[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-109-2-psychiatric-community-009":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"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":10},"nurse-109-2-精神科與社區衛生護理學-009","nurse-109-2-psychiatric-community-009",109,2,9,"38 歲林先生，騎車時發生嚴重車禍，之後持續出現睡不著、惡夢連連、感覺還聽到撞車時的剎車聲，抱怨被截斷的左腳似乎猶存，感到極度疼痛，常獨自在家中生氣，也不敢再經過車禍地點，上述症狀持續 1 個月以上，下列何項為最可能的問題？",{"A":14,"B":15,"C":16,"D":17},"重度憂鬱症（major depressive disorder）","創傷後壓力症候群（posttraumatic stress disorder）","思覺失調症（schizophrenia）","恐慌症（panic disorder）","B",null,[],"本題考點為創傷後壓力症候群的診斷辨識。依 PTSD 的診斷準則，個體經歷重大創傷後出現再經驗（惡夢、閃現剎車聲）、逃避（不敢經過車禍地點）、警醒度增高（睡不著）與負向情緒（易怒），且症狀持續超過一個月，林先生車禍後症狀達一個月以上完全符合，選 B。A 重度憂鬱症以持續憂鬱與失去興趣為核心，未能解釋創傷再經驗與逃避。C 思覺失調症以幻覺妄想等精神病症狀為主，本例的剎車聲屬創傷閃現而非幻聽。D 恐慌症為反覆突發的恐慌發作，與創傷連結的症狀樣態不符。","PTSD 四大症狀群：侵入性再經驗、持續逃避、認知情緒負向改變、警醒與反應性改變。時間是鑑別關鍵：症狀滿一個月為 PTSD，一個月內則為急性壓力症。幻肢痛屬截肢後神經現象，與 PTSD 並存但機轉不同。治療含創傷焦點認知行為治療與 EMDR。",[24,26,28,31],{"term":25,"count":10},"症狀持續一個月",{"term":27,"count":10},"急性壓力症鑑別",{"term":29,"count":30},"創傷後壓力症候群",1,{"term":32,"count":30},"再經驗與逃避",[34,38,43,47,52,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-109-2-psychiatric-community-010","團體成員在團體中，覺得自己的問題不再是那麼特殊，可以分享各自的感受，而得到相互支持，這項團體的治療性因子，下列何項正確？",10,{"webId":39,"stem":40,"number":41,"year":42,"session":30},"nurse-110-1-psychiatric-community-026","美沙冬（Methadone）可作為海洛因（Heroin）的替代治療藥物之原因，下列敘述何者錯誤？",26,110,{"webId":44,"stem":45,"number":46,"year":42,"session":10},"nurse-110-2-psychiatric-community-040","有關遭受精神病人暴力攻擊的護理人員之輔導，下列何者較適當？",40,{"webId":48,"stem":49,"number":50,"year":51,"session":10},"nurse-111-2-psychiatric-community-078","有關老人跌倒的危險因子中，下列何者屬於外因性的因素？",78,111,{"webId":53,"stem":54,"number":55,"year":56,"session":57},"nurse-112-3-psychiatric-community-042","有關我國母乳哺餵政策之敘述，下列何者最不適當？",42,112,3,{"webId":59,"stem":60,"number":61,"year":62,"session":30},"nurse-114-1-psychiatric-community-036","王先生參加口腔癌篩檢，表示嘴破未癒合長達一個月，且最近有位同事因口腔癌治療飽受身心之苦，很害怕自己也得了口腔癌，妻子鼓勵他參與篩檢。依據健康信念模式，下列何者是影響王先生採取預防行為的因素？①罹患性認知     ②嚴重性認知   ③行動線索   ④利益性認知   ⑤自我效能",36,114,"2026-09-04",1788510717877]