— 心理社會完整性 · HARD · MCQ —
一位邊緣性人格障礙（BPD）的個案試圖透過對護理師說「只有你懂我，其他人對我都很壞」來挑撥離間。護理師應如何回應？
A client with borderline personality disorder (BPD) attempts to split the staff by saying, 'You are the only nurse who understands me; the others are so mean.' How should the nurse respond?
- ATell the client that the other nurses are actually very kind告訴病人其他護理師其實非常和藹可親
- BIgnore the comment and continue with the nursing care忽略此評論並繼續進行護理照顧
- CAgree with the client to build rapport同意病人的說法以建立良好關係
- DSet firm limits and state that all staff members provide the same care✓ 正解設立明確界限並說明所有工作人員提供相同的照護
— Explanation · 中文詳解 —
「分裂」（Splitting）是 BPD 的防衛機轉，表現為對人際關係的極端化評價。護理重點在於保持團隊一致性與專業界線，避免掉入個案的操控陷阱。應客觀陳述團隊照護的一致性，並溫和但堅定地設定界線，不隨之偏袒。
Nurses must maintain team consistency and set firm limits to address splitting behaviors without validating the client's divisive perceptions.
✦ 台美臨床差異
台美護理教育均重視處理 BPD 的分裂機制，美國臨床更強調跨專業團隊（MDT）的一致性會議，台灣則仰賴護理站內的口頭交班。