[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-115-1-psychiatric-community-006":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":62},"精神科與社區衛生護理學","psychiatric-community",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":26},"nurse-115-1-精神科與社區衛生護理學-006","nurse-115-1-psychiatric-community-006",115,1,6,"有關第一代抗精神病藥物之敘述，下列何者正確？",{"A":14,"B":15,"C":16,"D":17},"主要作用機轉是來自於多巴胺受體的促進作用","抗精神病作用越強的藥物，其鎮靜作用較低","抗精神病作用越強的藥物，其錐體外徑副作用越低","相較於haloperidol，chlorpromazine較會靜坐不能","B",null,[],"本題考點是第一代（典型）抗精神病藥物的效價與副作用蹺蹺板關係。第一代藥物的共同機轉是拮抗多巴胺 D2 受體而非促進，故 A 錯。依效價分類，高效價藥（如 haloperidol）與 D2 受體親和力高、所需劑量小，對組織胺 H1 與 α1 受體的阻斷相對少，鎮靜與姿位性低血壓因此較輕，所以抗精神病作用越強者鎮靜作用越低，選 B。C 錯在方向剛好相反：高效價藥的錐體外症狀（EPS）反而更明顯，低效價藥則以鎮靜與抗膽鹼副作用為主。D 錯在把兩藥對調，靜坐不能屬 EPS，高效價的 haloperidol 比低效價的 chlorpromazine 更容易出現。","EPS 的四型與出現時序值得整理成表：急性肌肉張力不全（給藥後數小時至數天，頸部歪斜、眼球上吊）、類帕金森症狀（數天至數週，動作遲緩、僵硬、靜止性顫抖）、靜坐不能（數天至數週，主觀煩躁、坐不住、來回走動）、遲發性運動障礙 tardive dyskinesia（數月至數年，特徵是口舌不自主蠕動、扭動等不自主動作「過多」，與動作缺乏的 akinesia 恰好相反，不可混稱為運動不能）。記法是一條蹺蹺板：效價高則 D2 阻斷強、EPS 高、鎮靜低；效價低則受體選擇性差、鎮靜與抗膽鹼、姿位性低血壓明顯、EPS 相對低。chlorpromazine 屬低效價 phenothiazine 類，臨床上以鎮靜、口乾、視力模糊、姿位性低血壓與光敏感為特徵；haloperidol 屬高效價 butyrophenone 類。兩類共同的罕見重症是抗精神病藥惡性症候群（NMS：高燒、肌肉僵硬、意識改變、CPK 上升），可與 EPS 一併複習。",[24,27,29,31],{"term":25,"count":26},"遲發性運動障礙",2,{"term":28,"count":10},"第一代抗精神病藥物效價分類",{"term":30,"count":10},"多巴胺 D2 受體拮抗",{"term":32,"count":10},"錐體外症狀(EPS)",[34,38,43,47,52,57],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-115-1-psychiatric-community-007","根據團體治療型態的定義及目標，鼓勵成員在團體中用言語表達，並探討個人現在與過去情境中，情緒或心理上的問題，以增進成員的人格重建或行為型態之修正與調適。屬於下列何種團體治療？",7,{"webId":39,"stem":40,"number":41,"year":42,"session":10},"nurse-106-1-psychiatric-community-003","一位從小被父親性侵至大學的 20 歲女大學生，因出現自傷行為而住院。主護護理師與之會談，談及家庭時，認為爸爸是愛她的，承認父親性侵她卻完全記不起來任何一次性侵的過程。但有時突然大哭時卻能詳細說出父親性侵她的過程。此種心理防衛機轉最有可能是下列何項？",3,106,{"webId":44,"stem":45,"number":46,"year":42,"session":26},"nurse-106-2-psychiatric-community-017","減少阿茲海默症病人之問題行為發生的護理處理，下列何者最適宜？",17,{"webId":48,"stem":49,"number":50,"year":51,"session":26},"nurse-107-2-psychiatric-community-055","下列何者不是家庭增能（family empowerment）的表現？",55,107,{"webId":53,"stem":54,"number":55,"year":56,"session":26},"nurse-109-2-psychiatric-community-019","丁小姐害怕服鋰鹽，擔心青春痘與發胖的副作用，下列何種護理處置最為適切？",19,109,{"webId":58,"stem":59,"number":60,"year":61,"session":26},"nurse-110-2-psychiatric-community-053","有關護理師運用社區資源的敘述，下列何者不適當？",53,110,"2026-08-06",1787299089718]