[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-113-2-psychiatric-community-016":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":34,"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-113-2-精神科與社區衛生護理學-016","nurse-113-2-psychiatric-community-016",113,2,16,"蕭小姐，46 歲，育有二子，因先生外遇，最近離婚後獨居，整日鬱鬱寡歡沉默不語，近日突出現語言障礙，發聲困難及奇異步態，影響日常作息，住院後神經學檢查無異常，下列護理措施何者最適切？",{"A":14,"B":15,"C":16,"D":17},"簡單環境介紹，不須過度詳細說明，以免增加蕭小姐負擔","協助蕭小姐改善身體不適、促進舒適，與其建立信任感為首要護理措施","首先應立即依據神經學檢查報告予以面質蕭小姐，促進面對問題進行心理治療","宜暗示檢查結果並不是百分之百正確，建議蕭小姐宜有更進一步檢查","B",null,[],"本題考點在於轉化症(conversion disorder)的護理處置。個案在心理壓力(離婚、獨居)後出現語言障礙、發聲困難與奇異步態,神經學檢查卻無異常,符合轉化症:心理衝突轉化為身體症狀且非病人偽裝。B 正確:協助改善身體不適、促進舒適並建立信任關係為首要護理措施,故為最適切、即答案。A「不須詳細說明以免增加負擔」低估病人、態度消極,並不恰當。C「立即依檢查報告面質病人」屬直接對質,會破壞信任並增加防衛,轉化症症狀非病人有意造成,面質無益。D「暗示檢查不準、建議再檢查」會強化病人對身體疾病的關注、延誤心理處理。考點在於轉化症以建立信任、接納症狀真實性、避免面質為原則。","轉化症的症狀是無意識產生、病人真實感受到失能,並非詐病(malingering)或做作症(factitious)。護理原則:不強化也不否定症狀、避免過度關注身體症狀而增強次級獲益(secondary gain)、建立信任後引導覺察情緒與壓力源。面質與暗示皆屬禁忌。記憶:轉化症症狀是真的、心因性的,先接納建立關係,別戳破也別過度聚焦。",[24,27,29,32],{"term":25,"count":26},"轉化症",3,{"term":28,"count":26},"次級獲益",{"term":30,"count":31},"心因性症狀",1,{"term":33,"count":31},"避免面質",[35,39,44,48,53,58],{"webId":36,"stem":37,"number":38,"year":9,"session":10},"nurse-113-2-psychiatric-community-017","林小姐，為重大火車出軌事件的倖存者，診斷為創傷後壓力症（posttraumatic stress disorder），下列敘述何者最不適切？",17,{"webId":40,"stem":41,"number":42,"year":43,"session":31},"nurse-114-1-psychiatric-community-013","承上題，住院第二天，陳同學表示我的父母一定是假的，否則不會將自己的小孩抓來住院。下列護理師的回答何者最適當？",13,114,{"webId":45,"stem":46,"number":47,"year":43,"session":26},"nurse-114-3-psychiatric-community-007","關於同理心，下列敘述何者最適當？",7,{"webId":49,"stem":50,"number":51,"year":52,"session":31},"nurse-106-1-psychiatric-community-055","有關世界衛生組織（WHO）的描述，下列何者錯誤？",55,106,{"webId":54,"stem":55,"number":56,"year":57,"session":10},"nurse-107-2-psychiatric-community-019","王同學，20 歲，上課時突然站起毆打鄰座同學，表示同學說他壞話，但同學否認，於是班導師將其轉介到心輔室，一星期後又出現攻擊室友的情形，造成室友受傷而報警處理，因王同學當時情緒非常激動，警察將之制伏後送至急診處理，經家屬同意轉至精神科病房接受治療，王同學頻頻詢問這是何處，環伺四周，神情嚴肅，警戒心高，對問話回應簡短，下列護理措施那項最適當？",19,107,{"webId":59,"stem":60,"number":61,"year":62,"session":31},"nurse-109-1-psychiatric-community-053","護理師執行社區均衡飲食計畫，下列何者為行為目標的效果評價？",53,109,"2026-09-04",1788510755905]