一名 55 歲高血壓病史病人主訴突然出現劇烈頭痛及視力模糊，血壓 210/130 mmHg。優先處置為何？
A 55-year-old client with a history of hypertension reports a sudden onset of severe headache and blurred vision. Blood pressure is 210/130 mmHg. Which action is the priority?
- AObtain a neurological assessment✓ 正解進行神經學評估
- BPlace the client in a high-Fowler’s position將病人置於高福勒氏臥位
- CPerform a routine 12-lead ECG執行常規十二導程心電圖
- DAdminister an oral antihypertensive tablet給予口服降壓藥錠
高血壓急症（hypertensive emergency, BP ≥180/120 + 末端器官損害徵象）的真正優先動作為立即給予 IV 降壓藥（如 labetalol、nicardipine），但本題未提供此選項。現有選項中 C「神經學評估」為合理優先：210/130 + 頭痛 + 視力模糊暗示腦血管事件可能（如顱內出血、高血壓性腦病），需評估意識、瞳孔、肢體力與感覺以引導後續處置。其他選項：D 口服降壓藥對急症太慢；B 高坐臥位為支持性處置；D 12-lead ECG 評估心臟相關但非優先動作。
The true priority action for a hypertensive emergency (BP ≥180/120 with signs of end-organ damage) is to immediately administer IV antihypertensives such as labetalol or nicardipine; however, this option is not provided in this question. Among the available choices, A, 'neurologic assessment,' is a reasonable priority: 210/130 along with headache and blurred vision suggests possible cerebrovascular events (such as intracranial hemorrhage or hypertensive encephalopathy), and assessment of consciousness, pupils, and motor and sensory function is needed to guide subsequent management. Other options: A, oral antihypertensives are too slow for acute presentations; B, high-Fowler's position is only supportive; C, a 12-lead ECG assesses cardiac involvement but is not the priority action.
美國護理師依 protocol 可給予靜脈注射藥物，台灣通常須醫師到場執行靜脈降壓藥物。