[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-113-3-medical-surgical-011":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-113-3-內外科護理學-011","nurse-113-3-medical-surgical-011",113,3,11,"60 歲女性病人主訴清晨會出現左側膝關節僵硬，熱敷後僵硬可以改善，且上下樓梯時關節會有輾軋音。下列何者為病人最可能的疾病診斷？",{"A":14,"B":15,"C":16,"D":17},"骨質疏鬆症","退化性關節炎","類風濕性關節炎","痛風性關節炎","B",null,[],"本題考點在於退化性關節炎(骨關節炎)的典型臨床表現辨識。依病史,60 歲女性、清晨關節僵硬但熱敷後短時間內改善(晨僵通常\u003C30 分鐘)、上下樓梯負重活動時關節有輾軋音(crepitus),為關節軟骨磨損的典型表現,最可能診斷為退化性關節炎,選 B。A 骨質疏鬆症本身無症狀,以骨折表現為主,不致關節輾軋音;C 類風濕性關節炎晨僵常>1 小時、對稱侵犯小關節、伴全身發炎;D 痛風性關節炎為急性紅腫熱痛,好發第一蹠趾關節,與此慢性負重痛型態不符。本題屬關節疾病鑑別診斷題。","退化性關節炎 vs 類風濕的鑑別是必考:退化性=晨僵短(\u003C30 分)、負重大關節(膝、髖)、活動後加重、非對稱、無全身症狀;類風濕=晨僵長(>1 小時)、對稱小關節、休息後僵硬、伴發燒疲倦與 RF\u002Fanti-CCP 陽性。輾軋音源於磨損的關節面摩擦。骨關節炎屬「用久磨損」,好發於年長與負重關節。",[24,26,29,31],{"term":15,"count":25},4,{"term":27,"count":28},"晨僵時間",1,{"term":30,"count":28},"關節輾軋音",{"term":32,"count":28},"類風濕鑑別診斷",[34,38,44,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-113-3-medical-surgical-012","承上題，有關此類病人的護理措施，下列何者最適宜？",12,{"webId":39,"stem":40,"number":41,"year":42,"session":43},"nurse-114-2-medical-surgical-008","有關上腸胃道出血的照護，下列何者錯誤？",8,114,2,{"webId":45,"stem":46,"number":43,"year":47,"session":28},"nurse-115-1-medical-surgical-002","有關重症肌無力之敘述，下列何者正確？①屬於自體免疫疾病，體內產生攻擊Ach接受器的抗體           ② 第一型僅侵犯眼肌，造成複視和眼瞼下垂          ③四肢肌肉的無力發生在遠端和下肢且為不對稱   ④當侵犯肋間肌，通氣容積會減少，嚴重呼吸困難致死",115,{"webId":49,"stem":50,"number":51,"year":52,"session":43},"nurse-106-2-medical-surgical-020","有關全髖關節置換術病人出院之護理指導，下列何者正確？",20,106,{"webId":54,"stem":55,"number":56,"year":57,"session":43},"nurse-107-2-medical-surgical-064","有關預防膀胱癌之護理指導，下列何者不適當？",64,107,{"webId":59,"stem":60,"number":61,"year":62,"session":28},"nurse-109-1-medical-surgical-018","有關脂肪栓塞症之症狀和徵象，下列何者正確？①呼吸急促 ②意識混亂 ③排尿增加 ④體溫上升",18,109,"2026-09-04",1788510752537]