[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-113-3-medical-surgical-002":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-113-3-內外科護理學-002","nurse-113-3-medical-surgical-002",113,3,2,"有關重症肌無力病人發生膽鹼激性危象之敘述，下列何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"因 Mestinon 使用過量而失去阻斷作用","病人會出現視力模糊、瞳孔收縮","病人會出現血壓上升、心搏過速","病人會出現支氣管分泌增加、腹部疼痛和腹瀉","C",null,[],"本題考點在於重症肌無力膽鹼激性危象(cholinergic crisis)的臨床表現,要求選出錯誤敘述。膽鹼激性危象源於抗膽鹼酯酶藥(Mestinon)過量,乙醯膽鹼堆積過度刺激副交感神經,故表現為瞳孔縮小、分泌物增多、腹瀉、心搏過緩與低血壓;C 敘述「血壓上升、心搏過速」屬交感興奮方向,與副交感過度激活相反,故錯誤為正解。A 正確,即 Mestinon 過量致接受器持續去極化而失效;B 正確,瞳孔收縮與視力模糊為毒蕈鹼作用;D 正確,支氣管分泌增加、腹痛腹瀉皆為膽鹼過量表現。本題為反向題,屬藥理危象辨識題。","區分兩種危象是重點:肌無力危象(藥量不足)vs 膽鹼激性危象(藥量過量),兩者都會呼吸衰竭。鑑別用 Tensilon(edrophonium)test:肌無力危象給藥後改善,膽鹼危象反惡化。膽鹼過量記憶 SLUDGE:Salivation、Lacrimation、Urination、Defecation、GI cramps、Emesis,加上瞳孔縮小、心搏過緩,全屬副交感亢進。",[24,27,29,32,34],{"term":25,"count":26},"膽鹼激性危象",4,{"term":28,"count":11},"SLUDGE 症狀",{"term":30,"count":31},"抗膽鹼酯酶過量",1,{"term":33,"count":31},"副交感神經亢進",{"term":35,"count":31},"Tensilon test",[37,40,45,49,54,59],{"webId":38,"stem":39,"number":10,"year":9,"session":10},"nurse-113-3-medical-surgical-003","墨菲氏徵象（Murphy’s sign）陽性是下列何種疾病的常見特徵？",{"webId":41,"stem":42,"number":43,"year":44,"session":31},"nurse-114-1-medical-surgical-049","有關輸血品項與適應症之敘述，下列何者錯誤？",49,114,{"webId":46,"stem":47,"number":48,"year":44,"session":10},"nurse-114-3-medical-surgical-043","有關原發性多醛固酮症（primary aldosteronism）的臨床表徵，下列敘述何者最適當？",43,{"webId":50,"stem":51,"number":52,"year":53,"session":11},"nurse-106-2-medical-surgical-011","下列何者顯示結腸造口病人可能有貧血現象？",11,106,{"webId":55,"stem":56,"number":57,"year":58,"session":11},"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,{"webId":60,"stem":61,"number":62,"year":63,"session":31},"nurse-109-1-medical-surgical-009","有關肛門瘻管手術治療後常見的併發症，下列何者正確？①出血 ②腹股溝疝氣 ③瘻管復發 ④解便失禁",9,109,"2026-09-04",1788510752433]