一位氣喘病患急性發作，下列哪項評估發現最令護理師擔憂？
A client is experiencing an acute asthma attack. Which assessment finding is most concerning to the nurse?
- AShortness of breath during exertion勞力後呼吸困難
- BAbsence of wheezing with accessory muscle use✓ 正解輔肌用力但無哮鳴音
- CAudible wheezing on expiration呼氣時可聞及哮鳴音
- DRespiratory rate of 24 breaths/min呼吸頻率為每分鐘 24 次
氣喘急性發作時，聽診到哮鳴音（Wheezing）代表氣流仍能通過狹窄的氣道。若哮鳴音突然消失，但病人仍表現出呼吸窘迫（如使用輔助肌肉呼吸、頻率增加），這極可能代表肺部通氣極度減少，進入「沉默肺（Silent chest）」狀態，這是呼吸衰竭的前兆，病人隨時可能停止呼吸，屬於醫療緊急狀況，需立即搶救。
During an acute asthma exacerbation, audible wheezing indicates that airflow is still moving through narrowed airways. If wheezing suddenly disappears but the patient continues to demonstrate respiratory distress (such as use of accessory muscles and increased respiratory rate), this most likely reflects severely diminished ventilation, signaling a 'silent chest.' This is a harbinger of respiratory failure; the patient may stop breathing at any moment, and the situation constitutes a medical emergency requiring immediate resuscitation.