[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-113-1-psychiatric-community-016":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-113-1-精神科與社區衛生護理學-016","nurse-113-1-psychiatric-community-016",113,1,16,"李同學，12歲，對無法停止洗手行為，感到情緒低落並無自信，導致每次不停的洗手，即使手已經破皮仍繼續洗手。護理師建議李同學藉由玩自己最喜歡的小小兵玩具轉移注意力並練習不繼續洗手。此種照護處置是應用下列何種治療技巧？",{"A":14,"B":15,"C":16,"D":17},"沙箱療法（sand body therapy）","非指引性治療（non-directive play）","暴露與反應阻止法（exposure and response prevention）","生理回饋（bio-feedback）","C",null,[],"本題考點在於強迫症行為治療技巧的辨識。依行為治療理論,暴露與反應阻止法(ERP)是讓個案暴露於引發焦慮的情境(手接觸「髒」的感覺、焦慮升起),同時阻止其執行強迫行為(不繼續洗手),並以替代活動(玩喜歡的小小兵玩具轉移注意)協助耐受焦慮,直到焦慮自然消退,本題處置正是「練習不洗手+轉移注意」的反應阻止設計,故選 C。A 沙箱(沙遊)療法是透過沙盤與小物件投射內在世界的表達性治療,與阻止洗手無關;B 非指引性遊戲治療強調治療者不主導、由兒童自由表達,本題護理師明確指導策略,並非非指引性;D 生理回饋是藉儀器監測生理訊號(如肌電、心率)學習自我調控,題中無任何儀器監測。","ERP 的理論基礎是古典制約的消弱(extinction)與習慣化(habituation):強迫行為之所以維持,是因為它短暫降低焦慮而被負增強;若暴露於焦慮情境卻不執行儀式行為,個案會體驗到「焦慮不靠洗手也會自己下降」,制約連結逐漸消弱。ERP 是強迫症心理治療的第一線、實證等級最高的方法,常與 SSRI 併用。執行原則:焦慮階層由低到高漸進暴露、阻止反應期間可用替代活動協助耐受但不可變成新的儀式。對比記憶:系統減敏感法=暴露+放鬆(用於畏懼症);ERP=暴露+不准做儀式(用於強迫症)。",[24,27,29,31],{"term":25,"count":26},"強迫症行為治療",2,{"term":28,"count":10},"暴露與反應阻止法(ERP)",{"term":30,"count":10},"負增強與強迫行為維持",{"term":32,"count":10},"消弱與習慣化",[34,38,43,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-113-1-psychiatric-community-017","有關物質使用障礙症成因之敘述，下列何者錯誤？",17,{"webId":39,"stem":40,"number":41,"year":9,"session":42},"nurse-113-3-psychiatric-community-013","有關疾病與核心症狀配對的描述，下列何者最適切？",13,3,{"webId":44,"stem":45,"number":46,"year":47,"session":26},"nurse-114-2-psychiatric-community-007","關於理情治療（rational emotive therapy）的論點，下列敘述何者正確？",7,114,{"webId":49,"stem":50,"number":51,"year":52,"session":10},"nurse-106-1-psychiatric-community-005","謝先生因思覺失調症（schizophrenia）住院，在許護理師上班時經常對她出現吵鬧、依賴或討好等行為，許護理師了解這是謝先生對自己的情感轉移，進而提供適當的護理措施，下列何者最不適宜？",5,106,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-107-1-psychiatric-community-049","規律且正確的運動對糖尿病個案的益處，下列何者錯誤？",49,107,{"webId":59,"stem":60,"number":42,"year":61,"session":10},"nurse-109-1-psychiatric-community-003","對於急性期症狀穩定，將出院的精神病人，其出院護理計畫的內容，包括下列何者為宜？①教導壓力調適策略 ②建議可依症狀自行調藥 ③提供健康指導與諮詢 ④討論緩解藥物副作用的方法",109,"2026-09-04",1788510751185]