[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-113-2-maternal-pediatric-030":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":63},"產兒科護理學","maternal-pediatric",{"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-113-2-產兒科護理學-030","nurse-113-2-maternal-pediatric-030",113,2,30,"張小妹，1 歲，因發燒入院，護理師欲進行生命徵象測量，有關生命徵象測量相關護理，下列何者最適切？",{"A":14,"B":15,"C":16,"D":17},"壓脈帶的寬度應覆蓋過測量肢體長度的 1\u002F2","觀察腹部起伏測量 10 秒鐘，並乘以六","於左鎖骨中線第三～四肋間測量心尖脈","耳溫測量時，應將耳朵向上向後拉","C",null,[],"本題考點在於嬰幼兒生命徵象測量的正確技術。1 歲幼兒測量心尖脈的正確位置為左鎖骨中線第三至第四肋間（嬰幼兒心臟位置較高且偏外側），並應聽診測量完整一分鐘，故選 C。A 錯，血壓壓脈帶寬度應覆蓋上臂長度約 2\u002F3（或肢體周徑的 40%），而非 1\u002F2，過窄會使讀值偏高。B 錯，嬰幼兒呼吸不規則，觀察腹部起伏應測量「完整一分鐘」而非測 10 秒乘六，短時間取樣會失準。D 錯，幼兒（3 歲以下）耳溫測量時外耳道應「向下向後」拉直，3 歲以上才向上向後拉，選項方向錯誤。本題須掌握小兒生命徵象各項目的年齡對應技術與量測時間。","小兒生命徵象要點：心尖脈—嬰幼兒因橫膈較高、心臟橫置，聽診點在左鎖骨中線第 3–4 肋間（成人與較大兒童在第 5 肋間鎖骨中線），須聽滿 1 分鐘。呼吸—嬰幼兒以腹式呼吸為主且節律不規則，須觀察腹部起伏滿 1 分鐘。血壓—壓脈帶氣囊寬度約為上臂長度 2\u002F3、氣囊長度環繞臂圍 80–100%，過窄讀值偏高、過寬偏低。耳溫—拉直外耳道方向以 3 歲為界：＜3 歲向後下方拉、≥3 歲向後上方拉。記憶法：小小孩「耳朵往下拉、心尖在上面、脈搏數滿分（1 分鐘）」。",[24,27,29,31],{"term":25,"count":26},"小兒心尖脈位置",1,{"term":28,"count":26},"耳溫測量拉耳方向",{"term":30,"count":26},"血壓壓脈帶寬度",{"term":32,"count":26},"嬰幼兒呼吸測量",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-113-2-maternal-pediatric-031","有關厭食症的敘述，下列何者錯誤？",31,{"webId":39,"stem":40,"number":41,"year":42,"session":26},"nurse-114-1-maternal-pediatric-027","有關兒童遭受虐待的護理處置，下列敘述何者錯誤？",27,114,{"webId":44,"stem":45,"number":46,"year":42,"session":47},"nurse-114-3-maternal-pediatric-021","楊女士，28 歲，G 1 P 0 ，孕前 BMI 正常，本次懷孕為同卵雙胞胎，胎位皆為頭位，下列護理指導何者最適當？",21,3,{"webId":49,"stem":50,"number":51,"year":52,"session":26},"nurse-106-1-maternal-pediatric-069","小樺，7 歲，最近因持續發燒、易流鼻血而求診，診斷疑似急性淋巴性白血病，下列那一項檢查結果可以確定其診斷？",69,106,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-107-2-maternal-pediatric-033","以比夏計分法（Bishop’s score）評估產婦引產的難易度，下列何者錯誤？",33,107,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-108-2-maternal-pediatric-067","有關哮吼（croup）之敘述，下列何者正確？",67,108,"2026-09-04",1788510755585]