B缺乏抗利尿激素是尿崩症的病因，與HHS無關；選項C腎臟無法濃縮尿液是結果之一而非根本原因，真正驅動因子仍是高血糖引起的滲透性利尿。故正解為D。","串起HHS的病生理鏈：極高血糖（常大於600 mg\u002FdL）→血糖超過腎糖閾（約180 mg\u002FdL）→尿糖產生滲透梯度把水拉進腎小管→大量排尿（osmotic diuresis）→水分電解質流失→血漿滲透壓飆高（大於320 mOsm\u002Fkg）→細胞內脫水與神經功能障礙。與DKA對比：HHS多為第二型、仍有少量胰島素故不生酮、脫水更嚴重、意識障礙更明顯；DKA則酮體堆積、代謝性酸中毒。護理重點是積極補液矯正脫水與高滲透壓，並謹慎降糖以免腦水腫。",[24,27,30,32],{"term":25,"count":26},"血漿滲透壓",4,{"term":28,"count":29},"高血糖高滲透壓狀態",1,{"term":31,"count":29},"滲透壓性利尿",{"term":33,"count":29},"腎糖閾",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-109-2-medical-surgical-074","有關糖尿病酮酸中毒（DKA）病人之檢驗結果，下列何者正確？①動脈血氧分析 pH 7.2 ②動脈血氧分析 pH 7.5 ③血中碳酸根離子濃度 14 mEq\u002FL ④血中碳酸根離子濃度 25 mEq\u002FL ⑤血清滲透壓>320 mOsm\u002Fkg ⑥血清滲透壓\u003C320 mOsm\u002Fkg",74,{"webId":40,"stem":41,"number":42,"year":43,"session":10},"nurse-110-2-medical-surgical-010","有關腸造瘻口護理指導的敘述，下列何者錯誤？",10,110,{"webId":45,"stem":46,"number":47,"year":48,"session":29},"nurse-111-1-medical-surgical-024","下列腫瘤何者源自結締組織？",24,111,{"webId":50,"stem":51,"number":52,"year":53,"session":29},"nurse-112-1-medical-surgical-062","有關逆行性腎盂造影術之敘述，下列何者正確？①檢查前評估病人有無鋇劑過敏病史 ②檢查前衛教病人勿排空膀胱 ③此檢查使用的顯影劑不會進入血流 ④檢查後監測病人有無尿瀦留、感染、血尿情形",62,112,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-113-2-medical-surgical-006","腦中風病人有吞嚥困難的問題，由口進食的食物性狀須採漸進性改變，下列何者是最後採用的類型？",6,113,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-114-2-medical-surgical-050","有關困難梭狀桿菌相關腹瀉（Clostridium difficile associated diarrhea）之敘述，下列何者錯誤？",50,114,"2026-09-04",1788510716968]