護理師正在照顧一位患有邊緣性人格障礙 (BPD) 的病人。該病人正在對工作人員進行「分裂」（Splitting），告訴大夜班護理師說白班護理師很不專業。下列哪項護理行動最為適當？
A nurse is caring for a client with Borderline Personality Disorder who is 'splitting' staff members by telling the night shift nurse that the day shift nurse is incompetent. Which nursing action is most appropriate?
- AMeet with the staff to ensure a consistent approach to the client's care✓ 正解與護理人員開會，確保對病人照護採取一致的方法
- BInform the client that such comments are hurtful to the staff告知病人此類言論對護理人員造成傷害
- CAgree with the client to maintain a therapeutic alliance同意病人的說法以維持治療性關係
- DRestrict the client to their room for the remainder of the shift將病人限制在房間內直至當班結束
分裂（Splitting）是邊緣性人格障礙病人常用的防禦機制，將人看作「全好」或「全壞」，藉此引發工作人員之間的矛盾。對付分裂最有效的護理干預是「團隊的一致性」（Consistency）與「設定限制」（Limit-setting）。透過團隊會議，所有護理人員能達成共識，使用統一的口徑與護理計畫對待病人，讓病人無法透過挑撥來操弄。選項 C 會落入病人的操弄陷阱；選項 B 太過主觀且無助於治療；選項 D 屬於不必要的處罰，除非病人有立即暴力風險。
Vigorous exercise immediately before bedtime stimulates the central nervous system and raises body temperature, which interferes with the ability to fall asleep. Sleep hygiene guidelines recommend exercising at least three to four hours before bed, whereas avoiding clock-watching, maintaining a dark environment, and drinking warm milk are appropriate supportive behaviors.
在美國的精神科病房，團隊會議（Staff meetings/Rounds）是非常標準化的程序，專門用來討論應對 BPD 病人的策略。台灣臨床上雖然也有交班，但有時較缺乏針對「操弄行為」的結構化行為計畫，護理師需主動與其他班別協調一致的應對方式。