[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-112-2-psychiatric-community-039":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"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-112-2-精神科與社區衛生護理學-039","nurse-112-2-psychiatric-community-039",112,2,39,"王先生，診斷為思覺失調症，使用抗精神病藥物 clozapine（Clozaril ® ），用藥前體重、血壓及空腹血糖在正常範圍，第 8 週時體重上升 10%，第 12 週時血糖驗出 130 mg\u002FdL，目前精神症狀及認知功能明顯改善，且已回到職場。下列敘述何者最適切？",{"A":14,"B":15,"C":16,"D":17},"病人服用 clozapine 時，出現血糖高，不需過度緊張，也不需再追蹤處理","造成病人血糖高的因素與其年齡、運動程度、家族史有關，與藥物無關","clozapine 屬於第一代抗精神病藥物，導致代謝症候群的可能性低","病人精神症狀及認知功能已經改善，雖出現血糖問題，不宜驟然停藥","D",null,[],"本題考點是 clozapine 的代謝副作用與用藥決策，最適切者為 D。王先生精神症狀與認知功能明顯改善且已重返職場，療效顯著，雖出現體重上升與血糖升高等代謝問題，也不宜驟然停藥，而應在監測與處置代謝風險下續用，故 D 正確為正解。A 錯，血糖升高需追蹤與處理，不可輕忽。B 錯，clozapine 本身即會引起體重增加、血糖與血脂異常等代謝症候群，說「與藥物無關」錯誤。C 錯，clozapine 屬第二代（非典型）抗精神病藥物，且是引起代謝症候群風險最高者之一，並非第一代、風險低。考點在於辨識「clozapine 療效佳但代謝副作用高，應監測續用而非驟停」。","clozapine 是難治型思覺失調症的首選，療效卓越但副作用需嚴密監測，最嚴重者為顆粒性白血球缺乏（agranulocytosis），須定期驗全血球計數；代謝方面則易致體重增加、高血糖、高血脂。突然停用抗精神病藥可能導致症狀急性復發，故有效藥物應在管理副作用的前提下維持。記憶要點：clozadine 效果好但要顧白血球與代謝，別亂停。可延伸連結非典型抗精神病藥代謝症候群、白血球監測與難治型思覺失調症治療。",[24,27,29,32],{"term":25,"count":26},"代謝症候群",8,{"term":28,"count":10},"顆粒性白血球缺乏",{"term":30,"count":31},"clozapine(第二代抗精神病藥)",1,{"term":33,"count":31},"驟停復發風險",[35,39,44,48,54,59],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-112-2-psychiatric-community-040","承上題，王先生服用 clozapine 藥物時，下列何者為首要健康風險控制預防措施？",40,{"webId":40,"stem":41,"number":42,"year":43,"session":31},"nurse-113-1-psychiatric-community-006","汪小姐剛入住急性精神科病房，覺得門把骯髒，都使用紙張包覆才願意轉動把手，下列何項護理措施最適宜？",6,113,{"webId":45,"stem":46,"number":47,"year":43,"session":10},"nurse-113-2-psychiatric-community-050","社區護理師進行居家訪視為張先生測量血壓，血壓值為 190\u002F98 mmHg，張先生表示頭痛、視力模糊，下列護理處置何者最適當？",50,{"webId":49,"stem":50,"number":51,"year":52,"session":53},"nurse-114-3-psychiatric-community-048","根據長期照顧十年計畫 2.0，有關喘息服務，下列敘述何者最不適當？",48,114,3,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-106-2-psychiatric-community-022","長期大量使用某種物質，在停用或減用後，會出現渴藥、不安、流淚、發汗、瞳孔放大、虛弱無力、噁心、腹痛、骨頭酸痛、失眠等，最可能是下列何種濫用物質的戒斷反應？",22,106,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-107-2-psychiatric-community-056","住護理之家的朱老先生，最近護理師發現他手指縫出現抓痕、紅斑，經醫師診斷為疥瘡，治療中。下列有關疥瘡之描述，何者正確？①常見於人口密集機構 ②疥蟲在皮膚表面挖出隧道產卵 ③只要 40 度高溫即可殺死疥蟲 ④照顧者常接觸，只要勤清潔不需要一同治療 ⑤常見於白天劇烈搔癢",56,107,"2026-09-04",1788510749001]