[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-115-2-psychiatric-community-013":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"lastmod":63},"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-115-2-精神科與社區衛生護理學-013","nurse-115-2-psychiatric-community-013",115,2,13,"小蕙，21 歲，因嚴重幻聽和混亂行為，被診斷思覺失調症。有關影響疾病預後較好的因素，下列何者最適當？",{"A":14,"B":15,"C":16,"D":17},"父親有思覺失調症病史","能適應藥物治療且規則服藥","持續有嚴重的認知功能障礙","家屬為高情感表達（high expressed emotion）","B",null,[],"本題考點為思覺失調症預後的影響因素。預後較佳的因素包括:急性發病、發病年齡較晚、有明顯誘發事件、病前社會功能良好、對藥物反應佳且規則服藥、家庭支持系統良好等;能適應藥物治療且規則服藥可有效控制症狀、顯著降低復發率,屬預後良好因素,故B正確。A錯在一等親有思覺失調症病史代表遺傳負荷較重,屬預後不良因素。C錯在持續嚴重的認知功能障礙反映疾病對腦功能的侵蝕深,預後較差。D錯在高情感表達家屬(高批評、敵意、過度情感涉入)已被證實會顯著提高病人復發率,屬預後不良因素。","預後因素可用「快、晚、有因、有功能、有支持」記憶:發病快(急性)、發病晚、有明顯誘因、病前功能好、支持系統佳,再加上「正性症狀為主、女性、已婚、藥物反應佳」皆屬預後好;反之「隱匿漸進發病、年輕發病、負性症狀為主、家族史、認知缺損、高情感表達家庭」預後差。高情感表達(high EE)是社區精神照護的重要概念:家屬的批評、敵意與過度涉入會使病人復發率倍增,因此家屬衛教與家庭介入(降低EE)本身就是防復發的治療手段,也解釋了為何家庭護理在思覺失調症照護中份量吃重。",[24,27,30,32],{"term":25,"count":26},"服藥遵從性",5,{"term":28,"count":29},"思覺失調症預後因素",1,{"term":31,"count":29},"高情感表達",{"term":33,"count":29},"遺傳負荷",[35,39,44,48,53,58],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-115-2-psychiatric-community-014","一位 30 歲男性，診斷反社會型人格障礙，因酒駕肇事被強制送醫，住院期間不斷抱怨醫院伙食、環境，並對醫護人員咆哮，甚至出現言語威脅。下列那項護理措施最為適切？",14,{"webId":40,"stem":41,"number":42,"year":43,"session":29},"nurse-106-1-psychiatric-community-060","有關廢棄物處理程序的描述，下列何者錯誤？",60,106,{"webId":45,"stem":46,"number":47,"year":43,"session":10},"nurse-106-2-psychiatric-community-074","我國長期照顧服務法，所指之長期照顧對象是指身心失能持續達多久以上的人？",74,{"webId":49,"stem":50,"number":51,"year":52,"session":10},"nurse-108-2-psychiatric-community-032","罹患分離焦慮症（separation anxiety disorder）的兒童，其護理重點為何？①增強病童的安全感 ②增加分離的次數 ③教導病童的因應能力 ④訓練病童的獨立性",32,108,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-109-2-psychiatric-community-076","周先生近日痛風頻繁發作，社區護理師進行家訪衛教，下列何者錯誤？",76,109,{"webId":59,"stem":60,"number":61,"year":62,"session":29},"nurse-111-1-psychiatric-community-030","有關注意力不足／過動症（ADHD）的治療原則，下列何者最不適當？",30,111,"2026-08-06",1787299016880]