[{"data":1,"prerenderedAt":75},["ShallowReactive",2],{"q-nurse-108-1-psychiatric-community-024":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-023",23,{"webId":9,"number":10},"nurse-108-1-psychiatric-community-025",25,"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-024","nurse-108-1-psychiatric-community-024",108,1,24,"游先生，雙相情緒障礙症病人，在病房看到一位思覺失調症病人因手抖而掉藥物到地上，游先生認為這是病友的拒藥行為，大聲要求護理人員處理此病友的拒藥行為。針對此情況，護理人員最適宜的處理為下列何者？",null,{"A":21,"B":22,"C":23,"D":24},"鼓勵游先生說出其過去拒藥的經驗","先了解掉藥病人的狀況，並將游先生帶開轉移其注意力","告訴游先生，這不關他的事","以平靜的口吻告訴游先生藥物再補給就好了","B",[],"本題考點是躁症個案人際界線過度介入時的處置——兼顧另一位個案安全與轉移注意力的雙重考量。依雙相情緒障礙症躁期的臨床特徵，個案易有過度活躍、愛管閒事、要求多且易被環境刺激激發的表現，處置原則為「降低刺激、轉移注意、不正面衝突」；同時被掉藥的思覺失調症個案手抖可能是抗精神病藥物的錐體外徑症狀，需先確認其狀況，故選 B 兼顧兩者。A 引導躁期個案回顧自身拒藥經驗，反而延長其停留在該話題並升高激動。C 「這不關他的事」是拒絕與指責，易觸發躁期個案的易怒與衝突。D 僅平靜回應補藥，未處理躁期個案持續介入的行為，也未評估掉藥者的手抖成因。","本題其實同時測兩個知識點。第一，躁期護理的三原則：減少環境刺激、以簡短明確的語句設限、以體能性或中性活動轉移注意力（redirection）——正面辯論或說理只會強化其誇大與滔滔不絕。第二，手抖掉藥的鑑別：第一代抗精神病藥物（如 Haloperidol）阻斷黑質紋狀體徑路的 D2 受體，可造成類巴金森氏症（震顫、僵硬、動作遲緩）等錐體外徑症狀（EPS），並非拒藥行為；亦須與鋰鹽中毒的粗大震顫、遲發性運動障礙（tardive dyskinesia）作區辨。\n\n口訣：躁期個案「不辯論、不指責、不追問過去，帶開＋給替代活動」。四個選項套進去：A 追問過去、C 指責、D 沒帶開，只有 B 同時做到帶開與照顧到另一位個案。\n\n可延伸複習：EPS 四型（急性肌張力不全、靜坐不能、類巴金森氏症、遲發性運動障礙）與其處理藥物（抗膽鹼類）、躁期的環境治療（低刺激單人房、避免競爭性團體活動）、病房中個案間互動的界線設定。",[30,33,35,37,39],{"term":31,"count":32},"環境治療",8,{"term":34,"count":16},"雙相情緒障礙症躁期護理",{"term":36,"count":16},"轉移注意力(redirection)",{"term":38,"count":16},"錐體外徑症狀(EPS)",{"term":40,"count":16},"人際界線設定",[42],{"id":43,"name":44},"bipolar-mania","雙相情緒障礙症與躁症",[46,48,53,58,63,68],{"webId":9,"stem":47,"number":10,"year":15,"session":16},"吳先生服用古柯鹼過量，出現血壓上升呼吸不規則的中毒症狀而求醫，下列何項護理措施為最優先考量？",{"webId":49,"stem":50,"number":51,"year":15,"session":52},"nurse-108-2-psychiatric-community-041","欲了解社區中罕見疾病的危險因子，下列何種流行病學方法最適合？",41,2,{"webId":54,"stem":55,"number":56,"year":57,"session":16},"nurse-109-1-psychiatric-community-055","根據 Anderson 和 McFarlane（2008）以社區為夥伴的健康評估模式，了解居民與社區中正式與非正式領導人物的互動情形是屬於那一個次系統？",55,109,{"webId":59,"stem":60,"number":61,"year":62,"session":52},"nurse-110-2-psychiatric-community-013","初次入住精神科急性病房的李先生，擔心醫院伙食被人下毒，有被害妄想不願意用餐，下列何者護理措施最適當？",13,110,{"webId":64,"stem":65,"number":66,"year":67,"session":52},"nurse-111-2-psychiatric-community-057","社區護理師於社區關懷據點推動健康飲食計畫，記錄每次活動參與人數，是屬於下列何者護理指導的評價？",57,111,{"webId":69,"stem":70,"number":71,"year":72,"session":73},"nurse-112-3-psychiatric-community-011","病人主要服用的精神科藥物為 clozapine（Clozaril ® ），下列敘述何者正確？",11,112,3,"2026-09-29",1790672290792]