[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-113-1-psychiatric-community-017":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-017","nurse-113-1-psychiatric-community-017",113,1,17,"有關物質使用障礙症成因之敘述，下列何者錯誤？",{"A":14,"B":15,"C":16,"D":17},"成癮物質會直接活化酬償系統，產生愉悅感","同儕互相影響是使用成癮物質的因素之一","家庭功能失調是使用成癮物質的因素之一","與對成癮物質的認知無關，不會想戒除","D",null,[],"本題考點在於物質使用障礙症的多因子成因,辨識錯誤敘述。依 DSM-5 與成癮醫學觀點,物質使用障礙症的診斷準則本身就包含「渴求」與「多次想戒卻失敗」,顯示個案對物質的認知、渴求與戒除意圖是疾病歷程的一部分,D 說「與認知無關、不會想戒除」違反事實,錯誤敘述為 D。A 正確,成癮物質直接活化中腦邊緣多巴胺酬償系統(腹側被蓋區—依核路徑),產生愉悅感並驅動再次使用;B 正確,同儕壓力與模仿是青少年開始用藥的重要社會因素;C 正確,家庭功能失調(衝突、疏離、管教失當)是公認的環境危險因子。","成癮的生物—心理—社會模式:生物面—酬償系統(多巴胺)被物質劫持,長期使用後受體下調,須更大劑量才有同等效果(耐受性),前額葉抑制功能受損使自控力下降;心理面—低自尊、逃避負面情緒、對物質效果的期待認知;社會面—同儕影響、家庭失功能、物質可近性。重要觀念:多數成癮者反覆經歷「想戒—復發」循環,DSM-5 準則第 2 條即「持續想要戒除或控制使用但不成功」,故任何「成癮者不想戒」的敘述都是錯的。跨理論模式(改變階段:懵懂期→沉思期→準備期→行動期→維持期)是評估戒癮動機的護理工具。",[24,27,29,31],{"term":25,"count":26},"生物心理社會模式",3,{"term":28,"count":10},"物質使用障礙症 DSM-5 準則",{"term":30,"count":10},"中腦邊緣多巴胺酬償系統",{"term":32,"count":10},"改變階段理論",[34,38,42,48,53,58],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-113-1-psychiatric-community-018","廖奶奶，84歲，獨居，三個月前經歷結縭60年的老伴過世，面帶愁容、不與人打招呼。廖奶奶向女兒表示自己不想再吃藥了，活著沒有意思。評估廖奶奶的精神健康狀況後，下列何者應為最優先的護理處置？",18,{"webId":39,"stem":40,"number":41,"year":9,"session":26},"nurse-113-3-psychiatric-community-014","王女士，遭遇嚴重土石流而家園全毀，倖存後診斷為創傷後壓力症（posttraumatic stress disorder），下列敘述何者最不適切？",14,{"webId":43,"stem":44,"number":45,"year":46,"session":47},"nurse-114-2-psychiatric-community-008","關於團體療效因子「凝聚力」的敘述，下列何者正確？",8,114,2,{"webId":49,"stem":50,"number":51,"year":52,"session":10},"nurse-106-1-psychiatric-community-006","臨床上發現病人有問題行為而需進行行為治療時，護理師在評估病人的問題行為時，應主要觀察的內容，下列何項正確？①在何種情況下（行為前情境）②病人出現何種行為 ③家人的感受 ④行為之後產生什麼結果",6,106,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-107-1-psychiatric-community-050","骨質疏鬆的危險因子，下列何者錯誤？",50,107,{"webId":59,"stem":60,"number":61,"year":62,"session":10},"nurse-109-1-psychiatric-community-004","護理師在精神科病房帶領團體治療，鼓勵病人與他人分享生病感受，並在團體中表示感謝其他病人對他的包容、接納與信任，此活動運用下列何項精神護理概念模式？",4,109,"2026-09-04",1788510751188]