# 一位肝性腦病變的個案正在接受乳果糖治療。下列哪一項發現最能顯示藥物已達到預期效果？

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=498858&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: ROR

## 題目

一位肝性腦病變的個案正在接受乳果糖治療。下列哪一項發現最能顯示藥物已達到預期效果？

## 選項

1. 腹部脹氣減輕，體重下降 1 公斤
2. 血清白蛋白上升，下次回診時依賴性水腫較不明顯
3. 精神狀態改善，且個案每日解 2 至 3 次軟便 **✔ 正確答案**
4. 尿量增加，血清肌酸酐恢復至基準值

**正確答案: 3**

## 解析

乳果糖可減少腸道氨的吸收，並調整劑量至規律的軟便。精神狀態改善且每日解 2 至 3 次軟便，顯示預期的神經學與腸道反應，且未出現過度腹瀉。

## 深入解析

快速解答
認知功能改善且每日解 2 至 3 次軟便，顯示乳果糖治療有效。

為什麼這是正確的
腸道細菌將乳果糖轉化為酸性物質，將氨困在結腸中，其輕瀉作用則促進氨的排出。意識清晰反映腦病變改善，而排便模式顯示已達到有效的劑量調整目標。

簡單比喻或心智圖像
乳果糖就像一輛接駁車，將廢物困在腸道內並運送出去。這個比喻有助於解釋氨的清除，但不代表應以血清氨值取代臨床神經學評估。

記憶掛鉤
思緒變清晰加上每日 2 至 3 次軟便，代表乳果糖正在發揮作用。

NCLEX 決策規則
以治療欲改變的結果來評估療效。對於使用乳果糖治療肝性腦病變，應將神經學改善與處方的軟便目標配對，並監測脫水或電解質流失。

為什麼其他選項是錯的
腹水、白蛋白、水腫、尿量或肌酸酐的變化，反映的是其他肝臟或腎臟的病程，無法直接顯示乳果糖預期的降氨反應。參考文獻

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]DailyMed: Lactulose Solution Prescribing InformationU.S. National Library of Medicine

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