[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-112-2-medical-surgical-038":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"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":25},"nurse-112-2-內外科護理學-038","nurse-112-2-medical-surgical-038",112,2,38,"王小姐最喜歡吃速食，餐餐吃都不膩，最近出現口炎、吞嚥困難且指甲萎縮變薄呈湯匙狀，醫師告知為貧血，王小姐最有可能罹患那一種貧血？",{"A":14,"B":15,"C":16,"D":17},"缺鐵性貧血","惡性貧血","葉酸缺乏性貧血","再生不良性貧血","A",null,[],"本題考點為缺鐵性貧血的典型臨床表徵辨識。個案長期偏食速食、鐵質攝取不足，出現口炎（angular stomatitis）、吞嚥困難及指甲呈匙狀甲（koilonychia，湯匙狀凹陷），此組合是缺鐵性貧血的經典表現，故選 A。依機轉，缺鐵導致含鐵酵素與上皮組織代謝異常，才會出現匙狀甲與黏膜病變。B 惡性貧血因維生素 B12 缺乏，特徵為神經學症狀與舌炎；C 葉酸缺乏性貧血以巨球性貧血為主、無匙狀甲；D 再生不良性貧血為全血球減少，以出血、感染表現為主，皆與匙狀甲不符，故選 A。","匙狀甲（koilonychia）與缺鐵性貧血的關聯在於鐵是甲床角質生成相關酵素的輔因子，缺乏時指甲變薄、脆而反甲。Plummer-Vinson 症候群即為缺鐵性貧血合併吞嚥困難與食道蹼的典型三聯徵。缺鐵性貧血血液學特徵為小球性低血色素（microcytic hypochromic，MCV↓、MCH↓），血清鐵蛋白（ferritin）下降是最早期敏感指標。對比記憶：小球性→缺鐵、地中海型；巨球性→B12、葉酸缺乏。看到『匙狀甲＋偏食』幾乎可直接鎖定缺鐵。",[24,26,29,31],{"term":14,"count":25},8,{"term":27,"count":28},"匙狀甲koilonychia",1,{"term":30,"count":28},"小球性低血色素貧血",{"term":32,"count":28},"Plummer-Vinson症候群",[34,38,43,47,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-112-2-medical-surgical-039","有關化學藥物 cyclophosphamide（Cytoxan）的副作用或毒性，不包括下列何者？",39,{"webId":39,"stem":40,"number":41,"year":42,"session":28},"nurse-113-1-medical-surgical-005","有關癲癇藥物Dilantin的敘述，下列何者正確？",5,113,{"webId":44,"stem":45,"number":46,"year":42,"session":10},"nurse-113-2-medical-surgical-049","當意識不清病人被送至急診，檢查瞳孔兩側等大且小於 2.0 mm，可能為下列何者中毒？①有機磷 ②安非他命 ③鴉片 ④古柯鹼",49,{"webId":48,"stem":49,"number":50,"year":51,"session":52},"nurse-114-3-medical-surgical-047","病人誤食含有機磷成分的巴拉松農藥，導致噁心、嘔吐、淚流不止、口水跟痰液很多，送入急診，下列敘述何者最適當？",47,114,3,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-106-2-medical-surgical-021","有關白內障症狀之敘述，下列何者錯誤？",21,106,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-107-2-medical-surgical-055","有關氣管內插管病人之護理措施，下列何者錯誤？",55,107,"2026-09-04",1788510747602]