— 基本照護與舒適 · HARD · MCQ —
一位第 4 期失智症病人出現睡眠障礙。護理師應優先採取哪項措施？
A client with stage 4 dementia is experiencing sleep disturbances. Which intervention should the nurse implement first?
- AKeep the room lights on at night to prevent disorientation夜間保持房間燈光開啟，以預防定向力障礙
- BAdminister a PRN sedative給予處方用镇静劑
- CRequest a referral for a sleep study申請睡眠檢查轉介
- DEncourage daytime physical activity and light exposure✓ 正解鼓勵白天進行身體活動並接受光照
— Explanation · 中文詳解 —
失智症病人睡眠障礙的優先處置應從非藥物性介入開始：B. 鼓勵白天適度體能活動與光照可調節晝夜節律（circadian rhythm），是 NCLEX 失智症照護的標準首選非藥物介入。其他選項：B. PRN 鎮靜劑會增加跌倒、譫妄與認知惡化風險，應避免；C. 夜間開燈會干擾睡眠周期，反而加重睡眠障礙；D. 睡眠檢查為侵入性、非首選介入，應在非藥物方法無效後再考慮。
Nonpharmacologic interventions are the first-line treatment for sleep disturbances in dementia. Encouraging daytime physical activity and light exposure helps regulate the circadian rhythm, whereas keeping lights on at night disrupts sleep, sedatives increase fall and delirium risks, and sleep studies are invasive and not initial management.