[{"data":1,"prerenderedAt":71},["ShallowReactive",2],{"q-nurse-108-1-psychiatric-community-013":3},{"subject":4,"prev":5,"next":8,"subjectSlug":11,"subjectFullName":4,"question":12,"related":43,"lastmod":70},"精神科與社區衛生護理學",{"webId":6,"number":7},"nurse-108-1-psychiatric-community-012",12,{"webId":9,"number":10},"nurse-108-1-psychiatric-community-014",14,"psychiatric-community",{"id":13,"webId":14,"year":15,"session":16,"subject":4,"number":17,"stem":18,"scenario":19,"carryOver":20,"options":21,"answer":26,"answerNote":20,"images":27,"explanation":28,"explanationDeep":29,"topics":30,"freq":10,"concepts":39},"nurse-108-1-精神科與社區衛生護理學-013","nurse-108-1-psychiatric-community-013",108,1,13,"護理人員對張先生之精神症狀評估，下列何項正確？","張先生因攻擊行為而被家人帶來住院，入院第 2 天突然出手攻擊鄰床病友，護理人員和張先生會談時，張先生表示：「他是被派來要殺我的，我很害怕！」",null,{"A":22,"B":23,"C":24,"D":25},"誇大妄想","被害妄想","關係妄想","控制妄想","B",[],"本題考點在於妄想內容的分型鑑別。依妄想分型定義，被害妄想（persecutory delusion）指堅信自己被他人跟蹤、監視或加害，且不因客觀事實而動搖。情境中張先生把鄰床病友說成「被派來要殺我的」，將無關他人認定為受指使的加害者，並伴隨害怕與出手攻擊，符合以自我防衛為動機的被害妄想，選 B。A 誇大妄想是抬高自身身分、能力或使命，其陳述無誇大成分。C 關係妄想是把無關的中性事件解讀為特別針對自己傳訊，核心是「與我有關」而非「要害我」。D 控制妄想的核心是自覺思想或行動被外力操控，被支配者是病人本身；本題被派來的是他人。","被害妄想屬思覺失調症正性症狀之一，病生理上與中腦邊緣（mesolimbic）多巴胺路徑過度活化造成的異常凸顯性（aberrant salience）有關：中性刺激被賦予不該有的威脅意義，病人再以自己的邏輯建構一套解釋，形成牢不可破的妄想系統。情境中「他是被派來的」正顯示妄想已系統化，出現幕後指使者的組織架構，這也解釋了為何會出現攻擊行為——攻擊在病人主觀世界裡是先發制人的自我保護，而非單純衝動。\n\n四型妄想速記對比：誇大＝我很偉大（自我膨脹）、被害＝有人要害我（威脅指向自己）、關係＝這件事在說我（無關事件被指涉化）、控制＝我被操控（自主性喪失，常與被動體驗、思想插入併存）。口訣可記成「大、害、關、控」四字，判讀時只問兩個問題：主角是誰、方向朝哪——威脅由外朝向我＝被害；訊息由外指涉我＝關係；力量進入我、取代我的意志＝控制。\n\n延伸複習可連結：DSM-5 思覺失調症診斷準則的正性／負性症狀分類、妄想與錯覺（illusion）及幻覺（hallucination）的區辨、以及思考流程異常（如聯想鬆弛、意念飛躍）與思考內容異常的層次差異。",[31,32,34,36,37],{"term":23,"count":10},{"term":24,"count":33},4,{"term":35,"count":16},"妄想分型",{"term":25,"count":16},{"term":38,"count":16},"思覺失調症正性症狀",[40],{"id":41,"name":42},"psychopathology-assessment","精神症狀學與精神狀態評估",[44,46,51,56,60,65],{"webId":9,"stem":45,"number":10,"year":15,"session":16},"護理人員對張先生的攻擊行為，在初期建立治療性關係過程中，給予的護理措施，下列何項正確？",{"webId":47,"stem":48,"number":49,"year":15,"session":50},"nurse-108-2-psychiatric-community-030","對於有行為規範障礙症（conduct disorder）的兒童之護理，下列何者正確？",30,2,{"webId":52,"stem":53,"number":54,"year":55,"session":16},"nurse-109-1-psychiatric-community-044","欲了解社區中 75 歲以上腦中風死亡率，應調查那些資料？①年中總人口數 ②年中 75 歲以上總人口數 ③全年 75 歲以上死亡人數 ④全年 75 歲以上腦中風死亡人數",44,109,{"webId":57,"stem":58,"number":50,"year":59,"session":50},"nurse-110-2-psychiatric-community-002","有關症狀穩定且日常生活可自理的精神病人，剛轉入康復之家，首要的復健目標為何？",110,{"webId":61,"stem":62,"number":63,"year":64,"session":50},"nurse-111-2-psychiatric-community-046","有關出院準備服務的敘述，下列何者最不適當？",46,111,{"webId":66,"stem":67,"number":68,"year":69,"session":50},"nurse-112-2-psychiatric-community-080","社區護理師教導糖尿病患者足部自我照顧的內容，下列何者最不適當？",80,112,"2026-09-29",1790672290642]