[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-111-2-medical-surgical-034":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"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-111-2-內外科護理學-034","nurse-111-2-medical-surgical-034",111,2,34,"奇脈（paradoxical pulse）是指下列何種情況？",{"A":14,"B":15,"C":16,"D":17},"呼氣時，收縮壓下降超過 10 mmHg","吸氣時，收縮壓下降超過 10 mmHg","呼氣時，舒張壓下降超過 10 mmHg","吸氣時，舒張壓下降超過 10 mmHg","B",null,[],"本題考點為奇脈(paradoxical pulse)的定義。奇脈依定義是指吸氣時收縮壓下降超過 10 mmHg 的現象,故選 B。正常呼吸吸氣時收縮壓會輕微下降(小於 10 mmHg),但在心包填塞、嚴重氣喘或阻塞性肺病時,吸氣使胸內壓變化放大、左心充盈受限而收縮壓明顯下降。A 說呼氣時錯誤,方向相反;C、D 說舒張壓也錯誤,奇脈是以收縮壓下降幅度定義,非舒張壓。","奇脈的機轉在於吸氣時胸腔負壓增加,靜脈回流至右心增多,室間隔向左膨出,壓迫左心室充盈,加上肺血管容積增加使肺靜脈回流減少,兩者共同使吸氣期左心搏出量與收縮壓下降。心包填塞時心臟被固定於僵硬心包內,右心擴張只能以壓迫左心為代價,故奇脈特別明顯,是床邊重要診斷線索。測量方式為以血壓計緩慢放氣,記錄僅在呼氣期聽到與整個呼吸週期都聽到 Korotkoff 音的壓差,超過 10 mmHg 即為陽性。",[24,27,30,33],{"term":25,"count":26},"心包填塞",6,{"term":28,"count":29},"奇脈",3,{"term":31,"count":32},"吸氣期收縮壓下降",1,{"term":34,"count":32},"胸內壓與心室充盈",[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-111-2-medical-surgical-035","有關多發性骨髓瘤病人的護理指導，下列何者錯誤？",35,{"webId":41,"stem":42,"number":43,"year":44,"session":32},"nurse-112-1-medical-surgical-051","協助醫師拔除胸管時，應指導病人採取下列何種呼吸方式？",51,112,{"webId":46,"stem":47,"number":48,"year":44,"session":10},"nurse-112-2-medical-surgical-065","有關腎臟移植之合併症，下列敘述何者不適當？",65,{"webId":50,"stem":51,"number":52,"year":53,"session":29},"nurse-113-3-medical-surgical-033","有關病人的動脈血液氣體分析結果，下列何者應立即報告醫師？",33,113,{"webId":55,"stem":56,"number":57,"year":58,"session":32},"nurse-115-1-medical-surgical-037","提供腎絲球過濾率為17 mL\u002Fmin\u002F1.73 m 2的病人之護理指導，下列何者正確？",37,115,{"webId":60,"stem":61,"number":43,"year":62,"session":10},"nurse-106-2-medical-surgical-051","肺炎病人合併低血氧時最早出現的精神狀態改變，下列何者正確？",106,"2026-09-04",1788510738540]