[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-113-1-psychiatric-community-018":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":33,"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-113-1-精神科與社區衛生護理學-018","nurse-113-1-psychiatric-community-018",113,1,18,"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？",{"A":14,"B":15,"C":16,"D":17},"了解廖奶奶對於伴侶離世的內心感受，協助抒發與轉移注意","進一步評估廖奶奶的自殺意念與計畫，防範自殺危險","陪伴廖奶奶透過緬懷過往記憶，重新找到價值與存活意義","儘快安排廖奶奶入住護理之家，提供緊急密切的生理照護","B",null,[],"本題考點在於老年喪偶憂鬱個案的自殺危險評估優先性。依自殺防治原則與馬斯洛需求層級,安全需求優先於心理社會層面介入;廖奶奶具多重自殺高危險因子(高齡、獨居、近期喪偶、憂鬱表現),且已說出「不想再吃藥、活著沒有意思」的消極意念,此時最優先是直接評估其自殺意念強度與具體計畫,以防範立即危險,故選 B。A 了解感受、協助抒發屬支持性會談,重要但須在確認安全之後;C 緬懷治療(懷舊治療)適合穩定期提升生命意義,非危機當下首務;D 逕自安排入住護理之家未經評估也未處理自殺風險,且剝奪個案自主決定權。","老人自殺危險因子口訣「獨、病、喪、鬱、男」:獨居、慢性病、喪偶(尤其一年內)、憂鬱症、老年男性(致死率最高)。自殺評估層次:意念(ideation)→計畫(plan)→工具可近性(means)→過去企圖史,愈往後危險性愈高;「不想活」的語句是求助訊號,直接、開放地詢問自殺想法不會誘發自殺,反而是評估與建立關係的關鍵。危機處理排序原則:國考遇到「最優先」,先掃「生命安全>生理>心理>社會靈性」。延伸:喪親之慟與鬱症的鑑別(DSM-5 已移除喪慟排除條款),持續性複雜喪慟障礙為 ICD-11 新診斷。",[24,27,29,31],{"term":25,"count":26},"自殺危險評估",6,{"term":28,"count":10},"老人自殺危險因子",{"term":30,"count":10},"馬斯洛需求層級與護理優先順序",{"term":32,"count":10},"喪慟反應",[34,38,43,49,54,59],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-113-1-psychiatric-community-019","承上題，廖奶奶經醫師建議入院治療，有關各項治療的敘述，下列何者最適當？",19,{"webId":39,"stem":40,"number":41,"year":9,"session":42},"nurse-113-3-psychiatric-community-015","畏避型人格障礙症（avoidant personality disorder）臨床特徵的敘述，下列何者最適切？",15,3,{"webId":44,"stem":45,"number":46,"year":47,"session":48},"nurse-114-2-psychiatric-community-009","有關 Caplan 的危機理論，下列敘述何者最適當？",9,114,2,{"webId":50,"stem":51,"number":52,"year":53,"session":10},"nurse-106-1-psychiatric-community-007","會談中護理師說：「你有什麼事想告訴我？」「我們從那兒談起？」這屬於治療性溝通中的何種技巧？",7,106,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-107-1-psychiatric-community-051","實證研究結果發現母乳哺餵對母嬰健康有多重益處，世界衛生組織設定 2025 年 6 個月以下純母乳哺育率目標為何？",51,107,{"webId":60,"stem":61,"number":62,"year":63,"session":10},"nurse-109-1-psychiatric-community-005","林先生，診斷思覺失調症，表情緊張地對護理師說：「我都沒跟別人說話，但是別人都可以知道我在想什麼，知道我所有的秘密。」林先生的描述最符合下列那個症狀？",5,109,"2026-09-04",1788510751209]