[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-114-3-psychiatric-community-050":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-114-3-精神科與社區衛生護理學-050","nurse-114-3-psychiatric-community-050",114,3,50,"下列那一種慢性病個案最需持續管理？",{"A":14,"B":15,"C":16,"D":17},"血糖於連續三次訪視皆在正常值的第二型糖尿病人","每日家屬都能監督服藥與測量血壓的高血壓病人","血糖不穩又不遵從服藥的糖尿病病人","已完成治療的乳癌病人","C",null,[],"本題考點在於社區慢性病個案管理的優先順序判定。依個案管理(case management)原則,資源應優先投入「病情控制不佳且自我照顧或遵從行為有問題」的高風險個案,因為這類個案併發症風險最高、最能從持續追蹤與介入獲益。C 的糖尿病病人血糖不穩又不遵從服藥,同時存在生理指標失控與遵從性問題,屬高風險族群,最需列入持續管理,故選 C。A 錯在血糖連續三次訪視皆正常,控制良好,可降級為定期追蹤即可;B 錯在有家屬每日監督服藥與量血壓,自我管理支持系統健全,非優先對象;D 錯在乳癌已完成治療,屬康復期定期追蹤個案,不屬於需高強度持續管理的失控慢性病個案。","社區個案管理的核心概念是「風險分層」(risk stratification):將個案依病情穩定度與自我管理能力分層,高風險者密集管理、中風險者定期追蹤、低風險者衛教維持,對應公共衛生三段五級中的第二、三段預防資源配置。判斷「誰最需要管理」可抓兩軸:一看「疾病控制指標」(血糖、血壓是否達標),二看「遵從行為與支持系統」(服藥遵從性、家庭支持),兩軸皆差者優先——C 正是兩軸皆差的典型。此邏輯同樣適用於結核病都治計畫(DOTS)優先收案、高血壓與糖尿病共同照護網的分級管理等考點。對比記憶:控制好+支持好=維持;控制好或支持好其一=追蹤;控制差+遵從差=積極個案管理。",[24,27,30,32],{"term":25,"count":26},"服藥遵從性",5,{"term":28,"count":29},"個案管理(case management)",1,{"term":31,"count":29},"風險分層",{"term":33,"count":29},"三段五級預防資源配置",[35,39,44,49,54,59],{"webId":36,"stem":37,"number":29,"year":38,"session":29},"nurse-115-1-psychiatric-community-001","吳小姐，24歲，碩士生，單親家庭，因應疫情返家遠距學習，在家期間與母親朝夕相處備感壓力。返診時對護理師說:「我坐在房間窗邊會想，如果跳下去會怎樣？」，根據同理心的原則，下列何項護理師的回應最適切？",115,{"webId":40,"stem":41,"number":42,"year":38,"session":43},"nurse-115-2-psychiatric-community-047","司馬先生為重度失能者，太太為主要照顧者，因女兒生產需到外縣市探視 1 週，太太煩惱先生的照顧問題。依據此家庭狀況，使用下列那一項長期照護服務資源最適當？",47,2,{"webId":45,"stem":46,"number":47,"year":48,"session":43},"nurse-106-2-psychiatric-community-011","有關電氣痙攣療法（electroconvulsive therapy, ECT）護理照護的敘述，下列何者正確？",11,106,{"webId":50,"stem":51,"number":52,"year":53,"session":43},"nurse-107-2-psychiatric-community-049","5 個月大的小旬，應完成下列何種疫苗接種？",49,107,{"webId":55,"stem":56,"number":57,"year":58,"session":43},"nurse-109-2-psychiatric-community-013","朱同學 16 歲，因重度憂鬱症而住院治療，有關其住院時之環境治療，下列敘述何項正確？①環境須是高度結構化及控制的 ②以外在的控制處理其抗拒行為 ③協助個案統整好的／壞的自我 ④支持個案的自我探索及提供希望",13,109,{"webId":60,"stem":61,"number":42,"year":62,"session":43},"nurse-110-2-psychiatric-community-047","有關孕婦的疫苗接種，下列何者是可以接種的？",110,"2026-09-04",1788510763154]