[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-113-2-maternal-pediatric-041":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":62},"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-041","nurse-113-2-maternal-pediatric-041",113,2,41,"下列何者為急性淋巴性白血病最有效之鑑別診斷？",{"A":14,"B":15,"C":16,"D":17},"血液檢查","骨髓抽吸檢查","淋巴組織切片檢查","腦脊髓液檢查","B",null,[],"本題考點在於急性淋巴性白血病（ALL）的確診檢查。白血病是骨髓造血細胞的惡性增生，最有效的鑑別診斷是骨髓抽吸（併骨髓切片）檢查，直接觀察骨髓中芽細胞（blast）比例（≥20–25% 可確診）並做免疫分型與細胞遺傳學分析，故選 B。A 血液檢查（全血球計數與周邊血抹片）可見芽細胞、貧血、血小板低下，有提示性但不足以確診與分型，非最有效鑑別。C 淋巴組織切片主要用於淋巴瘤診斷，非白血病首選。D 腦脊髓液檢查用於評估中樞神經是否受侵犯（分期與治療用），並非診斷白血病本身的依據。本題須掌握骨髓檢查為白血病確診黃金標準，並區分周邊血、淋巴切片與腦脊髓液各自的角色。","急性淋巴性白血病（ALL）是兒童最常見的白血病，診斷流程：周邊血液檢查發現血球異常（貧血、血小板低下、白血球可高可低、可見芽細胞）→骨髓抽吸與切片確認芽細胞比例並進行免疫表型（flow cytometry）、細胞遺傳學與分子檢查以分型與危險分層→腰椎穿刺取腦脊髓液評估中樞神經是否浸潤（決定是否需鞘內化療與顱部照射）。骨髓檢查是確診與分型的核心，因白血病本質是骨髓病變。記憶法：白血病「病在骨髓，就抽骨髓」；血液看端倪、骨髓下定論、腦脊髓液看擴散。",[24,27,28,30],{"term":25,"count":26},"急性淋巴性白血病診斷",1,{"term":15,"count":26},{"term":29,"count":26},"芽細胞比例",{"term":31,"count":26},"腦脊髓液評估中樞侵犯",[33,37,42,47,52,57],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-113-2-maternal-pediatric-042","有關扁桃腺切除（tonsillectomy）術後飲食之護理指導，下列敘述何者適當？",42,{"webId":38,"stem":39,"number":40,"year":41,"session":26},"nurse-114-1-maternal-pediatric-038","使用氧氣頭罩（O 2 hood）之照護措施，下列敘述何者最不適當？",38,114,{"webId":43,"stem":44,"number":45,"year":41,"session":46},"nurse-114-3-maternal-pediatric-032","小玲，2 歲，因骨折手術住院治療中，當您要進行換藥之疼痛評估時，下列何種疼痛評估工具最為適合？",32,3,{"webId":48,"stem":49,"number":50,"year":51,"session":26},"nurse-106-1-maternal-pediatric-080","小玲，1 歲，診斷為單純性熱性痙攣（simple febrile convulsion），小玲的媽媽詢問護理師：「小玲未來是否會再發作？」有關護理師的回答，下列敘述何者較適當？",80,106,{"webId":53,"stem":54,"number":55,"year":56,"session":10},"nurse-107-2-maternal-pediatric-044","琳琳，9 個月大，因細支氣管合併肺炎再度住院，醫囑需要胸腔物理治療，有關協助家屬進行出院準備，下列護理指導何者正確？",44,107,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-108-2-maternal-pediatric-078","有關皮肌炎（dermatomyositis）兒童的護理評估，下列何者錯誤？",78,108,"2026-09-04",1788510755670]