[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-106-2-psychiatric-community-029":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":10},"nurse-106-2-精神科與社區衛生護理學-029","nurse-106-2-psychiatric-community-029",106,2,29,"陳太太在一次大地震中，親眼目睹自己的家園及女兒被海嘯吞噬，而自己也因躲避海嘯而身體多處受傷。事發後，陳太太出現反覆夢見自己被海嘯吞噬的惡夢，不想參加任何活動，對未來抱持悲觀的心態，且不願談論與海嘯有關的話題，出現失眠、易怒等症狀，症狀持續一個月仍未改善，請問陳太太最可能的診斷為何？",{"A":14,"B":15,"C":16,"D":17},"創傷後壓力症（post-traumatic stress disorder）","恐慌症（panic disorder）","急性壓力症（acute stress disorder）","解離症（dissociative disorder）","A",null,[],"本題考點為創傷後壓力症（PTSD）與急性壓力症的病程區辨。依 DSM 準則，PTSD 需出現再經驗（惡夢）、逃避（不談論、不參加活動）、負向認知情緒（對未來悲觀）及過度警醒（失眠、易怒），且持續超過一個月；陳太太症狀滿一個月仍未改善，符合 PTSD，故正解為 A。B 錯在恐慌症以反覆突發的恐慌發作為核心，與再經驗症候群不同。C 錯在急性壓力症病程界定為創傷後 3 天至 1 個月，本題已滿一個月，應轉為 PTSD。D 錯在解離症以失憶、失自我感、失現實感為主軸，非題述的再經驗與逃避症候群。","PTSD 與急性壓力症最關鍵的鑑別在「時間」：症狀在 3 天至 1 個月內＝急性壓力症；持續超過 1 個月＝PTSD。四大症狀群記憶口訣：再經驗（惡夢、回閃）、逃避（避開相關人事物）、認知與情緒負向改變（悲觀、疏離）、過度警醒（失眠、易怒、易受驚）。本題滿一個月是判斷分水嶺。治療以創傷焦點認知行為治療、EMDR 為主，藥物可用 SSRI。與適應障礙、解離症的鑑別亦是常考點。",[24,26,29,31],{"term":25,"count":10},"急性壓力症",{"term":27,"count":28},"創傷後壓力症(PTSD)",1,{"term":30,"count":28},"症狀持續一個月的病程準則",{"term":32,"count":28},"再經驗\u002F逃避\u002F警醒症狀群",[34,38,43,47,52,57],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-106-2-psychiatric-community-030","承上題，護理師提供陳太太的護理措施中，下列何者最適當？①漸進引導回顧創傷過程 ②鼓勵陳太太面對現實，不要沉浸悲傷中 ③適時陪伴及傾聽 ④運用團體治療過程互相支持",30,{"webId":39,"stem":40,"number":41,"year":42,"session":28},"nurse-107-1-psychiatric-community-046","社區護理師提供發展遲緩兒童之早期療育服務，下列何者錯誤？",46,107,{"webId":44,"stem":45,"number":46,"year":42,"session":10},"nurse-107-2-psychiatric-community-060","使用曝氣法處理水質的目的，下列何者正確？",60,{"webId":48,"stem":49,"number":50,"year":51,"session":10},"nurse-109-2-psychiatric-community-018","丁小姐出現濃妝、著清涼亮麗服飾，主動進入異性的房間，找異性聊天，下列何項措施最適宜？",18,109,{"webId":53,"stem":54,"number":55,"year":56,"session":10},"nurse-110-2-psychiatric-community-062","有關家庭內在資源中的軟體結構支持（structure support）下列敘述何者正確？",62,110,{"webId":58,"stem":59,"number":60,"year":61,"session":28},"nurse-112-1-psychiatric-community-016","趙女士，身高 165 公分，診斷為憂鬱症，近 2 週食慾不佳，每餐只喝少許果汁，體重從 55 公斤降至 45 公斤。依據上述症狀，何者為最適宜的護理診斷？",16,112,"2026-09-04",1788510700173]