[{"data":1,"prerenderedAt":76},["ShallowReactive",2],{"q-nurse-108-1-psychiatric-community-025":3},{"subject":4,"prev":5,"next":8,"subjectSlug":11,"subjectFullName":4,"question":12,"related":46,"lastmod":75},"精神科與社區衛生護理學",{"webId":6,"number":7},"nurse-108-1-psychiatric-community-024",24,{"webId":9,"number":10},"nurse-108-1-psychiatric-community-026",26,"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-025","nurse-108-1-psychiatric-community-025",108,1,25,"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？",null,{"A":21,"B":22,"C":23,"D":24},"鼓勵病人以語言方式表達內在感受","維持生命徵象的穩定","觀察戒斷症狀","給予衛生教育","B",[],"本題考點是物質中毒急性期的護理優先順序——生理危及生命的問題優先於心理社會問題。依 Maslow 需求層級與 ABC（呼吸道、呼吸、循環）優先原則，古柯鹼屬中樞神經興奮劑，會阻斷突觸前多巴胺、正腎上腺素、血清素的再回收，造成交感神經過度興奮：血壓上升、心跳過速、呼吸不規則、體溫升高，嚴重可致心律不整、心肌梗塞、痙攣，故最優先為 B 維持生命徵象穩定。A 鼓勵語言表達感受屬心理層面介入，須待生理穩定後才有意義。C 觀察戒斷症狀是中毒緩解、藥物代謝後的階段任務，並非中毒當下的優先。D 衛生教育屬復健與預防復發階段的措施，個案意識與生理狀態不穩時無法接收。","解此類「最優先」題只需一條規則：生理（尤其危及生命）> 安全 > 心理社會 > 衛教。四個選項一旦分類完畢，答案自動浮現。\n\n古柯鹼的中毒與戒斷是一組漂亮的對比記憶：中毒期為交感興奮的「快」——瞳孔放大、血壓心跳上升、體溫升高、警覺激動、甚至妄想與幻觸（cocaine bugs，皮膚有蟲爬感）；戒斷期則為「當機」——強烈渴求、疲倦、嗜睡、食慾大增、心情低落，古柯鹼戒斷本身少有生命危險，但憂鬱與自殺風險顯著上升。這與酒精、鎮靜安眠藥（BZD）恰恰相反：後者是戒斷才危及生命（震顫譫妄、痙攣），中毒則為中樞抑制。\n\n口訣：「興奮劑怕中毒，抑制劑怕戒斷。」古柯鹼、安非他命屬前者；酒精、BZD、鴉片類（鴉片類中毒的呼吸抑制亦致命）需個別記。\n\n可延伸複習：物質使用障礙症的 DSM 準則、興奮劑中毒的處置原則（降溫、控制血壓與痙攣、避免使用單純 β 阻斷劑以免 α 作用未受抗衡）、動機式晤談在戒治期的應用。",[30,33,36,38,40],{"term":31,"count":32},"護理優先順序",5,{"term":34,"count":35},"中樞神經興奮劑",4,{"term":37,"count":16},"Maslow 需求層級",{"term":39,"count":16},"古柯鹼中毒",{"term":41,"count":16},"生命徵象",[43],{"id":44,"name":45},"substance-use","物質使用障礙症",[47,49,54,59,64,69],{"webId":9,"stem":48,"number":10,"year":15,"session":16},"人格障礙症病人無法感受症狀所帶來的痛苦，所以病人極少認為有治療的必要，一般都是性格問題導致生活適應上產生障礙，才會到精神科求診，因此治療重點包括下列何者？①改變病人個性本質　②改善導致其困擾之症狀　③給予情緒支持　④增進病人適應生活及適應環境的能力",{"webId":50,"stem":51,"number":52,"year":15,"session":53},"nurse-108-2-psychiatric-community-042","下列何者是用來比較國家公共衛生與醫療進步最敏感與評估婦幼衛生工作推展成效的指標？",42,2,{"webId":55,"stem":56,"number":57,"year":58,"session":16},"nurse-109-1-psychiatric-community-056","社區健康評估的診斷期，應包括下列那些步驟？①歸納資料要點 ②解釋與組織資料 ③陳述社區健康問題 ④設立社區健康問題的優先順序 ⑤確認目標 ⑥訂定達成目標的策略與行動 ⑦確認預算與進度",56,109,{"webId":60,"stem":61,"number":62,"year":63,"session":53},"nurse-110-2-psychiatric-community-014","對於缺乏病識感的思覺失調症住院病人，拒絕服藥時，下列處理何者較為適當？",14,110,{"webId":65,"stem":66,"number":67,"year":68,"session":53},"nurse-111-2-psychiatric-community-058","有關健康促進介入措施描述，下列何者最不適當？",58,111,{"webId":70,"stem":71,"number":72,"year":73,"session":74},"nurse-112-3-psychiatric-community-012","有關情緒穩定劑 carbamazepine 的敘述，下列何者正確？",12,112,3,"2026-09-29",1790672290806]