[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-110-2-fundamental-nursing-024":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":35,"lastmod":64},"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":27},"nurse-110-2-基本護理學與護理行政-024","nurse-110-2-fundamental-nursing-024",110,2,24,"陳女士，50 歲，罹患糖尿病多年，下肢現有 5×3×2 公分潰瘍性傷口，傷口分泌物惡臭有腐肉，入院進行傷口清創手術，其護理目標之訂定，下列何者最適當？",{"A":15,"B":16,"C":17,"D":18},"一星期內傷口可完全癒合","二個星期後傷口可縮小至 3×2×1 公分","可攝取適當營養","自述高熱量、低蛋白飲食的重要性","B",null,[],"本題考點為護理目標的訂定原則。考點在於良好目標須具體、可測量、合理可達且有時間性；糖尿病慢性潰瘍癒合緩慢，故以「二個星期後傷口縮小至3×2×1公分」最符合可測量且務實的標準，選B。A一星期內完全癒合對慢性糖尿病傷口不切實際。C可攝取適當營養過於籠統、無法客觀評值。D自述高熱量、低蛋白飲食的重要性內容錯誤，傷口癒合應攝取高蛋白，且屬衛教而非傷口目標，故皆不適當。","護理目標宜符合SMART：具體、可測量、可達成、切合、有時限。糖尿病傷口因微血管病變與神經病變癒合慢，設短期可量化的縮小指標便於評值。傷口修復需足量蛋白質、維生素C與鋅，低蛋白反不利癒合。記憶：目標要可量、可達、有期限。可連結：傷口癒合營養、糖尿病足、目標評值。",[25,28,31,33],{"term":26,"count":27},"可測量目標",3,{"term":29,"count":30},"護理目標訂定",1,{"term":32,"count":30},"糖尿病傷口癒合",{"term":34,"count":30},"傷口營養需求",[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-110-2-fundamental-nursing-025","護理師收集病人主觀資料和客觀資料，下列敘述何者正確？",25,{"webId":41,"stem":42,"number":43,"year":44,"session":30},"nurse-111-1-fundamental-nursing-041","關於脈搏測量方式的描述，下列何者錯誤？",41,111,{"webId":46,"stem":47,"number":48,"year":44,"session":11},"nurse-111-2-fundamental-nursing-055","根據死亡後的遺體生理變化，有關遺體之擺位，下列敘述何者正確？①採側臥以利口腔分泌物流出 ②採仰臥維持遺容 ③頭下放置枕頭 ④將手腳以繃帶纏繞固定",55,{"webId":50,"stem":51,"number":52,"year":53,"session":27},"nurse-112-3-fundamental-nursing-013","林同學參加馬拉松賽跑，大量流汗未能及時補充水分，在一般情況下，林同學會產生那些生理反應？ ①ADH 分泌增加 ②醛固酮分泌減少 ③腎小管再吸收增加 ④腎小管細胞會排鈉留鉀",13,112,{"webId":55,"stem":56,"number":57,"year":58,"session":30},"nurse-114-1-fundamental-nursing-017","有關溫水坐浴（Warm Sitz Bath）常用溶液及其使用目的之敘述，下列何者錯誤？",17,114,{"webId":60,"stem":61,"number":62,"year":63,"session":11},"nurse-115-2-fundamental-nursing-011","醫囑 Ampicillin 2,000 mg IVD Q4H，此藥物為每 vial 含有 Ampicillin 500 mg，下列給藥敘述何者正確？",11,115,"2026-09-04",1788510728226]