[{"data":1,"prerenderedAt":77},["ShallowReactive",2],{"q-nurse-108-1-psychiatric-community-030":3},{"subject":4,"prev":5,"next":8,"subjectSlug":11,"subjectFullName":4,"question":12,"related":47,"lastmod":76},"精神科與社區衛生護理學",{"webId":6,"number":7},"nurse-108-1-psychiatric-community-029",29,{"webId":9,"number":10},"nurse-108-1-psychiatric-community-031",31,"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-030","nurse-108-1-psychiatric-community-030",108,1,30,"對於失智症病人的護理措施，下列何者正確？",null,{"A":21,"B":22,"C":23,"D":24},"環境儘量多樣化，以增加刺激","若病人夜裡睡眠紊亂，白天時調暗燈光，讓病人補充睡眠","儘量安排不同護理人員照顧，以增加病人對護理人員的熟悉","鼓勵家屬自家中帶病人熟悉的物品置於病人的房間，並儘量不更動擺設","D",[],"本題考點是失智症的環境治療原則——以熟悉、簡化、一致的環境降低認知負荷與混亂。依失智症的病理，個案近期記憶與定向感受損、對新刺激的處理與適應能力下降，故環境應維持穩定與熟悉，選 D 鼓勵家屬帶熟悉物品並儘量不更動擺設，可提供記憶提示、增加安全感並減少日落症候群與行為精神症狀。A 環境多樣化以增加刺激會造成刺激過載，反而誘發混亂與焦躁。B 白天調暗燈光讓個案補眠會破壞日夜節律，使夜間更加清醒躁動，正確作法是白天維持明亮與適度活動。C 頻繁更換照顧者違反一致性原則，陌生面孔增加而非減少陌生感，且會削弱個案已建立的信任。","失智症環境治療口訣：「熟、簡、穩、安、亮」——熟悉的人與物、簡化的選擇與指令、穩定不變動的擺設與作息、安全防護（防跌、防走失、防燙傷、危險物品收妥）、白天充足光照。\n\nB 選項背後其實是日落症候群（sundowning）的常考機轉：黃昏時光線減弱、視覺線索減少加上一天下來的疲累，使混亂、躁動、幻覺加重。處置方向是「白天亮、傍晚提前開燈、白天避免長時間補眠、睡前減少咖啡因與過度刺激」，恰與 B 的作法相反。\n\nC 選項的干擾設計很精緻：它把「一致」偷換成「多接觸幾個人就會都熟悉」。但對近期記憶受損者而言，新面孔無法被有效編碼進長期記憶，只會不斷重新經歷陌生感，故照顧者應固定、交班時以個案認得的稱謂自我介紹。\n\n溝通技巧補充：使用簡短句、一次一個指令、給充足反應時間、面對面在其視野內說話、避免爭辯與糾正錯誤記憶（改用確認情緒的方式回應），即所謂「認可療法」（validation therapy）的精神；另有懷舊治療（reminiscence therapy）利用相對保留的遠期記憶提升自尊與參與度。\n\n可延伸複習：失智症與譫妄的鑑別（起病快慢、意識清醒度、病程波動性、可逆性）、MMSE 與 CDR 評估工具、行為精神症狀（BPSD）的非藥物優先原則。",[30,33,36,39,41],{"term":31,"count":32},"日落症候群",10,{"term":34,"count":35},"環境治療",8,{"term":37,"count":38},"失智症",4,{"term":40,"count":16},"定向感",{"term":42,"count":16},"照顧一致性",[44],{"id":45,"name":46},"dementia-care","失智症照護",[48,50,55,60,65,70],{"webId":9,"stem":49,"number":10,"year":15,"session":16},"有關老年精神病人的護理評估原則，下列何者正確？",{"webId":51,"stem":52,"number":53,"year":15,"session":54},"nurse-108-2-psychiatric-community-047","某社區於公園內設置健康步道以鼓勵民眾運動，此屬於渥太華憲章推動健康促進的何項行動綱領？",47,2,{"webId":56,"stem":57,"number":58,"year":59,"session":16},"nurse-109-1-psychiatric-community-061","有關群體醫療執業中心之敘述，下列何者錯誤？",61,109,{"webId":61,"stem":62,"number":63,"year":64,"session":54},"nurse-110-2-psychiatric-community-019","沈女士為慢性精神病病人，平日都可依醫囑按時服用抗精神病藥物，但情緒仍常受幻聽干擾而時有波動，護理師提供的護理措施，下列何者錯誤？",19,110,{"webId":66,"stem":67,"number":68,"year":69,"session":54},"nurse-111-2-psychiatric-community-063","有關 Smilkstein 所提出之 APGAR 家庭功能評估的敘述，下列何者錯誤？",63,111,{"webId":71,"stem":72,"number":73,"year":74,"session":75},"nurse-112-3-psychiatric-community-017","林同學，20 歲，上台報告時總是會極度恐懼或焦慮，也無法在公共場所用餐，平時會儘量避免與他人交談或互動。林同學最有可能的問題是下列何者？",17,112,3,"2026-09-29",1790672290859]