[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-111-1-maternal-pediatric-075":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":64},"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":26},"nurse-111-1-產兒科護理學-075","nurse-111-1-maternal-pediatric-075",111,1,75,"有關先天性巨結腸症的臨床表徵，下列敘述何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"出生 24 小時內無法排出胎便","新生兒時有嘔吐現象且嘔吐物不含膽汁","嬰兒期時有難以進食及生長遲滯之狀況","兒童期有慢性便秘且呈現絲帶狀糞便","B",null,[],"本題考點為先天性巨結腸症（Hirschsprung disease）的臨床表徵辨識，題目要選「錯誤」者。此症因遠端腸段缺乏神經節細胞導致腸蠕動停滯、糞便堆積於近端形成阻塞，屬功能性遠端腸阻塞。依此機轉，新生兒嘔吐物常「含膽汁」，因阻塞位於膽總管開口（Vater 壺腹）之後，膽汁得以逆流入胃，故 B 敘述嘔吐物不含膽汁為錯誤，選 B。A 正確，典型表現為出生 24 小時內未解胎便。C 正確，餵食困難與生長遲滯為慢性阻塞後果。D 正確，兒童期慢性便秘且糞便受狹窄段擠壓呈絲帶狀。","病生理核心：胚胎期神經嵴細胞由近端向遠端遷移，若中途停止，遠端腸壁的黏膜下叢（Meissner）與肌間叢（Auerbach）缺乏神經節細胞，該段持續痙攣收縮無法放鬆，形成功能性阻塞；近端正常腸段代償性擴張肥厚，故名巨結腸。判斷嘔吐是否含膽汁可定位阻塞高低：十二指腸乳頭以下阻塞多為膽汁性嘔吐（綠色）。確診靠直腸切片證實無神經節細胞，鋇劑攝影可見移行區（transition zone）。對比幽門狹窄則為非膽汁性噴射狀嘔吐，可與本症區辨。",[24,27,29,31,33],{"term":25,"count":26},"先天性巨結腸症",2,{"term":28,"count":10},"神經節細胞缺乏",{"term":30,"count":10},"膽汁性嘔吐",{"term":32,"count":10},"功能性腸阻塞",{"term":34,"count":10},"絲帶狀糞便",[36,40,45,49,54,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-111-1-maternal-pediatric-076","小華，5 歲，罹患腎病症候群（nephrotic syndrome），全身出現水腫。為預防因水腫可能產生的皮膚完整性受損，下列護理指導何者不適當？",76,{"webId":41,"stem":42,"number":43,"year":44,"session":10},"nurse-112-1-maternal-pediatric-012","陰道分娩過程中，胎盤以暗紅色的粗糙面被牽引出陰道。有關此胎盤娩出的敘述，下列何者正確？ ①希氏法（Schultze mechanism）娩出 ②鄧氏法（Duncan mechanism）娩出 ③較容易發生剝離不完全 ④較少發生剝離不完全",12,112,{"webId":46,"stem":47,"number":48,"year":44,"session":26},"nurse-112-2-maternal-pediatric-026","張女士，剖腹產後第一天，表示整個腹部疼痛，全身疲憊無力，不想動，也不要親子同室。下列何項護理措施最適當？",26,{"webId":50,"stem":51,"number":52,"year":53,"session":26},"nurse-113-2-maternal-pediatric-044","有關白血病病童接受化學治療期間，依醫囑注射 Rasburicase 及 Allopurinol 的目的，下列敘述何者正確？",44,113,{"webId":55,"stem":56,"number":57,"year":58,"session":59},"nurse-114-3-maternal-pediatric-048","張小弟，8 歲，騎單車跌倒導致右側肱骨骨折，上石膏住院治療，下列護理措施何者最適當？",48,114,3,{"webId":61,"stem":62,"number":43,"year":63,"session":26},"nurse-106-2-maternal-pediatric-012","有關生產時會陰消毒原則，下列何者錯誤？",106,"2026-09-04",1788510736049]