— 心理社會完整性 · EASY · MCQ —
一位 45 歲患有廣泛性焦慮症的病人，主訴頻繁心悸及入侵性想法。下列哪項護理措施最為優先？
A 45-year-old client with a history of generalized anxiety disorder presents to the clinic reporting frequent palpitations and intrusive thoughts. Which initial nursing intervention is most appropriate?
- AMaintain a calm and quiet environment✓ 正解維持安靜平和的環境
- BEncourage the client to describe the thoughts in detail鼓勵病人詳細描述這些想法
- CTeach progressive muscle relaxation techniques教導漸進式肌肉放鬆技巧
- DAdminister an as-needed benzodiazepine給予按需使用的苯二氮平類藥物
— Explanation · 中文詳解 —
焦慮症病人出現明顯症狀時，護理師的首要任務是提供安全且穩定的環境，減少外在刺激（如噪音、人潮），這有助於病人的神經系統平靜下來，緩解心理與生理上的焦慮反應（如心悸）。在病人情緒尚未穩定前，強迫探討想法或進行複雜的放鬆教學，反而可能增加其心理壓力。藥物治療雖有效，但通常為後續或輔助性手段，非初始介入的首選。
The initial nursing intervention for a client experiencing acute anxiety symptoms is to maintain a calm and quiet environment to reduce sensory stimulation and promote de-escalation. Exploring intrusive thoughts or teaching complex relaxation techniques may increase distress during an acute episode, making environmental modification the priority.