[{"data":1,"prerenderedAt":74},["ShallowReactive",2],{"q-nurse-108-1-psychiatric-community-026":3},{"subject":4,"prev":5,"next":8,"subjectSlug":11,"subjectFullName":4,"question":12,"related":46,"lastmod":73},"精神科與社區衛生護理學",{"webId":6,"number":7},"nurse-108-1-psychiatric-community-025",25,{"webId":9,"number":10},"nurse-108-1-psychiatric-community-027",27,"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":43},"nurse-108-1-精神科與社區衛生護理學-026","nurse-108-1-psychiatric-community-026",108,1,26,"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",null,{"A":21,"B":22,"C":23,"D":24},"①②③","①②④","①③④","②③④","D",[],"本題考點是人格障礙症的治療目標設定——治療針對的是適應功能與困擾症狀，而非人格本質。依人格障礙症的定義，其為長期、僵化、廣泛且深植於個人特質的內在經驗與行為模式，起自青少年或成年早期且穩定持續，因此「改變病人個性本質」（①）在治療上既不可行也非目標，凡含①的選項皆錯，故選 D（②③④）。②改善造成困擾的症狀（如焦慮、憂鬱、衝動）是可達成的實際目標。③給予情緒支持可建立信任並降低治療中斷率。④增進生活與環境適應能力正是人格障礙症求診的核心主訴（適應障礙），為治療重點。A、B、C 三個選項皆含①，違反人格障礙症的本質定義，故均不選。","這是典型的「刪一即得」組合題：先鎖定最明顯的錯誤子項，含它的選項全部刪除，通常一步到位。本題的錯誤子項①之所以錯得乾脆，是因為 DSM 對人格障礙症的定義本身就強調「持久且僵化的模式（enduring pattern）」——特質可被理解、被涵容、被繞道，但不被「改造」。\n\n治療目標的層級可記為：症狀緩解（藥物針對共病的憂鬱、焦慮、衝動）→ 關係穩定（一致的治療架構與界線）→ 功能適應（職業、社交、生活自理）。人格特質本身頂多是「稜角磨圓」，而非置換。\n\n另一個常考的關鍵概念是自我調和（ego-syntonic）：人格障礙症個案認為自己的行為模式理所當然、不覺痛苦，故病識感低、少主動求診——這正是題幹前半段在鋪陳的內容，也是它與精神官能症（ego-dystonic，個案自覺痛苦而求助）最重要的分水嶺。\n\n可延伸複習：人格障礙症 A（古怪：妄想型、類分裂型、思覺失調型）、B（戲劇：反社會、邊緣、做作、自戀）、C（焦慮：畏避、依賴、強迫）三群的區辨，以及辯證行為治療（DBT）在 B 群的應用。",[30,33,36,39,41],{"term":31,"count":32},"DSM 診斷準則",5,{"term":34,"count":35},"適應功能",3,{"term":37,"count":38},"人格障礙症",2,{"term":40,"count":16},"自我調和(ego-syntonic)",{"term":42,"count":16},"治療目標設定",[44],{"id":45,"name":37},"personality-disorders",[47,49,53,58,63,68],{"webId":9,"stem":48,"number":10,"year":15,"session":16},"照護妄想型人格障礙症病人，為使病人至少可以信任一些人的態度，其治療首重下列何者？",{"webId":50,"stem":51,"number":52,"year":15,"session":38},"nurse-108-2-psychiatric-community-043","A、B 兩國之年齡標準化死亡率（standardized death rate）相同，但 A 國之粗死亡率（crude death rate）卻大於 B 國，下列原因何者最有可能？",43,{"webId":54,"stem":55,"number":56,"year":57,"session":16},"nurse-109-1-psychiatric-community-057","有關學童口腔衛生教學活動的情意目標設定，下列何者正確？",57,109,{"webId":59,"stem":60,"number":61,"year":62,"session":38},"nurse-110-2-psychiatric-community-015","有關雙相情緒障礙（bipolar disorder）的病因，下列敘述何者正確？",15,110,{"webId":64,"stem":65,"number":66,"year":67,"session":38},"nurse-111-2-psychiatric-community-059","為社區民眾進行護理指導時，下列策略何者無法促進情意層面的改變？",59,111,{"webId":69,"stem":70,"number":71,"year":72,"session":35},"nurse-112-3-psychiatric-community-013","28 歲男性病人，因嚴重精神病症狀，語無倫次及攻擊他人，連續注射 5 mg 的 haloperidol（Haldol ® ）達每天 20～30 mg，護理師發現他的生命徵象極不穩定、吞嚥困難、全身冒汗，對此抗精神病藥物惡性症候群，下列何項敘述最適切？",13,112,"2026-09-29",1790672290818]