[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-112-2-medical-surgical-008":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":64},"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-112-2-內外科護理學-008","nurse-112-2-medical-surgical-008",112,2,8,"重症肌無力病人使用抗膽鹼酯酶藥物的護理指導，下列何者正確？①腹部絞痛可能為劑量不足徵象 ②鼓勵進食高蛋白食物預防副作用 ③血壓上升可能為劑量過量徵象 ④務必準時服藥因延遲服藥可能會喪失吞藥力量",{"A":14,"B":15,"C":16,"D":17},"①②","①④","②③","②④","D",null,[],"本題考點是重症肌無力使用抗膽鹼酯酶藥物（如 pyridostigmine）的用藥指導，正解為②④（選 D）。依此藥理，抗膽鹼酯酶藥物抑制乙醯膽鹼分解、增強神經肌肉傳導：②鼓勵攝取高蛋白並於飯前服藥以維持進食所需肌力，是合理指導，正確；④務必準時服藥，因延遲服藥可能在用餐時喪失咀嚼與吞嚥肌力甚至誘發肌無力危象，正確。①腹部絞痛、流涎、腹瀉屬「劑量過量」的膽鹼激性（cholinergic）副作用，並非劑量不足，敘述錯誤；③血壓上升並非此藥的過量指標，過量表現為心搏過緩、瞳孔縮小、分泌物增多等副交感亢進症狀，敘述錯誤。","重症肌無力的兩大危象最需鑑別：肌無力危象（myasthenic crisis）源於藥量不足或感染壓力，膽鹼激性危象（cholinergic crisis）源於藥量過多，兩者都表現肌肉無力，但後者伴隨 SLUDGE 徵候（流涎 Salivation、流淚 Lacrimation、排尿 Urination、腹瀉 Diarrhea、腸胃不適 GI、嘔吐 Emesis）及瞳孔縮小、心搏過緩。臨床以 edrophonium（Tensilon）試驗鑑別：注射後改善為肌無力危象、惡化為膽鹼激性危象。用藥重點在「準時、飯前」，讓血中濃度高峰對上進食時段以保住吞嚥安全。高蛋白飲食有助維持肌肉功能，這是②正確的理由。",[24,27,30,33],{"term":25,"count":26},"重症肌無力",7,{"term":28,"count":29},"膽鹼激性危象",4,{"term":31,"count":32},"抗膽鹼酯酶藥物",3,{"term":34,"count":10},"肌無力危象",[36,40,44,49,54,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-112-2-medical-surgical-009","下列何者可用來做為大腸癌手術後是否復發的參考指標？",9,{"webId":41,"stem":42,"number":43,"year":9,"session":32},"nurse-112-3-medical-surgical-025","有關何杰金氏病（Hodgkin’s Disease）的敘述，下列何者正確？",25,{"webId":45,"stem":46,"number":47,"year":48,"session":10},"nurse-113-2-medical-surgical-019","下列何者不是骨質疏鬆症之危險因素？",19,113,{"webId":50,"stem":51,"number":52,"year":53,"session":32},"nurse-114-3-medical-surgical-017","58 歲中年婦女，平日血壓約為 138\u002F88 mmHg，沒有糖尿病與其他心血管疾病，BMI 為 30 kg\u002Fm 2 ，飲食偏好重油滷肉類食物，沒有抽菸與喝酒習慣，日常活動多為家務勞動，下列敘述何者最不適當？",17,114,{"webId":55,"stem":56,"number":57,"year":58,"session":59},"nurse-106-1-medical-surgical-071","唐女士，口腔癌術後狀況穩定，胰島素注射一天 4 次，鼻胃管灌食一天 6 餐，消化良好，空腹指尖血糖約 100～140 mg\u002FdL，手術前糖化血色素（HbA1c）為 9.5%。唐女士表示「我住院開刀前糖尿病是以口服藥控制，而且血糖控制很好的，我一定要注射胰島素嗎？」護理師的回答，下列何者最適切？",71,106,1,{"webId":61,"stem":62,"number":43,"year":63,"session":10},"nurse-107-2-medical-surgical-025","有關白內障摘除術後預防眼壓上升的護理指導，下列何者正確？",107,"2026-09-04",1788510747337]