[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-114-2-fundamental-nursing-005":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":36,"lastmod":64},"基本護理學與護理行政","fundamental-nursing","基本護理學(包括護理原理、護理技術)與護理行政",{"id":8,"webId":9,"year":10,"session":11,"subject":4,"number":12,"stem":13,"options":14,"answer":19,"answerNote":20,"images":21,"explanation":22,"explanationDeep":23,"topics":24,"freq":12},"nurse-114-2-基本護理學與護理行政-005","nurse-114-2-fundamental-nursing-005",114,2,5,"接受安寧緩和療護病人自拔鼻胃管，表示鼻胃管不舒服且想從嘴巴吃東西。依護理過程的特點，下列護理紀錄何者最適當？",{"A":15,"B":16,"C":17,"D":18},"護理問題：不遵從／自拔鼻胃管","護理目標：住院期間維持理想體重","護理計畫：跟病人共同討論可行的方法","護理評值：自拔管路導致營養不足","C",null,[],"本題考點在於護理過程各步驟的正確歸類，並符合安寧緩和以病人意願為中心的精神。依護理過程，計畫（planning）應與病人共同設定可行的照護方向，C「跟病人共同討論可行的方法」正確歸屬護理計畫且尊重自主，故選 C。A 錯誤：「不遵從／自拔鼻胃管」為帶價值批判的措辭，不宜作為安寧病人的護理問題陳述。B 錯誤：安寧階段以舒適與意願為主，「維持理想體重」的目標不符照護目標且方向錯置。D 錯誤：「營養不足」屬評估或診斷資料，將其列為評值內容步驟歸類不當，故均不符。","護理過程五步驟：評估、診斷、計畫、執行、評值，各步驟內容須對號入座是常見考法。安寧緩和強調生活品質與病人自主，避免以「不遵從」等指責式語言標籤病人。記憶：計畫＝訂方法且要「與病人一起」；評值＝比對目標達成與否，不是列缺失。",[25,27,29,32,34],{"term":26,"count":12},"護理過程五步驟",{"term":28,"count":12},"以病人為中心",{"term":30,"count":31},"計畫步驟歸類",1,{"term":33,"count":31},"安寧緩和病人自主",{"term":35,"count":31},"避免價值批判用語",[37,41,45,49,54,59],{"webId":38,"stem":39,"number":40,"year":10,"session":11},"nurse-114-2-fundamental-nursing-006","植皮供皮區需使用烤燈，有關其原理與使用原則，下列何者正確？",6,{"webId":42,"stem":43,"number":11,"year":44,"session":31},"nurse-115-1-fundamental-nursing-002","醫療人員面對傳染病防疫壓力的反應與相關處置，下列敘述何者錯誤？",115,{"webId":46,"stem":47,"number":48,"year":44,"session":11},"nurse-115-2-fundamental-nursing-046","下列何種疾病不是透過病媒傳染？",46,{"webId":50,"stem":51,"number":52,"year":53,"session":31},"nurse-107-1-fundamental-nursing-034","有關灌腸時肛管插入的深度，下列敘述何者正確？",34,107,{"webId":55,"stem":56,"number":57,"year":58,"session":31},"nurse-108-1-fundamental-nursing-078","依據績效考評方式，何者是屬於由直屬主管、員工、同儕及外部顧客反應的考評方式？",78,108,{"webId":60,"stem":61,"number":62,"year":63,"session":11},"nurse-109-2-fundamental-nursing-032","病人使用 Nystatin（Mycostatin）含漱後吞服，主要是治療口腔何種細菌感染？",32,109,"2026-09-04",1788510759000]