一位 25 歲男性因嚴重的強迫症（OCD）入院，他的症狀為持續性的洗手儀式。每天早上他必須花費長時間反覆地清潔雙手才能繼續日常活動。在住院的最初階段，護理師應採取何種介入？
A 25-year-old male is admitted for debilitating Obsessive-Compulsive Disorder (OCD) featuring a relentless handwashing ritual. Every morning, he must wash his hands exactly 30 times symmetrically to relieve his intense anxiety about contamination. Group therapy is scheduled to begin at 0800. At 0750, the nurse observes him only on his 15th handwash. If interrupted, he must start over at number one. What is the most therapeutic approach by the nurse during his initial hospitalization phase?
- AQuietly allow the client enough uninterrupted time to complete his ritual, even if it means he will be late to the group therapy session.✓ 正解安靜地讓個案有足夠不受打擾的時間完成其儀式，即使這意味著他會遲到團體治療課程。
- BLock the door to his bathroom during the day to physically prevent any further access to sinks or soap.白天鎖上浴室門，以物理方式防止其進一步接觸水槽或肥皂。
- CFirmly turn off the sink faucet and instruct the client that he must attend group therapy because the rigid schedule is mandatory.堅決關閉水龍頭，並指示個案必須參加團體治療，因為嚴格的日程安排是強制性的。
- DInform the client logically that his hands are already immaculately clean and washing them 15 more times will only cause his skin to bleed.以邏輯告知個案其雙手已經非常潔淨，再洗15次只會導致皮膚出血。
本題測驗精神科對於強迫症（Obsessive-Compulsive Disorder, OCD）行為的處置原則。在 OCD 病患中，反覆的動作（Compulsion / 強迫行為）是一種用來中和、緩解由強迫思考（Obsession / 對污染害怕的焦慮）所產生的極端焦慮的生存機制。如果在病患住院「初期（Initial phase）」，護理師突然強迫性地中斷、阻擋或封鎖其儀式行為（如選項C關掉水龍頭、選項B鎖門），病患的焦慮水平將會瞬間指數級爆發，引發恐慌發作。因此，初期的護理大原則是：「不打斷（Do not interrupt）」並「預留足夠時間（Allow time）」讓病患完成其儀式行為（選項A正確）。待與病患建立信任關係後，治療團隊才會漸進式地設定界線（Limit-setting）以縮短洗手時間。選項D用現實邏輯去說服一個 OCD 病患更是毫無意義，因為他們大多自己知道不合理，只是大腦無法克制而已。
During the initial phase of treatment, the nurse should allow the client sufficient uninterrupted time to complete compulsive rituals to prevent extreme anxiety escalation. Interrupting these behaviors abruptly can trigger panic, whereas allowing the ritual maintains safety until trust is established for gradual behavioral modification.
處理 OCD 考題也是全球相同的送分鐵律：Initial stage = 從不打斷，允許完成；Later stage = 限制次數，轉移注意力。台灣護理師稱之為「先允許病態發作，後縮減時間」。