[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-113-1-psychiatric-community-006":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"lastmod":63},"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-113-1-精神科與社區衛生護理學-006","nurse-113-1-psychiatric-community-006",113,1,6,"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？",{"A":14,"B":15,"C":16,"D":17},"不給與紙張，強迫他適應觸摸門把","向他解說，拿紙張是不必要的","要他負責清洗病房的門把","提供他紙張，直到他的焦慮減輕","D",null,[],"本題考點在於強迫症急性期的護理原則。依焦慮理論,強迫行為是個案用來緩解焦慮的防衛方式,急性期若強行剝奪儀式行為,焦慮會急遽升高甚至崩潰,故此階段應先接納並容許其強迫行為,提供紙張直到焦慮減輕,再逐步協助建立替代因應,選 D。A 強迫他直接觸摸門把等於粗暴剝奪防衛機轉,會使焦慮爆表;B 用說理否定其行為,強迫症病人明知不合理仍無法控制,解說無效且易增加羞愧感;C 要他負責清洗門把是懲罰性作法,違反治療性人際關係的接納原則。","強迫症(OCD)的核心病理是「強迫思考引發焦慮 → 強迫行為暫時降低焦慮」的惡性循環,行為本身是自我(ego)對抗焦慮的手段。護理分期原則:急性期「接納、不批判、容許儀式行為、保留足夠時間完成」;穩定期才逐步限制(如延遲、縮短儀式時間)並導入行為治療(暴露與反應阻止法 ERP)。記憶口訣:「先接住焦慮,再拆儀式」。相關概念可延伸:防衛機轉中的解除(undoing)與隔離(isolation)是 OCD 常用機轉;第一線藥物為 SSRI。",[24,27,29,31],{"term":25,"count":26},"防衛機轉",8,{"term":28,"count":10},"強迫症護理原則",{"term":30,"count":10},"焦慮與強迫行為的關係",{"term":32,"count":10},"治療性人際關係的接納原則",[34,38,42,47,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-113-1-psychiatric-community-007","有關日落症候群（sundown syndrome）較常見於何種疾患？",7,{"webId":39,"stem":40,"number":41,"year":9,"session":41},"nurse-113-3-psychiatric-community-003","王先生罹患慢性思覺失調症，精神症狀穩定，但局部功能退化，具有復健潛能，需積極復健治療，下列安排何者最適合？",3,{"webId":43,"stem":44,"number":45,"year":46,"session":10},"nurse-114-1-psychiatric-community-047","85歲方奶奶獨居，巴氏量表評估為65分，目前無法自行洗澡和備餐，需有社區志工陪同就醫。若要申請長期照顧服務項目，何項最合適？",47,114,{"webId":48,"stem":49,"number":50,"year":51,"session":52},"nurse-115-2-psychiatric-community-045","從事玻璃成型工作者，最常造成下列那一種職業病？",45,115,2,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-107-1-psychiatric-community-039","王先生不確定是否為精神科病人，因為在街頭揮舞水果刀，被居民合力帶至醫院急診室求治，王先生見到精神科醫師，仍拿著水果刀對醫師表示：「你若敢動我，我就告你侵犯人身自由，我又沒怎樣，我只是在運動」，此時急診護理師採取的措施，下列何項最適切？",39,107,{"webId":59,"stem":60,"number":61,"year":62,"session":52},"nurse-108-2-psychiatric-community-073","我國勞動基準法為保障在職婦女能持續哺餵母乳，除規定之休息時間外，雇主應每日另給哺乳之次數與時間為何？",73,108,"2026-09-04",1788510751110]