一位病人拒絕配合醫囑服藥，護理師應優先採取何種措施？
A nurse is caring for a client who is non-compliant with prescribed medications and refuses to take them. Which action should the nurse take first?
- ADocument the refusal in the medical record在病歷中記錄拒藥情形
- BExplain the consequences of not taking the medication說明不服藥的後果
- CDetermine the reason for the refusal✓ 正解確定拒藥的原因
- DNotify the physician immediately立即通知醫師
護理流程的第一步是評估。在病人拒藥時，首要任務是了解原因（如藥物副作用、經濟困難、恐懼），而非直接通知醫師或進行衛教。了解原因後，護理師才能進行有效的溝通、衛教或在必要時通報醫師進行調整，這是體現護理專業與病人自主權的關鍵步驟。
The first step of the nursing process is assessment. When a client refuses medication, the primary task is to determine the reason (e.g., side effects, financial difficulty, fear), rather than immediately notifying the physician or providing education. Once the reason is understood, the nurse can engage in effective communication, education, or notify the physician for adjustment if necessary. This is a key step that reflects nursing professionalism and respect for patient autonomy.
美國法規強調病人自主權；台灣臨床習慣較常採取「勸服」，有時護理師會面臨較大溝通壓力。