[{"data":1,"prerenderedAt":66},["ShallowReactive",2],{"q-nurse-111-1-psychiatric-community-017":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"lastmod":65},"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-111-1-精神科與社區衛生護理學-017","nurse-111-1-psychiatric-community-017",111,1,17,"黃先生，診斷為思覺失調症（Schizophrenia），規則服藥，在社區復健機構接受治療時，被一位女性踩到腳，他認為自己是病人，又沒結婚，那位女性才會故意踩他的腳。下列何項護理措施最適當？",{"A":14,"B":15,"C":16,"D":17},"病人有被害妄想，建議調藥","同理病人並討論對應方法","解釋那位女性不是故意行為","提醒病人走路要注意","B",null,[],"本題考點為思覺失調症被害妄想病人的溝通處置。病人將被踩到腳解讀為對方故意針對，屬被害妄想的關係意念；治療性回應應以同理病人的感受為基礎、不直接否定妄想，再與其討論可行的因應方法，故選 B。A 錯，病人規則服藥、屬單一情境的認知扭曲，遽以「被害妄想」為由建議調藥過度且非首要。C 錯，直接解釋對方非故意等於正面否定妄想，易引發防衛與對立、破壞關係。D 錯，僅提醒走路注意迴避了病人真正的情緒與想法，未觸及核心也無助於現實感建立。","面對妄想的溝通原則是「不爭辯、不附和」：既不與病人辯論妄想的真偽（會強化防衛），也不假意認同（會強化妄想），而是同理其伴隨的情緒（害怕、被威脅感），並將焦點引導回現實層面與因應策略。可運用反映情緒、提出懷疑等技巧，逐步協助檢視想法。此類關係意念常見於思覺失調症，處置著重維持治療關係與現實導向。可連結被害妄想、關係意念與治療性溝通中「表達同理、聚焦現實」的原則。記憶重點：先接住情緒，再談方法，不正面拆穿也不隨之起舞。",[24,27,29,32,34],{"term":25,"count":26},"治療性溝通",46,{"term":28,"count":11},"思覺失調症",{"term":30,"count":31},"被害妄想",10,{"term":33,"count":10},"同理情緒",{"term":35,"count":10},"不爭辯不附和",[37,41,46,51,56,61],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-111-1-psychiatric-community-018","有關思覺失調症（Schizophrenia）病程進展的描述，下列何者最適當？",18,{"webId":42,"stem":43,"number":44,"year":9,"session":45},"nurse-111-2-psychiatric-community-034","有關社區心理衛生的敘述，下列何者最適當？",34,2,{"webId":47,"stem":48,"number":49,"year":50,"session":10},"nurse-112-1-psychiatric-community-048","下列那一階段的疾病自然史，最能透過篩檢早期發現身體病理變化？",48,112,{"webId":52,"stem":53,"number":54,"year":55,"session":10},"nurse-113-1-psychiatric-community-036","平安社區老年人口逐年增加，里長規劃安全的健走步道，並在公園內增設運動器材且定期維護確保安全性。根據社會生態模式，是屬於何項因素之介入措施？",36,113,{"webId":57,"stem":58,"number":59,"year":60,"session":45},"nurse-114-2-psychiatric-community-040","民眾因不確定帶狀疱疹疫苗是否可有效預防其染病，故未施打疫苗。此敘述是屬於健康信念模式（Health Belief Model）中之何種概念？",40,114,{"webId":62,"stem":63,"number":44,"year":64,"session":10},"nurse-106-1-psychiatric-community-034","有關精神病人居家照護服務，下列何者正確？",106,"2026-09-04",1788510736275]