[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-108-2-psychiatric-community-023":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"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-108-2-精神科與社區衛生護理學-023","nurse-108-2-psychiatric-community-023",108,2,23,"有關思覺失調症生物的成因，主要為下列何者？",{"A":14,"B":15,"C":16,"D":17},"主要與多巴胺不平衡有關","側腦室有萎縮現象","γ -氨基丁酸（ γ -aminobutyric acid, GABA）過多有關","精神疾病的負性症狀與邊緣系統異常有關","A",null,[],"本題考點為思覺失調症的生物成因。依多巴胺假說,思覺失調症的正性症狀(幻覺、妄想)主要與中腦邊緣路徑多巴胺功能過度、亦即多巴胺神經傳導不平衡有關,故選 A。B 側腦室萎縮錯誤,影像研究顯示的是側腦室「擴大」而非萎縮,反映腦組織體積減少。C 稱 GABA 過多有關錯在思覺失調症主要涉及多巴胺與麩胺酸(glutamate)系統失調,並非 GABA 過多為主因。D 稱負性症狀與邊緣系統異常有關並不精確,負性症狀多與中腦皮質路徑多巴胺功能「不足」及前額葉功能低下相關,而非邊緣系統。判斷關鍵在於多巴胺不平衡是思覺失調症最核心的生物學假說。","多巴胺假說雙路徑:中腦邊緣路徑(mesolimbic)多巴胺過高→正性症狀;中腦皮質路徑(mesocortical)多巴胺過低+前額葉功能低下→負性與認知症狀。這解釋抗精神病藥(D2 拮抗)可壓正性症狀卻對負性症狀效果有限。影像變化:側腦室擴大、額顳葉萎縮。麩胺酸(NMDA)低下假說為補充。口訣:邊緣多巴胺高=幻聽妄想,皮質多巴胺低=退縮無動力。",[24,27,30,33],{"term":25,"count":26},"思覺失調症",17,{"term":28,"count":29},"多巴胺假說",5,{"term":31,"count":32},"中腦邊緣路徑",1,{"term":34,"count":32},"側腦室擴大",[36,40,45,49,54,59],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-108-2-psychiatric-community-024","呂小姐，42 歲，入院 4 週，預計下週出院，今天與護理師會談時提到自己的幻聽已改善很多，雖然仍會聽到一些聲音，不過內容已沒以前清楚，下列護理措施何者最適切？",24,{"webId":41,"stem":42,"number":43,"year":44,"session":32},"nurse-109-1-psychiatric-community-040","王太太有憂鬱症，經常向家人表示：「我會拖累你們，病又不會好，我活著沒什麼意思，真想死了!」，依自殺行為程度分級，最屬於下列何者？",40,109,{"webId":46,"stem":47,"number":48,"year":44,"session":10},"nurse-109-2-psychiatric-community-054","推動酒駕罰則以降低酒後駕車事故發生率，是屬於下列何種健康促進介入措施？",54,{"webId":50,"stem":51,"number":52,"year":53,"session":32},"nurse-111-1-psychiatric-community-012","王小姐在精神科病房住院，住院期間某日與其他病人爭執，出手攻擊對方。依據行為治療理論，下列何項負向增強（negative reinforcement）的處置最適當？",12,111,{"webId":55,"stem":56,"number":57,"year":58,"session":32},"nurse-112-1-psychiatric-community-056","根據渥太華憲章，科技公司設置運動教室讓員工使用，是屬於下列何項行動綱領？",56,112,{"webId":60,"stem":61,"number":43,"year":62,"session":32},"nurse-113-1-psychiatric-community-040","顧先生原為一家之主，因病辭職在家休養，現由妻子支撐全家開銷並成為家中主要經濟決策者，下列何者最符合其家庭權力類型？",113,"2026-09-04",1788510707649]