[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-115-2-psychiatric-community-014":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":65},"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-014","nurse-115-2-psychiatric-community-014",115,2,14,"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？",{"A":14,"B":15,"C":16,"D":17},"立即限制其行動自由，避免影響其他病人","同理病人的憤怒情緒，並給予擁抱以示安慰","對病人干擾行為給予設限，及說明對行為的期待","避免與病人有任何眼神接觸，以免激怒病人","C",null,[],"本題考點為反社會型人格障礙症病人的護理原則。此類病人常見操縱、試探界線與衝動攻擊行為,護理核心是行為設限(limit setting):以一致、明確、非懲罰性的態度對干擾與威脅行為劃出界線,並清楚說明對其行為的期待與違反的後果,故C最適切。A錯在限制行動自由屬保護性約束,須符合法定要件與臨床必要性,不能因抱怨、咆哮即逕行限制。B錯在給予擁抱逾越治療性關係的專業界線,對操縱性強的病人更易被利用,同理其情緒不等於身體安撫。D錯在完全迴避眼神接觸是退縮而非治療性態度,無法建立一致的行為規範,也可能被解讀為可以予取予求。","反社會型人格障礙的照護三支柱:一致(全團隊口徑一致,防止病人分化操縱工作人員,即splitting的因應)、設限(界線清楚、後果明確、執行不帶情緒)、就事論事(針對行為而非人格批判)。設限的標準步驟:描述不可接受的行為→說明期待的行為→告知違反的後果→一致執行。與邊緣型人格的照護對照記憶:兩者都需設限與團隊一致,但邊緣型另需處理自傷與情緒不穩,反社會型則側重操縱與侵犯他人權益的行為管理。專業界線議題(禮物、肢體接觸、私人關係)在人格障礙病房尤其嚴格,是考題常設的陷阱。",[24,27,30,33],{"term":25,"count":26},"專業界線",5,{"term":28,"count":29},"行為設限",4,{"term":31,"count":32},"團隊一致性",3,{"term":34,"count":35},"反社會型人格障礙",1,[37,41,46,50,55,60],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-115-2-psychiatric-community-015","林同學認為門把很髒，於碰觸門把之後要花 30 分鐘洗手，治療者讓林同學有意識的碰觸門把，再幫助林同學漸漸耐受不強迫洗手帶來的焦慮感，而學會控制與因應，為下列何項治療方法？",15,{"webId":42,"stem":43,"number":44,"year":45,"session":35},"nurse-106-1-psychiatric-community-061","下列那一個因素與公害程度成反比？",61,106,{"webId":47,"stem":48,"number":49,"year":45,"session":10},"nurse-106-2-psychiatric-community-075","慢性病危險群個案管理需要完整的計畫與防治步驟，其中最優先且重要的是：",75,{"webId":51,"stem":52,"number":53,"year":54,"session":10},"nurse-108-2-psychiatric-community-033","安排病人參與社區復健活動，護理師所執行的個案管理措施，下列何者正確？",33,108,{"webId":56,"stem":57,"number":58,"year":59,"session":10},"nurse-109-2-psychiatric-community-077","有關慢性病的特性，下列何者錯誤？",77,109,{"webId":61,"stem":62,"number":63,"year":64,"session":35},"nurse-111-1-psychiatric-community-031","張先生，80 歲，診斷為阿茲海默症，因情緒激動及焦慮而住院。近日因不明原因發燒、咳嗽有痰不舒服，表示要回家，且對陪同住院媳婦不諒解，故出手打了媳婦一巴掌。下列何者護理措施最適當？",31,111,"2026-08-06",1787299016890]