[{"data":1,"prerenderedAt":74},["ShallowReactive",2],{"q-nurse-108-1-psychiatric-community-031":3},{"subject":4,"prev":5,"next":8,"subjectSlug":11,"subjectFullName":4,"question":12,"related":44,"lastmod":73},"精神科與社區衛生護理學",{"webId":6,"number":7},"nurse-108-1-psychiatric-community-030",30,{"webId":9,"number":10},"nurse-108-1-psychiatric-community-032",32,"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":16,"concepts":40},"nurse-108-1-精神科與社區衛生護理學-031","nurse-108-1-psychiatric-community-031",108,1,31,"有關老年精神病人的護理評估原則，下列何者正確？",null,{"A":21,"B":22,"C":23,"D":24},"老年病人記性差，不論時間長短，收集資料宜一次完成","老年病人愛回顧過去生命經驗，基於此時此刻原則，此部分資料不須收集","老年病人對問題反應很慢或無法適當回答，可以改變問法試試看","老年病人因為記憶力和判斷力都不好，因此僅以家屬所敘述為主","C",[],"本題考點是老年精神科個案的護理評估技巧——依老化的生理與認知變化調整評估方式。依老化的認知歷程特徵，老年人訊息處理速度變慢、聽力與理解力可能下降，但理解能力並未消失，故當反應緩慢或答非所問時，應調整提問方式（換簡短句、換用語、放慢速度、確認聽力），而非放棄詢問，選 C。A 錯在「一次完成」，老年個案易疲倦、注意力持續時間短，資料收集應分次進行並安排休息。B 錯在排除生命回顧資料，依 Erikson 心理社會發展理論，老年期的發展任務為「自我統整對絕望」，回顧過去正是統整歷程的一部分，且能提供重要的心理社會資料。D 錯在僅採信家屬敘述，即使認知功能退化，個案的主觀陳述仍是第一手資料，且家屬敘述可能受照顧負荷或關係因素影響而失真，正確作法是兩者併陳並相互佐證。","老年評估的調整可記成「短、慢、清、分次、多來源」：每次會談時間短、語速放慢、句子簡潔具體且避免抽象或雙重否定、分多次收集、同時參照個案自述、家屬陳述與客觀紀錄。環境上另需坐在光線充足處面對面、確認助聽器與眼鏡已配戴、降低背景噪音。\n\nB 選項刻意誤用了「此時此刻（here and now）」原則。此原則原本用於治療性團體或人際取向治療中，避免個案以談論過去逃避當下議題；但在老年評估與治療脈絡下，生命回顧（life review）本身即是介入手段——懷舊治療（reminiscence therapy）已被廣泛用於提升老年個案的自尊、情緒與社會參與。國考很愛用「把某個正確原則搬到錯誤情境」來設計干擾項。\n\nD 選項的另一層錯誤在於剝奪個案的自主與尊嚴，也違反以個案為中心的照護精神；同時，僅憑家屬陳述無法區辨譫妄、憂鬱與失智這組著名的「3D」鑑別——憂鬱症個案常自述記憶差但測驗表現尚可、且回答「我不知道」；失智者則傾向掩飾或虛談。\n\n可延伸複習：Erikson 八階段（尤其老年期統整對絕望）、假性失智（pseudodementia）與失智的鑑別、老年憂鬱量表（GDS）與 MMSE 的適用時機。",[30,32,34,36,38],{"term":31,"count":16},"老年護理評估",{"term":33,"count":16},"Erikson 心理社會發展理論",{"term":35,"count":16},"生命回顧與懷舊治療",{"term":37,"count":16},"老化的認知變化",{"term":39,"count":16},"多來源資料佐證",[41],{"id":42,"name":43},"dementia-care","失智症照護",[45,47,52,57,62,67],{"webId":9,"stem":46,"number":10,"year":15,"session":16},"李小姐參加復健商店的工作訓練，此為第幾級的預防概念？",{"webId":48,"stem":49,"number":50,"year":15,"session":51},"nurse-108-2-psychiatric-community-048","根據勞工健康保護規則中規定，工作者暴露於下列那一種作業環境超過 8 hours\u002Fday，會造成聽力傷害？",48,2,{"webId":53,"stem":54,"number":55,"year":56,"session":16},"nurse-109-1-psychiatric-community-062","下列何項不屬於物理性的公害？",62,109,{"webId":58,"stem":59,"number":60,"year":61,"session":51},"nurse-110-2-psychiatric-community-020","憂鬱症病人常伴有退化行為而導致自我照顧能力缺失，護理師提供的相關護理措施，下列何者錯誤？",20,110,{"webId":63,"stem":64,"number":65,"year":66,"session":51},"nurse-111-2-psychiatric-community-064","王女士，45 歲，山地原住民女性，平時沒有抽菸、飲酒習慣，從沒參加社區健康篩檢活動，今天第一次參加篩檢。下列何者為其可使用的公費篩檢項目？①成人預防保健服務 ②子宮頸癌篩檢 ③大腸癌篩檢 ④B、C 型肝炎篩檢 ⑤乳癌篩檢 ⑥口腔癌篩檢",64,111,{"webId":68,"stem":69,"number":70,"year":71,"session":72},"nurse-112-3-psychiatric-community-018","葉先生，36 歲，診斷恐慌症，發作時感到喘不過氣、胸痛、四肢麻痺，在急診時大喊：「我覺得快死了！」，下列護理師的處置，何者最適宜？",18,112,3,"2026-09-29",1790672290865]