[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-110-1-psychiatric-community-039":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"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-110-1-精神科與社區衛生護理學-039","nurse-110-1-psychiatric-community-039",110,1,39,"張先生 40 歲，被診斷為思覺失調症，因出現被害妄想，持長棍於住家樓下，對路過行人出現言語恐嚇之行為。經聯絡警消人員送醫後強制住院治療。入病室後病人出現激躁不安、神情緊張、用力拍門及對病友口出威脅的言語，下列何者是醫護人員應立即採取的措施？",{"A":14,"B":15,"C":16,"D":17},"醫護人員勿單獨前去處理病人，召來足夠支援人力","請家屬來院安撫並引導病人","醫護人員站在病人後面，並儘量靠近病人","對病人的要求儘量滿足，避免破壞與病人關係","A",null,[],"本題考點為思覺失調症病人急性激躁時的立即安全處置。考點在於辨識「勿單獨處理、召集足夠支援人力」為首要,故選A。依暴力風險處置原則,面對激躁、具威脅性的病人,確保工作人員與環境安全為第一優先,應召集充足人力再介入,故A正確。B「請家屬來安撫」錯在急性激躁的立即階段不宜倚賴家屬,且緩不濟急、可能增加風險。C「站在病人後面並儘量靠近」錯在應保持安全距離、留在病人視線可及處與逃生動線上,靠近背後易激化並使自身受困。D「儘量滿足病人要求」錯在無條件順從可能強化威脅行為,並非安全介入原則。","急性暴力處置的優先順序:安全第一(人力、距離、動線)→非藥物介入(口語降溫de-escalation、降低刺激)→必要時藥物(鎮靜)→最後才是約束隔離。環境與姿勢原則:保持一個手臂以上距離、不背對或靠病人背後、站在近門與逃生路線側、移除可作為武器的物品、疏散圍觀者。A體現「先確保安全與人力」的黃金原則;C違反距離與動線安全;D的無條件順從與B的倚賴家屬都不符合立即階段的專業處置。此題與下一題(約束隔離)構成連續情境,由「現場安全」延伸到「約束執行細節」。",[24,26,28,30],{"term":25,"count":10},"急性暴力處置",{"term":27,"count":10},"工作人員安全優先",{"term":29,"count":10},"安全距離與逃生動線",{"term":31,"count":10},"口語降溫de-escalation",[33,37,42,47,52,57],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-110-1-psychiatric-community-040","承上題，經醫護人員規勸，病人仍無法控制行為時，需進行身體約束隔離措施，下列敘述何者正確？ ①身體約束目的是由具體的身體控制，以保護病人不傷害自己及他人 ②執行身體約束過程中，無須告知病人執行目的和時間，只要注意約束過程確保人員安全即可 ③執行身體約束隔離時，每 15 分鐘應探視病人，評估生理狀況與需求 ④疏散現場圍觀者",40,{"webId":38,"stem":39,"number":40,"year":9,"session":41},"nurse-110-2-psychiatric-community-056","有關健康促進的概念，下列敘述何者正確？",56,2,{"webId":43,"stem":44,"number":45,"year":46,"session":10},"nurse-111-1-psychiatric-community-070","有關國中學生健康檢查事項之敘述，下列何者正確？",70,111,{"webId":48,"stem":49,"number":50,"year":51,"session":41},"nurse-112-2-psychiatric-community-028","鴉片類的物質其作用越短效，引起的戒斷症狀發作及持續時間的通則為何？",28,112,{"webId":53,"stem":54,"number":41,"year":55,"session":56},"nurse-113-3-psychiatric-community-002","在執行精神病人保護約束時，護理人員告知每 15 分鐘會來探視病人，並確實按時探視，此符合下列那項倫理原則？",113,3,{"webId":58,"stem":59,"number":60,"year":61,"session":56},"nurse-114-3-psychiatric-community-046","有關家庭托顧服務，下列敘述何者最不適當？",46,114,"2026-09-04",1788510722777]