{"name":"老年心理照护师题库","level":"不分级","org":"中国老年学和老年医学学会等行业协会","count":300,"questions":[{"id":1,"type":"single","stem":"照护师发现轻度认知障碍老人反复问同一个问题，最适宜的第一反应是","options":["每次都当作新问题耐心回答并安抚情绪","告诉他刚才已经问过了不要再问","故意不理睬等他停止提问","回答后立刻转移话题不再回应"],"answer":[0],"explanation":"知识点：认知障碍沟通中的重复提问应对。正确项对：重复提问多源于记忆障碍与不安，每次给予耐心回应能降低焦虑。错误项错在：B直接指出已问过会加重挫败与焦虑；C不理睬会让老人更不安甚至激越；D转移话题但不回应等于回避，未满足其安全需求。","tier":"挑战"},{"id":2,"type":"single","stem":"老人因近期丧偶出现持续两周的入睡困难与食欲下降，照护师最恰当的处置是","options":["按常规生活照护继续观察并记录变化","劝他不要多想慢慢就会好起来","直接安排参加集体活动转移注意力","自行建议服用助眠药物帮助入睡"],"answer":[0],"explanation":"知识点：老年哀伤反应识别与转介边界。正确项对：持续两周的睡眠与食欲问题需持续观察记录，为后续专业评估提供依据。错误项错在：B空洞安慰忽视风险；C强行转移注意力可能压抑哀伤；D照护师无权建议用药。","tier":"进阶"},{"id":3,"type":"single","stem":"与听力下降的老人沟通时，照护师最有效的做法是","options":["面对老人放慢语速并适当提高音量","站在老人身后大声重复同一句话","用夸张口型逐字喊出关键词语","边走动边大声说明照护安排"],"answer":[0],"explanation":"知识点：老年听力障碍沟通技巧。正确项对：面对、放慢、适度提高音量便于读唇与听清。错误项错在：B身后说话看不到口型；C夸张口型反而难辨且易误解；D走动中说话距离和方向都不稳定。","tier":"基础"},{"id":4,"type":"single","stem":"照护师发现老人近期常把盐当糖放进粥里，最先应做的评估是","options":["了解近期认知与日常生活能力变化","检查厨房调味罐标签是否清晰","询问老人是否不喜欢甜味食物","观察老人当天情绪是否低落"],"answer":[0],"explanation":"知识点：认知障碍早期迹象识别。正确项对：调味混淆提示认知或执行功能变化，应评估整体认知与日常能力。错误项错在：B标签问题只解释单一情境；C口味变化不足以解释用盐；D情绪低落不能直接解释调味混淆。","tier":"挑战"},{"id":5,"type":"single","stem":"对处于中度认知障碍的老人进行穿衣照护时，适宜的做法是","options":["把衣服按穿着顺序摆好并逐步提示","直接替老人穿好以节省时间","把全部衣物放在床上让他自己选","反复纠正他扣错的纽扣直到正确"],"answer":[0],"explanation":"知识点：认知障碍保留能力的支持性照护。正确项对：按顺序摆放并逐步提示可维持参与感与自尊。错误项错在：B代劳会加速功能退化；C选项过多造成选择困难；D反复纠正增加挫败与激越。","tier":"基础"},{"id":6,"type":"single","stem":"老人夜间反复起床走动并说要去上班，照护师最恰当的应对是","options":["温和引导回床并了解其不安来源","锁住卧室门防止他再次外出","批评他打扰别人休息的行为","给他服用安眠药让他尽快入睡"],"answer":[0],"explanation":"知识点：痴呆相关夜间游走行为管理。正确项对：先安抚并了解需求，减少激越，保障安全。错误项错在：B锁门限制自由且增加危险；C批评加重情绪反应；D照护师无权给药。","tier":"进阶"},{"id":7,"type":"single","stem":"照护师与认知障碍老人交流时，一次提出多个问题最容易导致","options":["老人因信息过载而沉默或答非所问","老人更积极配合完成照护任务","老人主动回忆并补充更多细节","老人情绪稳定并加快反应速度"],"answer":[0],"explanation":"知识点：认知障碍沟通的信息加工负荷。正确项对：多重问题超出其加工能力，易出现沉默或答非所问。错误项错在：B、C、D均高估其信息处理能力，与临床沟通原则不符。","tier":"基础"},{"id":8,"type":"single","stem":"老人被怀疑有抑郁情绪时，照护师在沟通中最应避免的是","options":["说你这条件这么好有什么可愁的","安静陪伴并鼓励他说出感受","询问他最近睡眠和食欲情况","记录他情绪变化的持续时间和频率"],"answer":[0],"explanation":"知识点：老年抑郁沟通中的无效回应。正确项对：否定其感受会阻断表达并加重孤独。错误项错在：B、C、D均为支持性沟通与观察记录，属于恰当做法。","tier":"基础"},{"id":9,"type":"single","stem":"照护师发现老人近期常把白天发生的事说成是多年前的事，这种表现最可能提示","options":["记忆障碍导致时间定向出现偏差","老人故意编造故事吸引注意","老人听力下降听错了问题","老人性格变得爱开玩笑"],"answer":[0],"explanation":"知识点：认知障碍的时间定向障碍。正确项对：时间错位常见于记忆与定向功能受损。错误项错在：B无证据支持故意编造；C听力问题不导致时间错位；D性格变化不能解释系统性时间混淆。","tier":"挑战"},{"id":10,"type":"single","stem":"照护师在协助老人进餐时发现他咀嚼后长时间不吞咽，下一步最恰当的是","options":["轻声提醒并观察口腔内是否有残留","立即喂水帮助他把食物冲下","加快喂食速度减少停留时间","停止进餐并当天不再喂食"],"answer":[0],"explanation":"知识点：痴呆老人进食吞咽观察。正确项对：先提醒并检查口腔，判断是遗忘吞咽还是吞咽障碍。错误项错在：B喂水可能增加误吸风险；C加快喂食更危险；D停止进餐过度且影响营养。","tier":"挑战"},{"id":11,"type":"single","stem":"照护师对认知障碍老人使用怀旧疗法时，最适宜选择的素材是","options":["老人年轻时熟悉的歌曲和老照片","最新的时事新闻和科技产品","复杂的逻辑推理游戏","需要快速反应的电子游戏"],"answer":[0],"explanation":"知识点：怀旧疗法适用素材。正确项对：熟悉且与个人经历相关的素材能激发远期记忆与愉悦。错误项错在：B新近信息超出其记忆优势；C、D对认知要求高，易引发挫败。","tier":"基础"},{"id":12,"type":"single","stem":"照护师发现轻度认知障碍老人反复询问“我什么时候回家”，此时最恰当的初次回应是","options":["您现在住在养老院，这里就是您的家","您想回家看看谁呢，跟我说说他吧","您别问了，刚才不是刚说过吗","我帮您打电话让家人马上来接您"],"answer":[1],"explanation":"知识点：认知障碍老人的重复提问多源于焦虑或未满足的情感需求，回应应先接纳情绪、引导表达。正确项通过询问“想回家看谁”把话题引向情感需求，既安抚又收集信息。错误项一直接纠正居住事实，易引发争辩；错误项三带有责备，增加挫败感；错误项四做出无法兑现的承诺，会加剧不信任。","tier":"挑战"},{"id":13,"type":"single","stem":"对伴有失语症的认知障碍老人进行沟通时，照护师应当优先采用的方式是","options":["提高音量并放慢语速反复大声说","用简短句子配合手势和实物提示","一次把一天安排完整讲给老人听","让老人用书写方式回答每个问题"],"answer":[1],"explanation":"知识点：失语症老人理解与表达均受损，沟通需降低语言负荷并借助非语言线索。正确项用简短句加手势、实物，能同时调动理解通道。错误项一放慢语速有用但提高音量无助理解；错误项三信息量过大超出处理能力；错误项四书写对失语老人常同样困难，且并非首选。","tier":"进阶"},{"id":14,"type":"single","stem":"老人夜间反复起床翻找东西、说“要上班迟到了”，评估时最应首先了解的是","options":["老人白天睡眠时间和活动安排","老人年轻时的工作单位名称","老人子女对夜间照护的态度","老人房间夜间的照明亮度"],"answer":[0],"explanation":"知识点：认知障碍老人的夜间行为多与昼夜节律紊乱、白天活动不足或午睡过长有关。正确项先评估白天睡眠与活动，是寻找可干预原因的第一步。错误项二属于怀旧信息，对当前行为成因帮助有限；错误项三涉及家属态度，非行为原因评估；错误项四照明只是环境因素之一，不是首要评估点。","tier":"基础"},{"id":15,"type":"single","stem":"照护师与认知障碍老人交谈时，每次只问一个问题，主要目的是","options":["避免老人因选项过多而难以选择","体现照护师说话简洁的职业形象","缩短每次沟通占用的照护时间","防止老人把问题记成两件事"],"answer":[0],"explanation":"知识点：认知障碍老人工作记忆和信息加工容量下降，多问题叠加会造成选择困难。正确项指出一次一问可降低选择负荷，便于老人回应。错误项二把目的说成形象管理；错误项三把目的说成省时间；错误项四把机制误解为记成两件事，均偏离核心。","tier":"基础"},{"id":16,"type":"single","stem":"对刚刚入住养老机构、整日沉默不与人交流的老人，照护师较适宜的切入方式是","options":["安排老人参加集体歌唱活动融入","每天固定时间陪老人坐一会儿聊几句","请同屋老人主动多找其说话","要求老人每天完成一次活动打卡"],"answer":[1],"explanation":"知识点：新入住老人的沉默常源于陌生与失落，建立信任需低压力、可预期的陪伴。正确项以固定时间短聊，节奏温和、可预期，利于建立关系。错误项一集体活动对退缩老人压力偏大；错误项三把责任推给同屋，可能造成双方压力；错误项四带有任务要求，会增加抵触。","tier":"基础"},{"id":17,"type":"single","stem":"老人坚持说“我老伴刚才来过了”，而老伴已去世多年，照护师较恰当的回应是","options":["您记错了，老伴早就去世了","您很想念老伴吧，他以前对您很好","那您老伴现在人在哪里呢","我去帮您把老伴找过来"],"answer":[1],"explanation":"知识点：对认知障碍老人的幻觉或错认，应回应其背后的情感而非争辩事实。正确项承接思念情绪，既尊重体验又安抚。错误项一直接纠正事实，易引发悲伤或激越；错误项三顺着虚构内容追问，会加重混乱；错误项四做出无法实现的承诺，损害信任。","tier":"基础"},{"id":18,"type":"single","stem":"照护师协助老人进餐时，发现老人把药片藏在舌下不肯咽下，正确的下一步处置是","options":["让老人先喝一大口水把药冲下去","停止进餐并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