[{"data":1,"prerenderedAt":67},["ShallowReactive",2],{"q-nurse-110-1-fundamental-nursing-011":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":36,"lastmod":66},"基本護理學與護理行政","fundamental-nursing","基本護理學(包括護理原理、護理技術)與護理行政",{"id":8,"webId":9,"year":10,"session":11,"subject":4,"number":12,"stem":13,"options":14,"answer":19,"answerNote":20,"images":21,"explanation":22,"explanationDeep":23,"topics":24,"freq":12},"nurse-110-1-基本護理學與護理行政-011","nurse-110-1-fundamental-nursing-011",110,1,11,"有關護理診斷的敘述，下列何者錯誤？",{"A":15,"B":16,"C":17,"D":18},"書寫護理診斷使用之文字必須適當、簡潔、正確及確實","僅需一個明顯之臨床表徵即可確立一個護理診斷","護理措施主要在於矯正問題之導因","護理診斷主要是在護理實務範疇中，描述病人對於疾病或是情境之反應或需要","B",null,[],"本題考點是護理診斷的確立原則，題目問「錯誤」者。依護理過程，確立一個護理診斷需有一組相關的臨床表徵(資料群集)相互佐證，僅憑單一個明顯表徵並不足以成立，故B敘述錯誤、即為答案。A所述用字須適當簡潔正確、C所述護理措施在矯正問題導因、D所述護理診斷描述病人對疾病或情境的反應，皆為正確概念。故錯誤者為B，答案為B。","延伸：完整護理診斷常採PES格式——Problem問題、Etiology導因(related to)、Signs\u002FSymptoms佐證表徵(as evidenced by)。診斷須以一組界定性特徵(defining characteristics)為依據，單一線索易失準；措施則針對可改變的導因介入以解決問題。掌握PES三要素，即能理解為何「僅一表徵」不足以確立診斷。",[25,27,30,32,34],{"term":26,"count":12},"護理過程",{"term":28,"count":29},"護理診斷",2,{"term":31,"count":11},"PES格式",{"term":33,"count":11},"資料群集",{"term":35,"count":11},"界定性特徵",[37,41,45,50,55,60],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-110-1-fundamental-nursing-012","有關行為過程觀察與記錄方法，下列敘述何者正確？",12,{"webId":42,"stem":43,"number":44,"year":10,"session":29},"nurse-110-2-fundamental-nursing-028","10：00 am 開立一臨時醫囑：Oxacillin sodium（500 mg\u002Fvial）2,000 mg IVF stat.，然護理師於 1：00 pm 給予 Oxacillin sodium（500 mg\u002Fvial）2vial IVF，上述給藥過程，不符合那幾項給藥原則：①時間 ② 途徑 ③劑量 ④藥物",28,{"webId":46,"stem":47,"number":48,"year":49,"session":11},"nurse-111-1-fundamental-nursing-042","下列何者非維持血壓的因素？",42,111,{"webId":51,"stem":52,"number":53,"year":54,"session":11},"nurse-112-1-fundamental-nursing-080","護理長依據醫院訂定的標準考核員工的工作表現，屬於下列何種績效考評標準？",80,112,{"webId":56,"stem":57,"number":58,"year":59,"session":29},"nurse-113-2-fundamental-nursing-024","長期服用毛地黃的病人，胸悶覺得全身無力到急診求治，護理師進行心跳評估，下列敘述何者錯誤？",24,113,{"webId":61,"stem":62,"number":63,"year":64,"session":65},"nurse-114-3-fundamental-nursing-018","有關健康成人泌尿道的排泄，下列敘述何者最適當？",18,114,3,"2026-09-04",1788510719954]