一位居家護理師正在訪視高齡癌症病患。病患的女兒交給護理師一袋已去世父親遺留的藥物，包括幾瓶剩一半的 oxycodone (強效鴉片類止痛藥) 與過期的降血壓藥。女兒詢問：「我可以乾脆把這些藥全倒進馬桶沖掉，或者直接把藥瓶丟進外面的家用垃圾桶裡嗎？」護理師應提供何項最恰當的安全指導？
A home health nurse is visiting an elderly cancer patient. The patient's daughter hands the nurse a bag of the deceased father's leftover medications, including several half-empty bottles of oxycodone and expired blood pressure pills. The daughter asks, "Can I just flush all of these down the toilet or toss the bottles directly into the household trash?" What is the most appropriate safety instruction the nurse should provide?
- AAccept the medications personally on behalf of the agency and dispose of them in the facility's routine biohazard bin.以機構名義親自接收藥物，並將其丟棄於設施的常規生物危害垃圾桶中。
- BTell her to securely tape the oxycodone bottles closed and throw them into the outdoor community dumpster.告訴她用膠帶牢固封閉氧可定（oxycodone）藥瓶，並將其丟入戶外社區垃圾場。
- CAdvise her to crush and flush all the medications immediately to prevent accidental ingestion by visiting children.建議她立即壓碎並沖掉所有藥物，以防止探訪兒童意外攝入。
- DInstruct her to locate a DEA-authorized community "take-back" program or pharmacy receptacle for secure disposal.✓ 正解指示她尋找由 DEA 授權的社區「回收」計畫或藥局回收容器以進行安全處置。
本題測試藥物安全銷毀原則，尤其是針對高危害的管制藥物（如 Oxycodone）。根據 FDA 與 EPA 規範，將藥物沖入馬桶（選項C）會引發嚴重的水源與環境生態污染（僅有極少數 FDA 認可清單上的高致死危險藥品在無其他方案時才准許沖掉，但一般降壓藥絕對不行）。直接將強效鴉片類藥物丟棄在一般垃圾中（選項B），會使這些藥物輕易地被轉售、遭幼童誤食或被成癮者隨意翻找撿走濫用（Drug diversion）。居家護理師個人也不應私自接管或運送管制藥物（選項A），因為缺乏合法的保管鏈且屬違規。最佳且最具環境與公衛道德的處置方法是，衛教家屬將其帶往由執法單位或 DEA（緝毒局）授權的社區「藥物回收計畫（Take-back program / Pharmacy receptacles）」進行統一的專業銷毀（選項D）。
This question tests the principles of safe medication disposal, particularly for high-risk controlled substances such as oxycodone. According to FDA and EPA guidelines, flushing medications down the toilet (option C) causes significant contamination of water sources and aquatic ecosystems (only a very limited list of FDA-approved high-risk medications may be flushed when no other option is available, and routine antihypertensives are absolutely not on this list). Discarding potent opioids directly in the household trash (option B) allows these drugs to be diverted, accidentally ingested by children, or scavenged and misused by individuals with addiction (drug diversion). The home health nurse should also not personally accept or transport controlled substances (option A), as this lacks a legal chain of custody and is a violation of policy. The most appropriate option, ethically and environmentally, is to instruct the family member to take the medications to a DEA-authorized community take-back program or pharmacy receptacle for secure, professional disposal (option D).
廢棄藥品回收觀念相通。台灣近年積極推廣各大醫院藥局設置「藥品回收站」；但在美國，由於鴉片類藥物氾濫危機極其嚴重，考題會特別針對避免管制藥物流出市面的銷毀程序（如混入貓砂、丟棄法規）深入測試。