[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-111-2-psychiatric-community-032":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":36,"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-111-2-精神科與社區衛生護理學-032","nurse-111-2-psychiatric-community-032",111,2,32,"有關老年精神病人的藥物治療，下列敘述何者最適當？",{"A":14,"B":15,"C":16,"D":17},"第二代抗精神病藥物較第一代藥物不會引發老年人的錐體外徑症候群","使用三環抗憂鬱劑治療老人憂鬱症，較不會出現心血管方面的副作用","情緒穩定劑有嚴重的副作用，不建議老年躁症病人使用","老年病人使用抗精神病藥物，應從高劑量開始，以增加藥物療效","A",null,[],"本題考點是老年精神病人的藥物治療原則。依抗精神病藥物藥理分類,第二代(非典型)抗精神病藥物對多巴胺 D2 受體的阻斷較弱並兼具血清素 5-HT2A 拮抗作用,引發錐體外徑症候群(EPS)的風險低於第一代藥物,對 EPS 敏感的老年人相對安全,故 A 正確。B 錯在三環抗憂鬱劑(TCA)具抗膽鹼作用與心臟毒性,易致姿勢性低血壓、心律不整,老年人心血管副作用風險反而高。C 錯在情緒穩定劑(如鋰鹽)老年躁症病人仍可使用,僅需降低劑量並密切監測血中濃度,並非不建議使用。D 錯在老年人藥物代謝與排除功能下降,給藥原則是「低劑量開始、緩慢調升(start low, go slow)」,從高劑量開始會增加中毒風險。","老年精神藥物學核心:老化使肝代謝、腎排除下降、體脂比例上升(脂溶性藥物半衰期延長)、血腦障壁通透性增加,故同劑量血中濃度更高、副作用更明顯。TCA 在老人的三大風險:抗膽鹼(口乾、便祕、尿滯留、認知惡化)、姿勢性低血壓(跌倒)、心臟傳導異常,因此老人憂鬱症首選 SSRI。鋰鹽治療濃度區間窄(0.6~1.2 mEq\u002FL),老人腎功能下降易蓄積,須降低目標濃度並定期監測。EPS 對照:第一代高效價藥(如 haloperidol)EPS 最強,第二代以 clozapine、quetiapine EPS 最低。",[24,27,30,32,34],{"term":25,"count":26},"錐體外徑症候群",3,{"term":28,"count":29},"第二代抗精神病藥物藥理",1,{"term":31,"count":29},"三環抗憂鬱劑心血管副作用",{"term":33,"count":29},"老年給藥原則 start low go slow",{"term":35,"count":29},"鋰鹽治療濃度監測",[37,41,46,50,55,60],{"webId":38,"stem":39,"number":40,"year":9,"session":10},"nurse-111-2-psychiatric-community-033","慢性思覺失調症病人，於急性病房出院後，轉介至社區復健中心接受工作技能訓練。以三級預防概念來看，「社區復健中心」是屬於何種層級的預防性服務範疇？",33,{"webId":42,"stem":43,"number":44,"year":45,"session":29},"nurse-112-1-psychiatric-community-049","某研究欲探討過去 5 年暴露於空氣污染的環境與肺癌之關係，收集 1,000 位肺癌及 1,000 位無肺癌個案進行分析，這是屬於下列何種研究方法？",49,112,{"webId":47,"stem":48,"number":49,"year":45,"session":10},"nurse-112-2-psychiatric-community-063","家訪時個案家庭圈如圖示，下列敘述何者較適當？①所繪的家庭圈必須是和家人商議後的結果 ②家庭圈會隨時間變動 ③在個案的心中，自己和妻子在家中的付出最多 ④個案在家中和妻子的關係最親近 ⑤次子在家中的權力小於長子",63,{"webId":51,"stem":52,"number":53,"year":54,"session":26},"nurse-113-3-psychiatric-community-031","護理師擬定代謝症候群防治計畫，下列何者最符合目標（objective）訂定原則？",31,113,{"webId":56,"stem":57,"number":58,"year":59,"session":29},"nurse-115-1-psychiatric-community-035","護理師在沙塵暴季節針對氣喘病人的護理指導，下列何項較不適當？",35,115,{"webId":61,"stem":62,"number":44,"year":63,"session":10},"nurse-106-2-psychiatric-community-049","根據行政院環境保護署的定義，酸雨指的是雨水酸鹼值（pH）低於多少？",106,"2026-09-04",1788510740023]