— 心理社會完整性 · HARD · MCQ —
一位 28 歲邊緣型人格障礙（BPD）個案試圖操縱護理師：「只有你懂我，其他護理師都不關心我。」護理師最好的行動為何？
A 28-year-old client with borderline personality disorder (BPD) attempts to manipulate the nurse by saying, 'You are the only one who understands me; the other nurses don't care.' What is the nurse's best action?
- AInform the client that all staff members are working to provide care✓ 正解告知個案所有工作人員都在努力提供照護
- BIgnore the comment and continue with the medication administration忽略該評論並繼續給藥
- CAccept the compliment to help build rapport接受讚美以建立良好關係
- DDiscuss the observation with the other nurses at the shift change在交班時與其他護理師討論此觀察結果
— Explanation · 中文詳解 —
邊緣型人格障礙常見「分裂（Splitting）」機轉，即將醫護人員分成「好人」與「壞人」。護理師需維持團隊一致性，避免落入此陷阱。直接告知所有成員皆提供相同品質照護，能有效打破個案的操縱行為，重申團隊合作原則。
Clients with borderline personality disorder often exhibit splitting, viewing staff as either all good or all bad. The nurse should maintain consistent boundaries by informing the client that all staff members are working together to provide care, thereby preventing the reinforcement of manipulative behaviors.
✦ 台美臨床差異
美國護理強調護病邊界（Boundaries）；台灣臨床文化中，病人常以撒嬌尋求特殊待遇，處理上較為含糊。