# 一位患有閉鎖性脛骨骨折的成年個案正在接受一系列神經血管檢查。點選最早顯示的評估結果，該結果應立即提示評估急性腔室症候群，而無需等待遠端脈搏消失。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=582087&lang=zh-tw  
> language: zh-TW  
> subject: Physiological Adaptation  
> category: PA

## 題目

一位患有閉鎖性脛骨骨折的成年個案正在接受一系列神經血管檢查。點選最早顯示的評估結果，該結果應立即提示評估急性腔室症候群，而無需等待遠端脈搏消失。

![](https://mymerci.kr/data/nclex/hotspot/replacement_20260909/HSR545.svg)

## 解析

B 是最早的評估結果，顯示儘管使用了止痛劑，疼痛仍在加劇，被動伸展時出現疼痛，以及腔室緊繃；可觸及的脈搏並不能排除急性腔室症候群。

## 深入解析

快速解答
B. 09:00 的評估結果是第一個強烈提示急性腔室症候群的症狀群。
為何這是最佳選擇
在 09:00，儘管使用了處方止痛劑，疼痛仍從 5 分上升到 8 分，被動腳趾伸展會引起明顯疼痛，且小腿腔室緊繃。即使感覺和足背動脈脈搏仍然完整，這些發現也需要立即升級處理。序列變化和線索的組合比任何單一發現都更重要。
臨床表現
脛骨骨折後可能會發生急性腔室症候群。應在蒼白、癱瘓或無脈搏之前及早識別，這些都是晚期發現，可能預示著晚期缺血。
記憶點
疼痛加劇 + 被動伸展疼痛 + 腔室緊繃：在脈搏消失之前升級處理。
決策原則
使用序列趨勢和早期症狀群；存在遠端脈搏並不能排除腔室症候群。
為何其他選項不適合
A 顯示疼痛緩解和腔室柔軟。C 也令人擔憂，但發生在 B 之後，並增加了感覺異常。D 顯示晚期進展，伴有虛弱和無脈搏；等待 D 將是不安全的。
**資料來源**
- AAOS identifies acute compartment syndrome after traumatic extremity injury as requiring evidence-based diagnosis and timely management.

- Early findings include severe pain, pain with passive stretch, and a tense compartment; pulselessness and paralysis are typically late findings, and a palpable pulse does not exclude the condition.

## 重要概念

- **Acute compartment syndrome** — 閉鎖性筋膜腔室內的壓力升高可能會損害組織灌注，需要緊急評估。
- **Pain with passive stretch** — 當與疼痛加劇和腔室緊繃同時出現時，這是一個令人擔憂的早期評估結果。
- **Late pulse loss** — 腔室症候群發生後，遠端脈搏仍可能存在；無脈搏是晚期發現。

## 相同主題題目

- [A 58-year-old patient with metastatic lung cancer is admitted with progressive dyspnea, hy…](https://mymerci.kr/pages/nclex_q.php?qn_id=372843&lang=zh-tw)
- [A trauma patient who sustained blunt chest injury becomes acutely diaphoretic and hypotens…](https://mymerci.kr/pages/nclex_q.php?qn_id=372844&lang=zh-tw)
- [A patient with stage 5 chronic kidney disease has missed two scheduled hemodialysis sessio…](https://mymerci.kr/pages/nclex_q.php?qn_id=372845&lang=zh-tw)
- [An adult patient has been seizing continuously for 6 minutes. The provider asks the nurse …](https://mymerci.kr/pages/nclex_q.php?qn_id=373126&lang=zh-tw)
- [Four patients arrive in the ED. Which patient presentation indicates a hypertensive EMERGE…](https://mymerci.kr/pages/nclex_q.php?qn_id=373127&lang=zh-tw)
- [A 55-year-old patient on post-op day 5 from an extensive abdominal surgery suddenly develo…](https://mymerci.kr/pages/nclex_q.php?qn_id=373402&lang=zh-tw)
- [Four adults with asthma arrive at the urgent care. Which presentation indicates the MOST s…](https://mymerci.kr/pages/nclex_q.php?qn_id=373879&lang=zh-tw)
- [An 11-year-old is admitted with new-onset diabetic ketoacidosis (DKA): blood glucose 612 m…](https://mymerci.kr/pages/nclex_q.php?qn_id=374873&lang=zh-tw)

## 以其他語言閱讀

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=582087&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=582087&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=582087&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=582087&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=582087&lang=vi)

---

More free questions: [NCLEX-RN 題庫](https://mymerci.kr/pages/nclex_bank.php?lang=zh-tw)

_僅供學習參考。實際臨床請遵循最新指引與所屬機構規範。_