[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-112-3-medical-surgical-001":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"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-112-3-內外科護理學-001","nurse-112-3-medical-surgical-001",112,3,1,"陳先生因車禍造成頸椎第 5～6 節完全損傷，已度過脊髓休克期，目前進行膀胱訓練，下列敘述何者正確？ ①屬於痙攣型神經性膀胱 ②只要薦神經受到刺激，即會反射排尿 ③可以利用 Crede’s method 以手握拳，壓在膀胱，協助排空 ④當自解：餘尿量＝2：1，且餘尿小於 100 mL 表示膀胱訓練成功",{"A":14,"B":15,"C":16,"D":17},"①②","①③","②④","③④","A",null,[],"本題考點在於頸椎（上運動神經元）損傷後神經性膀胱的類型與膀胱訓練成效判定。頸髓第 5～6 節屬薦髓以上的上運動神經元損傷，度過脊髓休克期後會形成反射亢進的痙攣型（反射型）神經性膀胱（敘述①正確），且刺激薦神經反射弧即可誘發反射性排尿（敘述②正確），故選 A。判斷關鍵是損傷位置在薦髓以上。敘述③錯誤，Crede's method（手壓膀胱協助排空）適用於下運動神經元的鬆弛型膀胱，痙攣型膀胱按壓恐引發反射亢進與逆流，不宜使用。敘述④錯誤，膀胱訓練成功的標準是餘尿量小於 100 mL，而非以自解與餘尿 2：1 的比例判定。","神經性膀胱可依損傷位置二分：薦髓（S2–S4）以上損傷→上運動神經元→痙攣型（反射型）膀胱，膀胱容量小、反射亢進，訓練採「觸發技巧」如叩擊恥骨上、拉大腿毛髮誘發反射排尿；薦髓或以下損傷→下運動神經元→鬆弛型膀胱，膀胱無張力、餘尿多，才適用 Crede's 手壓法或 Valsalva 用力。餘尿小於 100 mL 是共通的訓練成功指標，可對比記憶「上痙攣、下鬆弛」。",[24,27,30,32,34],{"term":25,"count":26},"神經性膀胱",5,{"term":28,"count":29},"餘尿量",2,{"term":31,"count":11},"痙攣型膀胱",{"term":33,"count":11},"上運動神經元損傷",{"term":35,"count":11},"Crede's method",[37,40,45,49,54,59],{"webId":38,"stem":39,"number":29,"year":9,"session":10},"nurse-112-3-medical-surgical-002","有關癲癇病人發作時的護理措施，下列敘述何者錯誤？",{"webId":41,"stem":42,"number":43,"year":44,"session":11},"nurse-113-1-medical-surgical-048","有關食物中毒之敘述，下列何者正確？",48,113,{"webId":46,"stem":47,"number":48,"year":44,"session":10},"nurse-113-3-medical-surgical-042","有關愛迪生危機的特徵，下列何者正確？",42,{"webId":50,"stem":51,"number":52,"year":53,"session":11},"nurse-115-1-medical-surgical-040","預防腎功能不全病人血鉀過高之飲食護理指導，下列何者正確？",40,115,{"webId":55,"stem":56,"number":57,"year":58,"session":29},"nurse-106-2-medical-surgical-064","有關雙胍類降血糖藥物 Metformin（Glucophage）之敘述，下列何者正確？",64,106,{"webId":60,"stem":61,"number":62,"year":63,"session":11},"nurse-108-1-medical-surgical-018","有關膝關節損傷之評估方式，下列何者錯誤？",18,108,"2026-09-04",1788510744767]