# 一名 68 歲病人突然出現臉部不對稱與說話困難，35 分鐘後抵達急診。病人意識清醒，即時血糖為 108 mg/dL。請為每組選出所有適用的選項。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=603011&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一名 68 歲病人突然出現臉部不對稱與說話困難，35 分鐘後抵達急診。病人意識清醒，即時血糖為 108 mg/dL。請為每組選出所有適用的選項。

支持立即啟動中風的發現

請病人微笑時新出現左側臉部下垂

覆誦句子時新出現口齒不清

雙側膝蓋疼痛已惡化 6 個月

即時血糖 108 mg/dL

不得延誤中風路徑而需完成的行動

立即啟動機構中風應變

記錄病人最後已知正常的確切時間

等待症狀改善時給予口服液體

延遲通知直到症狀持續 1 小時

## 解析

突發性單側臉部無力與新出現的說話困難為中風警示徵象。應立即啟動中風路徑並確認最後已知正常時間；在緊急評估期間，請勿等待症狀持續或給予口服攝入。

## 深入解析

快速解答
中風線索：新出現的臉部下垂與口齒不清。行動：啟動中風應變並記錄最後已知正常時間。
為何此為最佳處置
發作突然且為局部性，而正常的床邊血糖無法解釋此神經學缺損。評估時間直接影響是否符合限時治療的資格。
為何其他選項不適用
慢性膝蓋疼痛並非急性局部神經學線索。等待或給予口服液體會延誤限時評估，且在確認吞嚥安全前可能增加吸入風險。
**參考資料**
- CDC — Signs and Symptoms of Stroke

- CDC — Treatment and Intervention for Stroke

## 重要概念

- **Last known well** — 病人已知處於神經學基準狀態的最後時間。
- **Stroke activation** — 立即進行急診評估，因為限時治療取決於快速辨識。

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