[{"data":1,"prerenderedAt":75},["ShallowReactive",2],{"q-nurse-108-1-psychiatric-community-017":3},{"subject":4,"prev":5,"next":8,"subjectSlug":11,"subjectFullName":4,"question":12,"related":45,"lastmod":74},"精神科與社區衛生護理學",{"webId":6,"number":7},"nurse-108-1-psychiatric-community-016",16,{"webId":9,"number":10},"nurse-108-1-psychiatric-community-018",18,"psychiatric-community",{"id":13,"webId":14,"year":15,"session":16,"subject":4,"number":17,"stem":18,"scenario":19,"carryOver":19,"options":20,"answer":25,"answerNote":19,"images":26,"explanation":27,"explanationDeep":28,"topics":29,"freq":32,"concepts":41},"nurse-108-1-精神科與社區衛生護理學-017","nurse-108-1-psychiatric-community-017",108,1,17,"許小姐住院 3 週後自言自語頻繁，持續在床上大聲怒罵叫旁人走開，但是身邊並無其他人。用餐時間護理師叫喚許小姐多次，她才抬頭回應有人在旁一直說她的不是。此情況下，護理師最適當的護理處置為下列何者？",null,{"A":21,"B":22,"C":23,"D":24},"與醫療團隊討論，考慮調整用藥","提供現實治療","需立即進入保護隔離室","鼓勵參加團體活動轉移注意力","A",[],"本題考點是幻聽症狀持續未改善時的護理處置優先順序。依症狀評估原則,許小姐住院已 3 週,自言自語與對空怒罵頻繁,且需多次呼喚才能回應,顯示幻聽持續干擾且已影響現實接觸與進食等基本作息,代表現行藥物治療反應不足,此時最適當的是與醫療團隊討論並考慮調整用藥,故選 A。B 現實治療在幻聽強烈干擾、注意力難以拉回時效果有限,無法解決症狀本身的生物層面問題;C 病人目前並無傷人或自傷的立即危險,直接進保護隔離室違反最少限制原則;D 團體活動的刺激量高,對正受幻聽強烈干擾者反而可能加重激躁,並非此刻的優先處置。","幻聽護理的完整架構可分四層:第一層評估,包括內容(是否為命令式幻聽)、頻率、出現時機、病人對幻聽的反應與是否服從;第二層安全,命令式幻聽指示傷人或自傷時須提高監測層級;第三層護理措施,包括不與病人爭辯幻聽是否存在、以簡短清楚的句子建立現實接觸、教導分散注意力與應對技巧(如聽音樂、與人交談、告訴聲音停止);第四層生物治療,當症狀持續且功能受損,即需回饋醫療團隊評估藥物劑量、劑型或換藥,並同時檢視服藥順從性與副作用。抗精神病藥物一般需 2 至 6 週才顯現完整抗精神病效果,住院 3 週仍無改善正是重新評估的合理時點,這是本題把「調整用藥」排在最前面的依據。可連結概念:命令式幻聽的風險評估、抗精神病藥物起效時程與錐體外徑症狀、藥物順從性。",[30,33,35,37,39],{"term":31,"count":32},"最少限制原則",10,{"term":34,"count":16},"幻聽的評估與護理",{"term":36,"count":16},"抗精神病藥物起效時程",{"term":38,"count":16},"現實治療的適用時機",{"term":40,"count":16},"跨團隊合作",[42],{"id":43,"name":44},"delusion-hallucination-care","妄想與幻覺護理",[46,48,53,58,63,68],{"webId":9,"stem":47,"number":10,"year":15,"session":16},"思覺失調症病人出現話少表情淡漠，不願參加慢性病房團體活動，整日躺床，前述狀況最可能為下列何種症狀？",{"webId":49,"stem":50,"number":51,"year":15,"session":52},"nurse-108-2-psychiatric-community-034","社區心理衛生的工作實務中，下列何者屬於次級預防工作？",34,2,{"webId":54,"stem":55,"number":56,"year":57,"session":16},"nurse-109-1-psychiatric-community-048","根據傳染病通報規定，下列何者不需於 24 小時內完成病例通報？",48,109,{"webId":59,"stem":60,"number":61,"year":62,"session":52},"nurse-110-2-psychiatric-community-006","下列何者為貝克（Beck）認知學說的主要論述？",6,110,{"webId":64,"stem":65,"number":66,"year":67,"session":52},"nurse-111-2-psychiatric-community-050","根據三段五級疾病預防概念，下列何者屬於特殊保護的層級？①婚前健康檢查 ②均衡飲食 ③職場使用護具 ④疫苗接種 ⑤性教育",50,111,{"webId":69,"stem":70,"number":71,"year":72,"session":73},"nurse-112-3-psychiatric-community-004","從社區精神醫學的立場來看，下列何者為第一級的預防策略？",4,112,3,"2026-09-29",1790672290687]