[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-110-2-maternal-pediatric-030":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":62},"產兒科護理學","maternal-pediatric",{"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":25},"nurse-110-2-產兒科護理學-030","nurse-110-2-maternal-pediatric-030",110,2,30,"張女士，妊娠 8 週，因陰道斷續性少量出血到門診檢查。主訴有嚴重的噁心和嘔吐，醫師初步評估子宮大小超過懷孕週數，hCG 值偏高，超音波掃描未看到胎兒影像。張女士最可能的情況是：",{"A":14,"B":15,"C":16,"D":17},"先兆性流產","子宮外孕","雙胞胎","葡萄胎","D",null,[],"本題考點為妊娠早期異常的鑑別診斷。依葡萄胎(hydatidiform mole)絨毛滋養細胞過度增生的病生理，典型表現為子宮大於妊娠週數、β-hCG異常升高、超音波呈雪花狀或葡萄串狀而看不到胎兒，並常伴嚴重噁心嘔吐，與題幹完全吻合，故選D。先兆性流產hCG不會異常偏高；子宮外孕子宮多小於或符合週數且hCG上升較緩；雙胞胎超音波可見胎兒影像。判斷關鍵在hCG過高加上無胎兒影像的組合。","葡萄胎分完全性(46,XX全來自父方，無胎兒)與部分性(三倍體，可有異常胎兒組織)。極高hCG因結構近似TSH可刺激甲狀腺致甲亢徵象，亦可能誘發早發子癇前症。處置為子宮清空並追蹤hCG至歸零，以偵測妊娠滋養層腫瘤(GTN)。記憶：大子宮、高hCG、雪花超音波、劇吐等於葡萄胎四聯。",[24,26,28,30],{"term":17,"count":25},1,{"term":27,"count":25},"β-hCG升高",{"term":29,"count":25},"子宮大於週數",{"term":31,"count":25},"妊娠滋養層疾病",[33,37,42,46,52,57],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-110-2-maternal-pediatric-031","王女士，懷孕 32 週，突然發生陰道出血而入院，醫囑住院安胎。評估個案未覺腹痛，出血呈鮮紅色、量中。護理師的處置與指導，下列何者錯誤？",31,{"webId":38,"stem":39,"number":40,"year":41,"session":25},"nurse-111-1-maternal-pediatric-047","一般 2 歲兒童的生長發育，下列敘述何者錯誤？",47,111,{"webId":43,"stem":44,"number":45,"year":41,"session":10},"nurse-111-2-maternal-pediatric-061","有關呼吸道融合病毒（Respiratory Syncytial Virus, RSV）的敘述，下列何者錯誤？",61,{"webId":47,"stem":48,"number":49,"year":50,"session":51},"nurse-112-3-maternal-pediatric-019","下列何種免疫球蛋白胎兒無法自行合成，需於出生後從母乳中獲得？",19,112,3,{"webId":53,"stem":54,"number":55,"year":56,"session":25},"nurse-114-1-maternal-pediatric-023","王女士，30歲，G 1P 1，有妊娠期糖尿病，有關產後的避孕護理指導，下列何者較為合適？",23,114,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-115-2-maternal-pediatric-017","有關新生兒的生殖系統，下列何者正確？",17,115,"2026-09-04",1788510729883]