— 心理社會完整性 · HARD · SATA —
一位護理師照護著出現危機徵兆的個案，預期會觀察到哪些表現？（選所有適合的）
A nurse is caring for a client who is displaying signs of crisis. Which manifestations would the nurse expect to see? (Select all that apply.)
- ADifficulty with problem-solving✓ 正解解決問題困難
- BIncreased anxiety and tension✓ 正解焦慮與緊張增加
- CInability to function in usual roles✓ 正解無法履行日常角色功能
- DRational and logical thought processes理性且邏輯的思考過程
- EFeelings of helplessness and confusion✓ 正解無力感與困惑
— Explanation · 中文詳解 —
危機狀態的定義為個案原有的應對機制失靈，導致功能受損。常見症狀包括焦慮飆升、混亂、無助感、無法進行邏輯思考與問題解決，以及難以維持日常社會角色功能。D 選項錯誤，危機狀態下理性思考能力反而會顯著下降。
A crisis state is defined as the failure of the individual's usual coping mechanisms, resulting in functional impairment. Common manifestations include marked increases in anxiety, confusion, helplessness, inability to think logically or solve problems, and difficulty maintaining usual social-role functioning. Option D is incorrect, as the capacity for rational thinking is markedly diminished during a crisis.
✦ 台美臨床差異
美國護理系統對危機介入（Crisis Intervention）有明確規範，台灣多由心理師或精神科醫師主導，護理師角色定位較偏向觀察與轉介。