[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-109-2-medical-surgical-075":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":66},"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-075","nurse-109-2-medical-surgical-075",109,2,75,"糖尿病病人在下列何種情況下不宜增加胰島素的劑量？",{"A":14,"B":15,"C":16,"D":17},"全身感染","食慾不振","嚴重外傷","情緒壓力","B",null,[],"本題考點是影響胰島素需求量的臨床情境判斷。全身感染、嚴重外傷與情緒壓力都會使壓力荷爾蒙（如皮質醇、腎上腺素、升糖素）上升，促進糖質新生使血糖升高，故需「增加」胰島素劑量；唯獨食慾不振代表醣類攝取減少、血糖來源下降，此時若仍增加胰島素反而易引發低血糖，故選項B「食慾不振」是不宜增加胰島素的情況，為正解。選項A、C、D皆屬壓力升糖情境，需視血糖上調胰島素，故非本題答案。","抓住『壓力荷爾蒙升糖』這條主軸：感染、創傷、手術、情緒壓力都會活化下視丘-腦下垂體-腎上腺軸，釋出皮質醇與兒茶酚胺、升糖素，促進肝糖分解與糖質新生、並造成胰島素阻抗，故血糖上升、胰島素需求增加，這也是為何糖尿病人生病時常需『生病日照護（sick day rules）』提高監測與可能增量。反之，進食減少時外源葡萄糖下降，胰島素若不下調就會低血糖。臨床原則是依實際血糖與進食量動態調整，而非固定劑量，這正是本題要辨識的核心。",[24,27,30,32,34],{"term":25,"count":26},"糖質新生",5,{"term":28,"count":29},"胰島素需求量",1,{"term":31,"count":29},"壓力荷爾蒙",{"term":33,"count":29},"低血糖風險",{"term":35,"count":29},"生病日照護",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-109-2-medical-surgical-076","有關「臺灣急診檢傷與急迫度分級量表」（TTAS）的敘述，下列何者正確？",76,{"webId":42,"stem":43,"number":44,"year":45,"session":10},"nurse-110-2-medical-surgical-012","有關內視鏡逆行膽胰攝影的敘述，下列何者正確？",12,110,{"webId":47,"stem":48,"number":49,"year":50,"session":29},"nurse-111-1-medical-surgical-026","有關心臟復健（Cardiac Rehabilitation, CR）活動時應注意事項的敘述，下列何者錯誤？",26,111,{"webId":52,"stem":53,"number":54,"year":55,"session":29},"nurse-112-1-medical-surgical-064","王先生的動脈血液氣體分析判讀結果為未代償性呼吸性酸中毒，下列敘述何者正確？",64,112,{"webId":57,"stem":58,"number":59,"year":60,"session":10},"nurse-113-2-medical-surgical-008","有關全腸道外營養療法（TPN）常見的併發症，下列何者錯誤？",8,113,{"webId":62,"stem":63,"number":10,"year":64,"session":65},"nurse-114-3-medical-surgical-002","62 歲王女士，因在家突然四肢無力至急診，意識清楚，但四肢癱瘓、不能言語，可依指示轉動眼球和眨眼，下列那一部分功能最可能受損？",114,3,"2026-09-04",1788510716994]