[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-110-1-medical-surgical-003":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"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":26},"nurse-110-1-內外科護理學-003","nurse-110-1-medical-surgical-003",110,1,3,"下列何者為重症肌無力病人最早受到影響的肌肉？",{"A":14,"B":15,"C":16,"D":17},"眼肌","咽喉肌","呼吸肌","膀胱逼尿肌","A",null,[],"本題考點為重症肌無力(myasthenia gravis)的臨床表現與受侵犯順序。依其病生理,神經肌肉接合處的乙醯膽鹼受體被自體抗體破壞,最先受影響的是小而精細、活動頻繁的眼外肌,故臨床最早、最常見的表現為眼瞼下垂與複視,答案選 A。選項 B 咽喉肌受侵犯較晚,出現吞嚥與構音困難是病程進展後的表現;選項 C 呼吸肌受累屬嚴重的肌無力危象,是後期危及生命的階段而非最早;選項 D 膀胱逼尿肌屬平滑肌、受自律神經支配,而重症肌無力侵犯的是骨骼肌的神經肌肉接合處,不會以逼尿肌無力為表現。","受侵順序記法『眼→球→肢→呼吸』:眼肌(眼瞼下垂、複視)最早,續及延髓支配的咀嚼吞嚥構音肌,再到四肢近端,最重為呼吸肌危象。特徵是『晨輕暮重』、反覆使用後無力加劇。診斷靠 Tensilon 試驗與抗 AChR 抗體,治療用抗膽鹼酯酶藥(pyridostigmine)增加突觸乙醯膽鹼。逼尿肌屬平滑肌不受影響是重要排除線索。",[24,27,30,32],{"term":25,"count":26},"重症肌無力",7,{"term":28,"count":29},"神經肌肉接合處",4,{"term":31,"count":10},"眼外肌最早受侵",{"term":33,"count":10},"乙醯膽鹼受體",[35,38,43,48,53,58],{"webId":36,"stem":37,"number":29,"year":9,"session":10},"nurse-110-1-medical-surgical-004","因車禍造成左側胸椎第 6 節受傷的病人，出現脊髓半側截斷症候群，下列敘述何者正確？",{"webId":39,"stem":40,"number":41,"year":9,"session":42},"nurse-110-2-medical-surgical-020","有關痛風性關節炎病人的護理指導，下列何者正確？",20,2,{"webId":44,"stem":45,"number":46,"year":47,"session":10},"nurse-111-1-medical-surgical-034","下列何者是心肌梗塞最常見且會導致死亡的併發症？",34,111,{"webId":49,"stem":50,"number":51,"year":52,"session":10},"nurse-112-1-medical-surgical-072","承上題，有關陳小姐術後之護理指導，下列敘述何者正確？",72,112,{"webId":54,"stem":55,"number":56,"year":57,"session":42},"nurse-113-2-medical-surgical-016","有關感染性心內膜炎臨床表徵之敘述，下列何者錯誤？",16,113,{"webId":59,"stem":60,"number":61,"year":62,"session":11},"nurse-114-3-medical-surgical-010","有關膽囊癌，下列敘述何者最不適當？",10,114,"2026-09-04",1788510720743]