— 心理社會完整性 · HARD · MCQ —
一位診斷為思覺失調症的病人說：「電視正在傳送秘密訊息叫我不要吃東西。」護理師最適當的回答為何？
A client diagnosed with schizophrenia says, 'The television is sending me secret messages to stop eating.' Which response by the nurse is most appropriate?
- A'I don't hear any messages from the television.'✓ 正解'我沒有聽到電視傳來任何訊息。'
- B'It must be frightening to hear those messages, but the television is not speaking to you.''聽到那些訊息一定很可怕，但電視並沒有在跟你說話。'
- C'The television cannot send messages, that is your illness talking.''電視不可能傳送訊息，那是你的疾病在作祟。'
- D'Why do you think the television is talking to you?''你為什麼認為電視在跟你說話？'
— Explanation · 中文詳解 —
處理幻覺與妄想的核心原則為「呈現現實」（Presenting Reality）。護理師應溫和地指出自己的感官經驗與病人不同，不爭辯、不認同幻覺，將焦點轉移至現實。選項 B 雖具同理心，但承認「恐怖感」仍需建立在現實界限上，選項 A 是經典且直接的現實感確認技巧。
The core principle for managing hallucinations and delusions is presenting reality without reinforcing the false belief. The nurse should gently state their own sensory experience differs from the client's, avoiding confrontation or validation of the delusion.
✦ 台美臨床差異
兩地精神護理原則相似，皆強調現實導向；台灣精神科病房更強調保護性醫療措施。