[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-113-1-psychiatric-community-025":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-025","nurse-113-1-psychiatric-community-025",113,1,25,"吳先生，因住院期間多次企圖割腕自殺，必須採取保護約束之措施。有關約束處置之敘述，下列何者最不適當？",{"A":14,"B":15,"C":16,"D":17},"需有醫師開立醫囑，才能給予約束","至少每15分鐘探視病人一次","每2小時評估病人是否可以解除保護約束","應持續約束病人，直到自殺意念消失","D",null,[],"本題考點在於保護約束的正確執行原則,辨識不當敘述。依精神衛生法與身體約束照護規範,約束是「不得已的最後手段」,須以最小限制、最短時間為原則,達到目的(急性危險解除)即應儘早解除;「持續約束直到自殺意念消失」錯誤,因自殺意念可能持續數週甚至更久,以意念消失為解除條件等於長期拘束,嚴重侵害人身自由並增加合併症(循環障礙、壓傷、吸入性肺炎)風險,故最不適當為 D。A 正確,約束屬醫療處置,須有醫師醫囑(緊急時可先執行後補醫囑);B 正確,約束期間至少每 15 分鐘觀察一次病人狀況與肢體循環;C 正確,應定時(如每 2 小時)重新評估約束必要性並鬆綁活動肢體。","保護約束執行要點總整理:(1)適應症:自傷、傷人之立即危險,且其他替代方法無效;(2)法源與醫囑:精神衛生法規定拘束身體須遵醫囑並記載,不得逾必要時間;(3)執行:向病人與家屬說明、使用合格約束帶、肢體保持功能位置、約束帶與皮膚間留 1–2 指寬;(4)監測:每 15 分鐘觀察意識、肢端循環(顏色、溫度、脈搏)、皮膚完整性;每 2 小時鬆綁活動關節、評估解除可能、協助如廁與翻身;(5)解除標準:危險行為緩解、能遵從指示、與醫療團隊達成行為約定——而非「意念完全消失」。約束是控制「行為危險」的暫時措施,意念的處理靠治療性關係、藥物與持續觀察。",[24,27,29,31],{"term":25,"count":26},"最小限制原則",12,{"term":28,"count":10},"保護約束執行原則",{"term":30,"count":10},"精神衛生法身體拘束規範",{"term":32,"count":10},"約束合併症預防",[34,38,43,49,54,59],{"webId":35,"stem":36,"number":37,"year":9,"session":10},"nurse-113-1-psychiatric-community-026","有關基層醫療保健之社區與醫療服務原則，下列何者最不適當？",26,{"webId":39,"stem":40,"number":41,"year":9,"session":42},"nurse-113-3-psychiatric-community-022","下列對於社區精神心理衛生服務系統的敘述何者正確？",22,3,{"webId":44,"stem":45,"number":46,"year":47,"session":48},"nurse-114-2-psychiatric-community-016","李同學對於成績表現非常在意，在考試時手能握筆但突然無法寫字，被送來急診，經神經內科檢查手部功能正常，李同學的臨床表徵最符合下列何項診斷？",16,114,2,{"webId":50,"stem":51,"number":52,"year":53,"session":10},"nurse-106-1-psychiatric-community-014","護理師評值治療過程及目標的完成，並與病人分享彼此對關係結束的感覺，是屬於治療性人際關係過程中那一期的任務？",14,106,{"webId":55,"stem":56,"number":57,"year":58,"session":10},"nurse-107-1-psychiatric-community-058","有關腸病毒之描述，下列何者正確？",58,107,{"webId":60,"stem":61,"number":26,"year":62,"session":10},"nurse-109-1-psychiatric-community-012","有關行為治療的「逐步養成法（shaping）」之敘述，下列何者最適切？",109,"2026-09-04",1788510751268]