[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-114-1-medical-surgical-037":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":65},"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-114-1-內外科護理學-037","nurse-114-1-medical-surgical-037",114,1,37,"有關高血鉀導因之敘述，下列何者正確？①使用血管收縮素轉換酶抑制劑         ②使用醛固酮拮抗劑 ③使用噻嗪類利尿劑（thiazide diuretics）   ④代謝性鹼中毒",{"A":14,"B":15,"C":16,"D":17},"①②","①④","②③","③④","A",null,[],"本題考點在於高血鉀症的成因辨識。依鉀離子的調節機轉，凡減少腎臟排鉀或使鉀離子移出細胞外者皆致高血鉀：①血管收縮素轉換酶抑制劑抑制醛固酮生成、減少遠端腎小管排鉀，②醛固酮拮抗劑（保鉀利尿劑）直接阻斷醛固酮的排鉀作用，兩者皆升高血鉀，故選A。③噻嗪類利尿劑增加遠端排鉀，反而導致低血鉀；④代謝性鹼中毒時氫離子移出、鉀離子移入細胞，造成低血鉀，故③④皆為低血鉀成因而排除。","血鉀受「腎臟排泄」與「細胞內外分布」兩機轉調控。醛固酮是排鉀的關鍵荷爾蒙，凡抑制此軸線（ACEI、ARB、保鉀利尿劑）皆升鉀；酸鹼方面，酸中毒時氫進鉀出致高血鉀、鹼中毒時反之。高血鉀心電圖典型為T波高尖、PR延長、QRS增寬，嚴重可致心室顫動。記憶對比：thiazide與loop利尿劑排鉀（低鉀），spironolactone保鉀（高鉀）。",[24,27,29,31,33],{"term":25,"count":26},"醛固酮拮抗劑",2,{"term":28,"count":10},"高血鉀症",{"term":30,"count":10},"血管收縮素轉換酶抑制劑",{"term":32,"count":10},"噻嗪類利尿劑",{"term":34,"count":10},"酸鹼與鉀離子分布",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-114-1-medical-surgical-038","尿液分析中出現紅血球的病因，下列何者錯誤？",38,{"webId":41,"stem":42,"number":43,"year":9,"session":44},"nurse-114-3-medical-surgical-034","有關心肌梗塞急性期處置，下列敘述何者最適當？",34,3,{"webId":46,"stem":47,"number":48,"year":49,"session":26},"nurse-115-2-medical-surgical-028","下列何項檢驗項目與傳染性疾病較無關？",28,115,{"webId":51,"stem":52,"number":53,"year":54,"session":10},"nurse-107-1-medical-surgical-016","急性心肌梗塞最典型的臨床表徵，下列何者正確？",16,107,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-108-1-medical-surgical-060","膀胱癌的初期臨床表徵，下列何者正確？",60,108,{"webId":61,"stem":62,"number":63,"year":64,"session":26},"nurse-109-2-medical-surgical-014","有關舌癌的敘述，下列何者正確？",14,109,"2026-09-04",1788510757511]