[{"data":1,"prerenderedAt":76},["ShallowReactive",2],{"q-nurse-108-1-psychiatric-community-038":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-037",37,{"webId":9,"number":10},"nurse-108-1-psychiatric-community-039",39,"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-038","nurse-108-1-psychiatric-community-038",108,1,38,"王先生因自傷傷人而由警消單位帶入強制住院，進病房後因出院需求未獲滿足立即舉起椅子砸向護理站，有關照護措施，下列何者正確？",null,{"A":21,"B":22,"C":23,"D":24},"護理師可立即自行予以約束協助王先生控制情緒","護理師應無論王先生的情緒狀態，先依醫囑給予王先生藥物注射，再協助控制躁動情緒","護理師應先評估王先生的反應，維持安全適當位置並進行自我防護準備","護理師應立即滿足王先生的需求，以緩解情緒","C",[],"本題考點是暴力行為當下的處置順序——評估與自我安全防護優先於任何約束或給藥。依暴力行為處置的原則，工作人員的人身安全是介入的前提，故面對已出現攻擊行為的個案，應先評估其情緒與行為反應、保持適當距離與可退出的相對位置（不背對個案、留出通往門口的動線、移除可作為武器的物品）並完成自我防護與人力支援的準備，故選 C。A 錯在「立即自行約束」，約束屬限制人身自由的處置，須依醫囑執行並具備足夠人力，單人約束對雙方都構成高度風險。B 錯在「無論情緒狀態一律先注射」，忽略個別評估且未考量安全前提，強行給藥反而升高衝突與受傷風險。D 錯在立即滿足要求，對強制住院個案而言出院須依法定程序，且以暴力換取需求滿足會強化該行為模式。","暴力處置的介入階梯由低到高：環境調整與降低刺激 → 語言安撫與設限（de-escalation：語調平穩、簡短句、稱呼姓名、給有限選擇）→ 提供替代出口（帶離現場、安靜室）→ 藥物介入（依醫囑）→ 約束或隔離（最後手段）。「最小限制原則」要求每一步都先試過較低侵入性的方法。本題選 C 正是在階梯最起點的評估與防護。\n\n自我防護的具體要點值得逐項記憶：與個案保持至少一個手臂加一步的距離、站在斜前方而非正前方、確保自己離出口較近、避免直視挑釁或雙手抱胸、事先按下緊急鈴集結人力、身上不佩戴長項鍊、聽診器等可被抓住之物、留意個案手上有無可作為武器的物品（本題個案已舉起椅子，屬立即危險）。\n\n法律面補充：依精神衛生法，約束與隔離須有醫囑、須記錄理由與起訖時間、須定時評估肢體循環與生理需求，且以保護個案與他人安全為目的，不得作為懲罰或人力不足的替代手段。緊急情況下護理人員得先行處置，但仍須立即通知醫師補開醫囑——這與 A 選項所述的「立即自行予以約束」在要件與人力條件上並不相同。\n\n可延伸複習：暴力風險的前驅徵象（來回踱步、握拳、音量升高、瞪視、破壞物品）、攻擊行為的三階段（前驅期、爆發期、緩解期）與各期處置重點、事件後的減壓討論（debriefing）。",[30,33,36,38,40],{"term":31,"count":32},"精神衛生法",21,{"term":34,"count":35},"最小限制原則",13,{"term":37,"count":16},"暴力行為處置",{"term":39,"count":16},"自我防護與安全評估",{"term":41,"count":16},"約束與隔離規範",[43],{"id":44,"name":45},"aggression-restraint","攻擊行為處理、隔離與約束",[47,49,54,59,64,69],{"webId":9,"stem":48,"number":10,"year":15,"session":16},"關於自閉症類群障礙症（原為自閉性疾患）的描述，下列何者正確？",{"webId":50,"stem":51,"number":52,"year":15,"session":53},"nurse-108-2-psychiatric-community-055","目前臺灣全民健保居家護理訪視費用的給付項目，下列何者錯誤？",55,2,{"webId":55,"stem":56,"number":57,"year":58,"session":16},"nurse-109-1-psychiatric-community-069","社區護理師為提升懷孕新住民的健康識能（health literacy），下列何者較不適當？",69,109,{"webId":60,"stem":61,"number":62,"year":63,"session":53},"nurse-110-2-psychiatric-community-027","邱同學在會考前 1 個月，每次學校模擬考時都感到右手無力，被家人送到神經內科求診，但經多科醫師會診及檢查，卻找不到任何跟生理病變有關的證據，邱同學最有可能是下列何項診斷？",27,110,{"webId":65,"stem":66,"number":67,"year":68,"session":53},"nurse-111-2-psychiatric-community-071","有關學校護理師應用流行病學方法進行校園評估的目的，下列何者最不適當？",71,111,{"webId":70,"stem":71,"number":72,"year":73,"session":74},"nurse-112-3-psychiatric-community-025","林先生，60 歲，罹患思覺失調症已 40 年，目前無明顯精神症狀，自我照顧功能下降需他人協助生活照顧，無其他家人可協助照料。依林先生之狀況，最適合安排下列何種精神醫療資源？",25,112,3,"2026-09-29",1790672290965]