— 心理社會完整性 · HARD · SATA —
一位患有創傷後壓力症候群（PTSD）的個案正在經歷創傷重現（flashback）。護理師應優先採取哪些措施？（選所有適合的）
A client with post-traumatic stress disorder (PTSD) is experiencing a flashback. Which actions should the nurse prioritize? (Select all that apply.)
- AMaintain a calm and firm voice✓ 正解保持鎮定堅定的語氣
- BKeep the client in a well-lit and quiet environment✓ 正解讓病人處於明亮安靜的環境中
- CTouch the client firmly to ground them用力觸碰病人以幫助其回到現實
- DUse short, simple sentences✓ 正解使用簡短簡單的句子
- EOrient the client to the present time and place✓ 正解引導病人回到當下的時間與地點
— Explanation · 中文詳解 —
PTSD 病人經歷創傷重現（flashback）時，會感覺自己彷彿回到了創傷事件的現場，與當下現實脫節。此時護理師的目標是幫助病人「回到現實（grounding）」。應以穩定、簡短、清晰的話語引導病人定向，並確保環境安全、安靜，避免感官過度刺激。絕不可在未經許可下觸碰病人，因為這可能被病人視為威脅，進而引發防衛性攻擊行為。
During a PTSD flashback, the client is disconnected from reality, so the nurse must prioritize safety and grounding techniques. Maintaining a calm demeanor, using simple language, and orienting the client to the present help reduce anxiety and sensory overload. Touching the client should be avoided as it may be perceived as a threat and escalate agitation.