[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-111-1-fundamental-nursing-036":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":34,"lastmod":63},"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-111-1-基本護理學與護理行政-036","nurse-111-1-fundamental-nursing-036",111,1,36,"有關協助病人翻身擺位之注意事項，下列何者正確？",{"A":15,"B":16,"C":17,"D":18},"膝膕處可用軟枕墊高，以預防受壓","頭頸部與脊柱應呈 15º 的擺位，以維持穩定","使用足托板時應保持足背側伸展","仰臥時，可用粗隆捲軸預防髖關節外旋","D",null,[],"本題考點為翻身擺位預防併發症的正確做法。仰臥時髖關節易因下肢重量而外旋,使用粗隆捲軸(trochanter roll)置於大腿外側可防止髖關節外旋、維持中立位,故選 D。A 錯在膝膕處不宜用軟枕墊高,因會壓迫膕窩血管神經並促成膝關節屈曲攣縮與靜脈血栓。B 錯在頭頸部與脊柱應維持成一直線的中立對位,而非刻意呈 15 度擺位。C 錯在使用足托板(foot board)的目的是維持踝關節於背屈中立位以預防垂足(foot drop),應保持足背屈而非「足背側伸展(蹠屈)」。整體考的是各擺位輔具的正確功能位置。","功能位置擺位原則:關節維持中立、避免長期屈曲或不良姿勢造成攣縮與神經血管壓迫。粗隆捲軸防髖外旋(外旋是仰臥的自然傾向);足托板防垂足(垂足=蹠屈攣縮,長期臥床腓神經受累與跟腱縮短所致)。膝膕下墊枕看似舒適,卻促成膝屈曲攣縮並壓迫膕動靜脈、增深層靜脈栓塞風險,故禁忌。脊椎維持自然中立對位可避免肌肉拉傷與壓瘡。記憶:每個輔具都對應一個要防的畸形。",[25,28,30,32],{"term":26,"count":27},"粗隆捲軸",3,{"term":29,"count":27},"髖關節外旋預防",{"term":31,"count":11},"足托板與垂足預防",{"term":33,"count":11},"功能位置擺位",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":38,"year":10,"session":11},"nurse-111-1-fundamental-nursing-037","某男士在高溫環境工作大量流汗，感覺頭暈，虛弱不適，至急診就醫時意識清楚，臉色蒼白、皮膚濕冷、體溫 37.9℃、血壓 100\u002F65 mmHg，依上述症狀判斷其可能發生的問題為下列何者？",37,{"webId":40,"stem":41,"number":42,"year":10,"session":43},"nurse-111-2-fundamental-nursing-053","有關痰液檢體收集方式，下列敘述何者正確？①痰液無法咳出，可協助震顫叩擊 ②早上起床後可先刷牙，再留第一口痰 ③痰液量少的病人，可以口咽部唾液代替 ④氣切留置病人，可用抽痰法取得檢體",53,2,{"webId":45,"stem":46,"number":47,"year":48,"session":11},"nurse-112-1-fundamental-nursing-067","有關組織結構的敘述，下列何者正確？",67,112,{"webId":50,"stem":51,"number":52,"year":53,"session":43},"nurse-113-2-fundamental-nursing-005","劉先生對護理人員抱怨說：「我受夠了每天做那麼多復健，醫生來看我的次數又那麼少，我很不滿」，下列何者為最合宜的回應？",5,113,{"webId":55,"stem":56,"number":57,"year":58,"session":27},"nurse-114-3-fundamental-nursing-009","病人表情平淡地對護理師說：「我現在好痛，需要止痛針」，護理師表情疑惑地看著病人。依據伯儂（Berlo）溝通模式，下列敘述何者最不適當？",9,114,{"webId":60,"stem":61,"number":42,"year":62,"session":11},"nurse-106-1-fundamental-nursing-053","王先生診斷為直腸癌末期併有多處骨頭轉移，住安寧病房，生命存活期以「日」計算，目前血壓下降，脈搏微弱，膝部以下呈現冰冷，其臨終照護，下列何者最適切？",106,"2026-09-04",1788510733768]