[{"data":1,"prerenderedAt":74},["ShallowReactive",2],{"q-nurse-108-1-psychiatric-community-021":3},{"subject":4,"prev":5,"next":8,"subjectSlug":11,"subjectFullName":4,"question":12,"related":45,"lastmod":73},"精神科與社區衛生護理學",{"webId":6,"number":7},"nurse-108-1-psychiatric-community-020",20,{"webId":9,"number":10},"nurse-108-1-psychiatric-community-022",22,"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":42},"nurse-108-1-精神科與社區衛生護理學-021","nurse-108-1-psychiatric-community-021",108,1,21,"朱小姐，憂鬱症，會談時頻頻責備自己不是一個稱職的母親，說：「我的小孩一定覺得我很糟，會看不起我這個母親。」，請問當朱小姐向護理人員做此反應時，護理人員運用認知治療回應朱小姐，下列何者較適宜？",null,{"A":21,"B":22,"C":23,"D":24},"世界上的媽媽都是好媽媽","有什麼情況，讓你有這種想法","想這些都沒用，應該想想要怎樣彌補他們","你真那麼糟嗎","B",[],"本題考點是認知治療（cognitive therapy）的核心技術——協助個案檢視並驗證自動化negative thoughts的證據基礎。依 Beck 憂鬱認知三角理論，憂鬱症個案對自我、世界、未來持有負向自動化思考，治療者的角色不是替個案下判斷，而是以蘇格拉底式詰問引導個案自行檢驗想法的依據，故選 B「有什麼情況，讓你有這種想法」，此問句正是在探究支持該信念的證據來源。A 是空泛保證（false reassurance），未處理個案的認知扭曲，反而阻斷會談。C 屬給予建議並否定個案感受（「想這些都沒用」），是溝通障礙而非認知治療。D 為封閉式且帶質問語氣，容易被個案解讀為批判，強化其「我很糟」的核心信念，並非引導檢驗證據。","認知治療的操作序列可記成「找出自動化思考 → 檢驗證據 → 找替代想法 → 行為實驗」。本題個案的「我的小孩一定覺得我很糟」同時踩中兩個典型認知扭曲：讀心術（mind reading，未經查證即認定他人想法）與過度類化（overgeneralization）。B 的問法把抽象斷言拉回具體情境，讓個案從「一定」退回到「哪一次、發生什麼事」，這是後續產生替代想法的必要素材。\n\n對比記憶表：空泛保證（A）＝否認情緒；給建議（C）＝剝奪自主；質問式封閉問句（D）＝防衛升高；開放式探究（B）＝治療性。國考常把 A、C、D 設計成「聽起來很溫暖但其實是治療性溝通障礙」的干擾項，判準只有一個——這句話是把焦點帶回個案的經驗，還是把護理人員的價值判斷塞給個案。\n\n可延伸複習：Beck 認知三角、常見認知扭曲類型（全有全無、災難化、應該句式、個人化）、治療性溝通技巧中的「反映」「澄清」「focusing」，以及與支持性心理治療、行為治療的分野。",[30,33,36,38,40],{"term":31,"count":32},"治療性溝通技巧",5,{"term":34,"count":35},"認知治療",3,{"term":37,"count":16},"Beck 認知三角",{"term":39,"count":16},"自動化負向思考",{"term":41,"count":16},"空泛保證",[43],{"id":44,"name":34},"cognitive-therapy",[46,48,53,58,63,68],{"webId":9,"stem":47,"number":10,"year":15,"session":16},"張同學情緒低落，母親偷看她的日記發現有輕生的念頭，送醫院接受治療，住院期間，對於他人的接近感到厭煩，對於病房活動參與不積極，常待在房間，不願到大廳活動，下列那一項短期目標較適當？",{"webId":49,"stem":50,"number":51,"year":15,"session":52},"nurse-108-2-psychiatric-community-038","有關自殺危險因子之說明，下列敘述何者正確？①自殺危險因子廣布於生物、心理、社會、經濟、文化層面，絕非單一因素 ②自殺危險因子具有快速變動與不易測度的特質，故此自殺防範應單一統由專責人員負責 ③自殺的危險遠端因子中包括精神科疾病、致命工具的可近性 ④社會心理因素會與自殺相關，如重大失落事件",38,2,{"webId":54,"stem":55,"number":56,"year":57,"session":16},"nurse-109-1-psychiatric-community-052","護理師參加社區所舉辦的「重陽節敬老健走」活動，以了解社區老人的健康體能狀況，此為何種社區評估方法？",52,109,{"webId":59,"stem":60,"number":61,"year":62,"session":52},"nurse-110-2-psychiatric-community-010","有關精神科護理中認知治療的敘述，下列何者最適當？",10,110,{"webId":64,"stem":65,"number":66,"year":67,"session":52},"nurse-111-2-psychiatric-community-054","進行社區評估資料收集時，下列資料，何者無法從各鄉鎮區公所的戶政系統取得？",54,111,{"webId":69,"stem":70,"number":71,"year":72,"session":35},"nurse-112-3-psychiatric-community-008","有關抗精神病藥物（antipsychotics）副作用之處理，下列何者正確？",8,112,"2026-09-29",1790672290743]