[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-111-2-psychiatric-community-019":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"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":26},"nurse-111-2-精神科與社區衛生護理學-019","nurse-111-2-psychiatric-community-019",111,2,19,"王小姐，與男朋友分手後，出現被跟蹤的感覺，身邊沒有人時卻聽到有人跟她說話，害怕到無法外出工作，且上述症狀持續 1 個月以上。依據 DSM-5 診斷準則，下列何者是王小姐最可能的診斷？",{"A":14,"B":15,"C":16,"D":17},"重度憂鬱症（major depressive disorder）","創傷後壓力症（posttraumatic stress disorder）","思覺失調症（schizophrenia）","強迫症（obsessive-compulsive disorder）","C",null,[],"本題考點是 DSM-5 精神病性症狀的鑑別診斷。個案出現被跟蹤感(被害妄想)與無人時聽見人聲(聽幻覺),符合 DSM-5 思覺失調症準則 A 的活躍期症狀(妄想、幻覺),且症狀持續 1 個月以上、已造成無法外出工作的功能減損,四個選項中以思覺失調症最符合,故選 C。A 重度憂鬱症核心是情緒低落與失去興趣,個案未呈現此主軸。B 創傷後壓力症準則 A 須暴露於死亡、重傷或性暴力等創傷事件,分手不符合此準則。D 強迫症核心是強迫思考與強迫行為,與妄想、幻覺不同。須說明:嚴格依 DSM-5,思覺失調症總病程須達 6 個月,題幹僅述 1 個月以上,但在給定選項中 C 仍是最可能診斷。","DSM-5 精神病性疾患病程鑑別口訣:「短暫 1 個月內、類思覺 1~6 個月、思覺失調 6 個月以上」——短暫精神病症(brief psychotic disorder)症狀 1 天至 1 個月;類思覺失調症(schizophreniform disorder)1 至 6 個月;思覺失調症活躍期症狀至少 1 個月且總病程含前驅期達 6 個月。準則 A 五大症狀:妄想、幻覺、混亂言語、混亂或僵直行為、負性症狀,須至少兩項且其一為前三者。本題若選項含類思覺失調症會更貼合病程敘述,考生記住病程切點即可應對變化題。",[24,27,29,31],{"term":25,"count":26},"DSM-5 思覺失調症診斷準則",1,{"term":28,"count":26},"妄想與幻覺",{"term":30,"count":26},"精神病性疾患病程鑑別",{"term":32,"count":26},"PTSD 創傷暴露準則",[34,38,43,47,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-111-2-psychiatric-community-020","林小姐，15 歲，診斷為思覺失調症，多次因和母親的男朋友有爭執，出現幻聽。下列何者居家護理措施最適當？",20,{"webId":39,"stem":40,"number":41,"year":42,"session":26},"nurse-112-1-psychiatric-community-036","在急診室有關藥物使用障礙症（藥物成癮）最常見的問題，下列敘述何者錯誤？",36,112,{"webId":44,"stem":45,"number":46,"year":42,"session":10},"nurse-112-2-psychiatric-community-050","關於個案對照研究法（case-control study）何者正確？",50,{"webId":48,"stem":49,"number":50,"year":51,"session":52},"nurse-113-3-psychiatric-community-018","有關自閉症類群障礙症（autism spectrum disorder）的描述，下列何者正確？",18,113,3,{"webId":54,"stem":55,"number":56,"year":57,"session":26},"nurse-115-1-psychiatric-community-022","承上題，有關身體約束的相關護理措施，下列敘述何者正確？",22,115,{"webId":59,"stem":60,"number":41,"year":61,"session":10},"nurse-106-2-psychiatric-community-036","王先生 44 歲，原於山上種植咖啡，去年遭受嚴重風災導致咖啡園全毀及妻子去世之雙重打擊，下列何者為首要的照護措拖？",106,"2026-09-04",1788510739884]