[{"data":1,"prerenderedAt":74},["ShallowReactive",2],{"q-nurse-108-1-psychiatric-community-046":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-045",45,{"webId":9,"number":10},"nurse-108-1-psychiatric-community-047",47,"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-046","nurse-108-1-psychiatric-community-046",108,1,46,"多重抗藥性肺結核（MDR-TB）的逐漸增加，目前 WHO 在肺結核治療大力推動的方法為下列何者？",null,{"A":21,"B":22,"C":23,"D":24},"DOTS（Directly-Observed Treatment, Short-course）","IDOTS（Indirectly-Observed Treatment, Short-course）","DOTL（Directly-Observed Treatment, Long-course）","IDOTL（Indirectly-Observed Treatment, Long-course）","A",[],"本題考點是 WHO 結核病防治的標準策略名稱。依 WHO 自 1990 年代推動的架構，其核心為 DOTS，即直接觀察治療、短程，由關懷員親眼看著個案服藥，確保短程療程完成，藉此避免中斷或漏服而誘發抗藥性，正是因應 MDR-TB 的關鍵手段，選 A。（B）IDOTS 的「間接觀察」與親眼監督的核心相反，並非既有名詞。（C）DOTL 與（D）IDOTL 皆為虛構選項，且長程療程與 WHO 強調的短程化學治療方向相反。","DOTS 五大要素（考題常拆開問）：①政府政治承諾與經費；②以痰塗片鏡檢（現多加分子快檢）為主的個案發現；③標準短程化療並直接觀察服藥；④穩定不中斷的藥品供應；⑤標準化的登記報告與療效評估系統。\n\n我國對應措施為都治計畫（DOTS），由關懷員送藥到點、看著吞下（送藥到手、看藥入口、吞下再走）。第一線抗結核藥物口訣 RIPE：Rifampin（利福平，尿液橘紅色為正常現象，須先衛教以免自行停藥）、Isoniazid（INH，周邊神經病變風險，故併用維生素 B6）、Pyrazinamide（高尿酸血症）、Ethambutol（視神經炎、紅綠色盲，須定期視力檢查）。\n\nMDR-TB 的定義是至少同時對 INH 與 Rifampin 具抗藥性；XDR-TB 則再加上對氟喹諾酮類與二線注射劑抗藥。抗藥性的根源幾乎都是「治療不完全」，因此 WHO 的解方不是換藥而是確保服藥完成，這正是本題把 MDR-TB 與 DOTS 綁在一起的命題邏輯。\n\n延伸複習：結核屬第三類法定傳染病，一週內通報；接觸者需接受胸部 X 光與丙型干擾素釋放試驗（IGRA）檢查，可與第 047 題的次段預防概念互相連結。",[30,32,34,36,38],{"term":31,"count":16},"DOTS 直接觀察治療短程",{"term":33,"count":16},"多重抗藥性結核 MDR-TB",{"term":35,"count":16},"WHO 結核病防治策略",{"term":37,"count":16},"都治計畫",{"term":39,"count":16},"抗結核第一線藥物",[41],{"id":42,"name":43},"infectious-diseases","社區重要傳染病",[45,47,52,57,62,67],{"webId":9,"stem":46,"number":10,"year":15,"session":16},"下列何種案例是屬於三段五級預防模式中第二段預防工作？",{"webId":48,"stem":49,"number":50,"year":15,"session":51},"nurse-108-2-psychiatric-community-063","有關新型 A 型流感之描述，下列何者正確？①H1N1, H3N2 屬於每年週期性流行的流感 ②致死率約為 80～90% ③常見於禽鳥病毒傳染人類，如：H7N9, H5N1 ④密切接觸者須自主健康管理 5 天 ⑤發現個案須於 48 小時內通報",63,2,{"webId":53,"stem":54,"number":55,"year":56,"session":16},"nurse-109-1-psychiatric-community-077","有關「代謝症候群」判定標準，下列何者錯誤？",77,109,{"webId":58,"stem":59,"number":60,"year":61,"session":51},"nurse-110-2-psychiatric-community-035","許小姐 35 歲，反覆住院的情感性精神病病人。近日剛從急性病房轉慢性病房，家屬可接受病人返家同住，只是擔心病人病情惡化，病人有工作及復健潛能。下列有關病人的出院準備何者較適當？",35,110,{"webId":63,"stem":64,"number":65,"year":66,"session":51},"nurse-111-2-psychiatric-community-079","有關慢性腎臟病初期病人的飲食指導，下列何者最不適當？",79,111,{"webId":68,"stem":69,"number":70,"year":71,"session":72},"nurse-112-3-psychiatric-community-033","護理師想要了解社區的動力，下列何種資料最不適當？",33,112,3,"2026-09-29",1790672291069]