[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-112-2-medical-surgical-025":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":62},"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-025","nurse-112-2-medical-surgical-025",112,2,25,"有關心內膜炎周邊症狀之敘述，下列何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"指甲床上會出現裂紋般的出血（Splinter hemorrhage）","手掌或腳底出現無痛性的紅斑，稱為賈尼威病灶（Janeway’s lesions）","手指或腳趾出現疼痛性的紅色結節，稱為奧斯勒氏結節（Osler’s nodes）","四肢末稍出現出血點，稱為羅氏斑（Roth’s spots）","D",null,[],"本題考點是感染性心內膜炎的周邊血管栓塞徵象，錯誤敘述為 D。依心內膜炎的病生理，瓣膜上的贅生物（vegetation）脫落形成微小栓子與免疫複合體沉積，造成一系列周邊徵象：A 指甲床下的線狀出血（splinter hemorrhage），正確；B 手掌腳底的無痛性紅斑——賈尼威病灶（Janeway lesions），正確；C 手指腳趾疼痛性紅色結節——奧斯勒氏結節（Osler's nodes），正確。D 敘述錯誤：羅氏斑（Roth's spots）是出現在「視網膜」上中央蒼白的出血點，並非「四肢末梢的出血點」，故此描述張冠李戴而為答案。","感染性心內膜炎的周邊表徵是經典必考，記憶可用「手指痛的是 Osler（Osler's = Ouch\u002Fpainful）、手掌腳底不痛的是 Janeway」對比：Osler's nodes 為免疫複合體沉積引起的疼痛性結節，位於指腹；Janeway lesions 為微栓塞造成的無痛性出血性紅斑，位於掌蹠。Splinter hemorrhage 是甲床下線狀出血；Roth's spots 則是「眼底」視網膜的白心出血點，本題把它錯植到四肢末梢即為破綻。其他表現含新出現或改變的心雜音、發燒、脾腫大、血栓栓塞事件。診斷用 Duke 準則（血液培養＋心臟超音波贅生物）。理解贅生物「脫落栓塞＋免疫反應」的雙重機轉，即可串起這些周邊徵象。",[24,27,30,32],{"term":25,"count":26},"感染性心內膜炎",3,{"term":28,"count":29},"周邊栓塞徵象",1,{"term":31,"count":29},"Roth's spots視網膜",{"term":33,"count":29},"Osler's nodes與Janeway lesions",[35,39,43,48,53,58],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-112-2-medical-surgical-026","有關心肌病變臨床表徵之敘述，下列何者錯誤？",26,{"webId":40,"stem":41,"number":42,"year":9,"session":26},"nurse-112-3-medical-surgical-042","有關腎臟移植發生排斥時的主要處置，下列敘述何者錯誤？",42,{"webId":44,"stem":45,"number":46,"year":47,"session":10},"nurse-113-2-medical-surgical-036","有關急性呼吸窘迫症候群（ARDS）病人使用機械性通氣時，配合使用呼氣末端正壓（PEEP）之目的，下列何者錯誤？",36,113,{"webId":49,"stem":50,"number":51,"year":52,"session":26},"nurse-114-3-medical-surgical-034","有關心肌梗塞急性期處置，下列敘述何者最適當？",34,114,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-106-2-medical-surgical-008","下列何者為重症肌無力病人最早出現的症狀？",8,106,{"webId":59,"stem":60,"number":42,"year":61,"session":10},"nurse-107-2-medical-surgical-042","有關缺鐵性貧血病人鐵劑補充之敘述，下列何者錯誤？",107,"2026-09-04",1788510747472]