[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-110-1-psychiatric-community-023":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":64},"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-110-1-精神科與社區衛生護理學-023","nurse-110-1-psychiatric-community-023",110,1,23,"照顧罹患身體症狀及相關障礙症的病人，須特別評估隨著症狀表現而來的附帶收獲（secondary gain），下列何項描述較適當？",{"A":14,"B":15,"C":16,"D":17},"附帶收獲是指表現出身體症狀便可以直接避免面對心理衝突或壓力","應儘量不要太關注病人的身體症狀，以避免不當的增強附帶收獲","以抗精神病（antipsychotics）藥物進行催眠會談，在過程中給予暗示及建議","鼓勵病人持續關注身體症狀，以關注病人的身體症狀為主要護理措施","B",null,[],"本題考點為身體症狀障礙症的附帶收獲(secondary gain)與相應護理。考點在於辨識「應避免過度關注身體症狀以免不當增強附帶收獲」,故選B。依行為學習原理,對症狀給予過多關注等同正增強,會強化症狀持續,故護理上應減少對症狀本身的過度注意、轉而關注病人的情緒與因應,B正確。A錯在把附帶收獲定義成「直接避免面對衝突」,那較接近初級收獲(primary gain,以症狀化解內在焦慮);附帶收獲是指因生病獲得的外在好處(被照顧、免責任)。C以抗精神病藥催眠會談的敘述與此處置不符。D「鼓勵持續關注症狀」正與不強化原則相反。","初級收獲vs附帶收獲是本題核心對比:初級收獲=症狀本身把內在心理衝突轉為身體不適、潛意識地緩解焦慮(病人不自覺);附帶收獲=生病後從環境得到的外在利益,如被關懷、免除責任義務。護理策略據此設計:不強化(減少對症狀的注意與獎賞)、轉移焦點到功能與情緒、鼓勵正常角色活動、探討壓力來源。A把附帶收獲說成「避免面對衝突」正是與初級收獲混淆的經典陷阱。要點:症狀是真實體驗、非裝病,護理態度須接納而不獎賞症狀。",[24,27,29,31],{"term":25,"count":26},"身體症狀障礙症",5,{"term":28,"count":10},"附帶收獲secondary gain",{"term":30,"count":10},"初級收獲對比",{"term":32,"count":10},"正增強與不強化",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-110-1-psychiatric-community-024","護理師在精神科急性病房照顧王老先生期間，王老先生常表示她就像是自己的女兒一樣，並以「女兒」稱呼護理師。對此狀況之解釋，下列敘述何者較適當？",24,{"webId":39,"stem":40,"number":41,"year":9,"session":42},"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？",40,2,{"webId":44,"stem":45,"number":46,"year":47,"session":10},"nurse-111-1-psychiatric-community-054","根據世界衛生組織（WHO）對社區的定義，下列何者正確？",54,111,{"webId":49,"stem":50,"number":51,"year":52,"session":42},"nurse-112-2-psychiatric-community-012","張小姐，診斷為妄想症，因懷疑學校同事向校長告狀阻礙其升遷，而有頻繁投訴教育部及謾罵同事等行為，由家屬陪同住院治療。下列護理措施，何者最適切？",12,112,{"webId":54,"stem":55,"number":56,"year":57,"session":42},"nurse-113-2-psychiatric-community-036","擬定老人肌少症護理指導計畫行為目標，下列何者最適當？",36,113,{"webId":59,"stem":60,"number":61,"year":62,"session":63},"nurse-114-3-psychiatric-community-030","某學者找無罹患過鼻咽癌的勞工，工作於高濃度甲醛環境的勞工視為暴露組，工作在甲醛濃度為環境背景值的勞工當非暴露組，追蹤 10 年後分析二組勞工罹患鼻咽癌的相對危險性（relative risk）為 2.5，下列最適當的推論為：",30,114,3,"2026-09-04",1788510722614]