# 個案說：『沒有我，每個人都會過得更好。』將每個可能的護理師回應拖曳至適當的溝通類別。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=395507&lang=zh-tw  
> language: zh-TW  
> subject: Therapeutic Communication  
> category: PSI

## 題目

個案說：『沒有我，每個人都會過得更好。』將每個可能的護理師回應拖曳至適當的溝通類別。

**1.** 告訴我現在覺得最困難的是什麼。

Select a category
Therapeutic and assessment-focused
Blocks communication or risk assessment

**2.** 你聽起來承受很大的壓力。我可以留下來陪你一起面對下一步。

Select a category
Therapeutic and assessment-focused
Blocks communication or risk assessment

**3.** 上次你有這種感覺時，是什麼幫助你度過的？

Select a category
Therapeutic and assessment-focused
Blocks communication or risk assessment

**4.** 當你說每個人都會過得更好時，你是在想自殺嗎？

Select a category
Therapeutic and assessment-focused
Blocks communication or risk assessment

**5.** 你不應該有這種感覺；你的家人需要你。

Select a category
Therapeutic and assessment-focused
Blocks communication or risk assessment

**6.** 你為什麼停止服藥？

Select a category
Therapeutic and assessment-focused
Blocks communication or risk assessment

**7.** 等你睡一覺之後，一切都會好轉的。

Select a category
Therapeutic and assessment-focused
Blocks communication or risk assessment

**8.** 如果你配合，你就能更快回家。

Select a category
Therapeutic and assessment-focused
Blocks communication or risk assessment

## 解析

治療性回應探索個案的經驗、反映情緒、確認因應方式，並直接詢問自殺。建議、「為什麼」的問題、虛假保證、輕視感受，以及強制性的承諾會阻礙評估與信任。

## 深入解析

快速解答
選擇能開啟對話並讓風險顯現的回應。

為何此為正確
開放式邀請、反映，以及詢問先前的因應方式能收集有用的資料，而不會剝奪個案的主導權。「沒有我會更好」這句話需要一個清楚、直接的自殺詢問。告訴個案應該有什麼感受、提出帶有指責意味的「為什麼」問題、保證一切都會好轉，或將出院與配合度掛鉤，都可能壓抑誠實的揭露。

NCLEX 決策規則
不要以舒適換取評估。確認、澄清、直接詢問安全問題，並持續陪伴。參考資料
1NIMH Adult Brief Suicide Safety Assessment Guide
2NCSBN 2026 NCLEX-RN Test Plan

## 臨床情境

治療性溝通與自殺篩檢
護理師必須確認情緒、邀請描述，並直接評估自殺風險，不帶批判或虛假保證。

## 重要概念

- **反映** — 重述或說出感受以表達理解。
- **虛假保證** — 提供無根據的安慰，可能阻斷溝通。
- **開放式問句** — 能引導出更完整回應的問句。

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