— 心理社會完整性 · MEDIUM · MCQ —
一位護理師照護遭受暴力攻擊的病人。下列何種發現代表病人處於危機的「衝擊階段」？
A nurse is caring for a client who experienced a traumatic assault. Which of the following findings would indicate the client is in the impact stage of crisis?
- AThe client appears dazed, confused, and detached from the event.✓ 正解病人看起來茫然、困惑，且與事件脫節。
- BThe client is crying and expresses feelings of helplessness.病人在哭泣並表達無助感。
- CThe client is asking for legal assistance and contacting family.病人正在尋求法律協助並聯繫家人。
- DThe client is starting to plan for future safety measures.病人開始規劃未來的安全措施。
— Explanation · 中文詳解 —
危機的衝擊階段（Impact stage）通常緊接在創傷後，病人常表現出麻木、困惑、茫然或情感解離的狀態，這是心理防禦機轉的一部分。選項 B 屬於後續的情緒反應期；選項 C 與 D 屬於解決問題或復原階段，代表病人已開始處理危機後的現實層面。
The impact stage of crisis follows immediately after trauma; the client often appears numb, confused, dazed, or emotionally detached as a defensive response. Option B reflects the later recoil/emotional response phase; options C and D describe the resolution or recovery phase, when the client is actively addressing the post-crisis reality.
✦ 台美臨床差異
美國醫院設有創傷知情照護（TIC）系統，護理師對此階段的辨識極為敏銳；台灣臨床則多以急性傷口處理為主，心理評估較為隱性。