護理師正在照護一名腹部手術後 12 小時的病人。哪項處置對降低肺不張（atelectasis）及肺炎風險最有效？
The nurse is caring for a client who is 12 hours post-abdominal surgery. Which intervention is most effective in reducing the risk of atelectasis and pneumonia?
- AAdministering supplemental oxygen at 2 L/min via nasal cannula.經鼻導管給予每分鐘 2 公升的補充氧氣
- BPerforming chest physiotherapy every 4 hours.每 4 小時執行胸部物理治療
- CTeaching the client to cough only when they feel a congestion.教導病人在感到擁塞時才咳嗽
- DEncouraging the use of an incentive spirometer 10 times every hour.✓ 正解鼓勵病人每小時使用誘發性肺量計 10 次
腹部手術後，由於傷口疼痛，病人往往呼吸淺快，不敢深呼吸，這會導致肺泡塌陷（肺不張），進而誘發肺炎。使用誘發性肺量計（Incentive Spirometer, IS）是標準的預防措施，它能提供視覺回饋，鼓勵病人進行有意識的深吸氣，增加跨肺壓使肺泡擴張。護理師應指導病人每小時練習 10 次。給氧（A）只能解決血氧低，不能預防肺部塌陷；胸腔物理治療（B）通常用於分泌物過多的病人，而非預防性首選；只在有痰時咳嗽（C）是不夠的，應強調「主動」的主動呼吸循環技術（ACBT）或有支撐的咳嗽（Splinting）。
After abdominal surgery, wound pain often causes shallow, rapid breathing because the client is reluctant to take deep breaths. This leads to alveolar collapse (atelectasis) and predisposes to pneumonia. Use of an incentive spirometer (IS) is the standard preventive measure: it provides visual feedback that encourages deliberate deep inspiration, increasing transpulmonary pressure and expanding the alveoli. The nurse should instruct the client to perform 10 breaths per hour. Oxygen therapy (A) addresses only low oxygenation and does not prevent alveolar collapse; chest physiotherapy (B) is usually reserved for clients with excessive secretions and is not the first-line preventive measure; coughing only when congestion is felt (C) is insufficient — the emphasis should be on active techniques such as Active Cycle of Breathing Technique (ACBT) or splinted coughing.
美國非常強調 IS 的使用頻率與病人自我管理的量化指標（每小時 10 次）。在台灣，臨床常合併使用「吹氣球」或簡單的深呼吸練習，但 IS 的標準化衛教與「止痛後執行（Pre-medicate for pain）」的協作在美國 NCLEX 中是核心考點。