— 健康促進與維護 · HARD · MCQ —
護理師評估一位疑似鉛中毒的兒童。面談時哪項問題應優先詢問？
A nurse is assessing a child with suspected lead poisoning. Which question should the nurse prioritize during the interview?
- AHow many hours does the child spend playing outside?孩子在外玩耍的時間有多久？
- BWhat year was the home where the child resides built?✓ 正解孩子居住的房屋是哪一年建造的？
- CDoes the child have a favorite type of food?孩子有沒有特別喜歡的食物？
- DDoes the child have a history of allergies?孩子有過敏史嗎？
— Explanation · 中文詳解 —
鉛中毒（Lead poisoning）在兒童群體中多源於環境暴露。美國於 1978 年禁用含鉛油漆，因此居住在該年份前建造的房屋是鉛暴露的最強預測因子。護理師進行評估時，必須優先確認暴露源，以進行後續的環境清理或血鉛濃度檢測（Blood Lead Level, BLL）。其他選項雖然涉及病史，但在環境致病因子面前，住家環境調查對早期介入最具決定性。
Lead poisoning in children is often linked to environmental exposure, particularly from lead-based paint in homes built before 1978. Determining the age of the residence helps identify the most likely source of toxicity. This information is critical for guiding further assessment and environmental interventions.
✦ 台美臨床差異
美國非常重視居家環境毒物檢測，特別是鉛暴露。NCLEX 常考關於「老舊房屋」的風險，這在美國公共衛生教育中是重點，而在台灣的考題則較常聚焦於食品安全或職業性暴露。