— 心理社會完整性 · EASY · MCQ —
一位強迫症（OCD）個案花費數小時洗手。在治療初期，護理師的目標為何？
A client with obsessive-compulsive disorder (OCD) spends hours washing hands. During the initial stage of treatment, what is the nurse's goal?
- AIncrease the medication dosage.增加藥物劑量
- BImmediately stop the washing behavior.立即停止洗手行為
- CAllow the behavior while setting limits for scheduled activities.✓ 正解允許該行為，但為計畫性活動設定限制
- DExplain that the behavior is illogical.解釋該行為不合邏輯
— Explanation · 中文詳解 —
在 OCD 治療初期，護理重點為尊重個案的焦慮減輕需求，不能強制中斷（會引發嚴重焦慮），但需透過結構化排程，逐步限制行為時間。B 選項會導致個案恐慌；D 選項個案自知行為不合理，無需解釋；A 選項護理師無權更改藥量。
In the initial stage of OCD treatment, the nurse should allow the ritualistic behavior while setting limits through structured scheduling to gradually reduce anxiety. Abruptly stopping the behavior causes extreme distress, and explaining its illogical nature is ineffective since the client already recognizes the irrationality.
✦ 台美臨床差異
美國常由行為治療師與護理師共同執行結構化計畫；台灣臨床多由精神科醫師主導藥物治療，護理師輔以生活常規管理。