{"name":"失智老人照护专项职业能力题库","level":"不分级","org":"人力资源和社会保障部门","count":300,"questions":[{"id":1,"type":"single","stem":"失智老人反复问“我什么时候能回家”，照护者最恰当的回应是","options":["先认同他的感受，再引导他聊当下熟悉的事","直接告诉他这里就是他的家，让他别再问了","拿出日历反复解释今天不能回家的原因","假装打电话给家属说马上就来接他"],"answer":[0],"explanation":"知识点是失智症沟通中的认可疗法。正确项先接纳情绪再转移注意力，能减少焦虑。错误项“直接纠正”会引发争辩和激越；“反复解释”超出其理解与记忆能力；“假装打电话”属欺骗，一旦识破会破坏信任。","tier":"挑战"},{"id":2,"type":"single","stem":"失智老人傍晚出现坐立不安、来回走动、反复拉扯窗帘，照护者首先应做的是","options":["检查是否饥饿、疼痛、想上厕所或环境过亮","立即给家属打电话要求接走老人","把老人扶到床上并约束其双手","关掉所有灯让房间变暗促其入睡"],"answer":[0],"explanation":"知识点是黄昏综合征的行为诱因排查。正确项先排查生理需求与环境诱因，是行为症状应对的第一步。错误项“叫家属接走”属推诿且不解决当下问题；“约束双手”属不当限制；“关灯变暗”可能加重定向障碍和恐惧。","tier":"进阶"},{"id":3,"type":"single","stem":"与中度失智老人交流时，照护者说话方式最适宜的是","options":["一次只问一个问题，语速放慢并配合手势","提高音量大声说，像对听力差的人那样","用成人对幼儿的夸张语调反复重复","同时问几个问题让他挑选回答"],"answer":[0],"explanation":"知识点是失智症沟通技巧。正确项一次一问、放慢语速、配合非语言提示，便于理解和回应。错误项“大声喊”不等于易理解且易被当成呵斥；“幼儿语调”有损尊严；“多个问题”增加处理负担导致答非所问。","tier":"基础"},{"id":4,"type":"single","stem":"失智老人把牙膏挤在梳子上梳头，照护者正确的做法是","options":["顺着他的动作递上梳子，再自然引导去洗漱","立刻夺下梳子并纠正他拿错了东西","大声告诉他牙膏是用来刷牙的不是梳头的","站在旁边看着他继续做直到自己发现"],"answer":[0],"explanation":"知识点是失智症物品误用与行为引导。正确项顺应其当下行为再顺势引导，可减少对抗。错误项“夺下纠正”易引发激越；“大声说教”超出其理解并伤自尊；“旁观不管”错过引导时机且可能误食牙膏。","tier":"挑战"},{"id":5,"type":"single","stem":"失智老人夜间起床在走廊来回走动，值班照护者最合适的处置是","options":["轻声陪同并了解需求，引导其回床或到安全区","把走廊门锁上防止他走出去","给他服用家属自备的助眠药让其睡觉","批评他半夜不睡觉影响别人休息"],"answer":[0],"explanation":"知识点是失智症夜间游走的安全照护。正确项陪同、了解需求并引导，兼顾安全与尊严。错误项“锁走廊门”属不当限制且应急时危险；“擅自给助眠药”超范围用药；“批评”会加重焦虑与对抗。","tier":"进阶"},{"id":6,"type":"single","stem":"照护失智老人进食时，预防误吸最关键的做法是","options":["坐直进食，小口慢咽，进食后保持坐位片刻","让他边看电视边吃饭以分散注意力","把饭菜打成糊状并让他快速吃完","进食时多和他聊天让他放松"],"answer":[0],"explanation":"知识点是失智症进食安全与误吸预防。正确项保持坐直、小口慢咽、餐后坐位可降低误吸风险。错误项“边看电视”分散注意力易呛咳；“快速吃完”增加误吸；“进食中多聊天”同样分散吞咽注意力。","tier":"基础"},{"id":7,"type":"single","stem":"失智老人突然出现比平时更严重的躁动并伴有发热，照护者应首先考虑","options":["可能是躯体疾病如感染或疼痛引起的行为改变","只是失智症自然加重的表现","是老人故意闹脾气引起注意","需要增加镇静药物让他安静"],"answer":[0],"explanation":"知识点是失智症行为突变需排查躯体病因。正确项意识到发热伴躁动常提示感染等躯体问题。错误项“自然加重”会延误就医；“故意闹脾气”是错误归因；“自行加镇静药”掩盖病情且超范围。","tier":"挑战"},{"id":8,"type":"single","stem":"失智老人坚持说“我的钱包被你们偷了”，照护者最恰当的应对是","options":["表示理解他的着急，陪他一起找并安抚情绪","翻出监控证明没人拿他的钱包","严肃告诉他不能随便冤枉别人","把他房间所有东西都收走以免再丢"],"answer":[0],"explanation":"知识点是失智症被窃妄想的应对。正确项共情并陪同寻找，可缓解焦虑、避免争辩。错误项“放监控对质”无法被其理解且激化情绪；“严肃指责”伤其尊严；“收走物品”属过度控制且不解决妄想。","tier":"进阶"},{"id":9,"type":"single","stem":"失智老人拒绝洗澡并推开照护者，下一步最合适的做法是","options":["暂缓洗澡，先了解原因并换个时间再尝试","叫两名同事一起把他架进浴室快速洗完","告诉他再不洗就不给他吃饭","用毛巾随便擦几下就算洗过了"],"answer":[0],"explanation":"知识点是失智症抗拒照护的应对。正确项暂缓并找原因、择时再试，尊重意愿又达成照护。错误项“强行架入”属强迫照护易致外伤与心理创伤；“以吃饭要挟”属不当惩罚；“随便擦几下”未满足清洁需求。","tier":"进阶"},{"id":10,"type":"single","stem":"失智老人夜间频繁起床徘徊，照护者首先应评估的是","options":["是否需要加用镇静药物","白天活动量与午睡时长","卧室窗帘的遮光效果","晚餐是否吃了易产气食物"],"answer":[1],"explanation":"知识点是失智症行为症状的非药物干预评估顺序。正确项先查白天活动与午睡，因为昼夜节律紊乱常源于日间活动不足或午睡过长。错误项A在未评估诱因前用药不符合规范；错误项C遮光只是环境因素之一，不是首要评估点；错误项D产气食物与徘徊无直接因果。","tier":"基础"},{"id":11,"type":"single","stem":"失智老人把牙膏挤在梳子上梳头，照护者最合适的做法是","options":["纠正他并示范牙膏应挤在牙刷上","拿走梳子，带他到洗手台递上牙刷","告诉他这样做不卫生会引起头皮病","让他继续，事后再帮他清洗梳子"],"answer":[1],"explanation":"知识点是失智症物品使用错误的应对。正确项用动作引导代替言语纠正，减少挫败感。错误项A反复讲道理，老人难以理解和记住；错误项C用疾病恐吓，增加焦虑且无效；错误项D放任错误行为，未完成刷牙清洁目标。","tier":"进阶"},{"id":12,"type":"single","stem":"与中度失智老人交流时，照护者一次提问包含几个信息点比较合适","options":["一次只问一个信息点","一次问两个相关信息点","一次问三个以便节省时间","一次把选项都列出来让他挑"],"answer":[0],"explanation":"知识点是失智症沟通的信息加工容量。正确项一次一个信息点，老人才能处理并回应。错误项B两个信息点已超出多数中度患者的工作记忆；错误项C三个信息点会造成混乱；错误项D罗列选项反而增加选择负担。","tier":"基础"},{"id":13,"type":"single","stem":"失智老人突然出现视幻觉并伴随恐惧喊叫，照护者恰当的即时处置是","options":["指出他看到的东西并不存在","陪他离开该房间并安抚情绪","让他独自静一静缓解幻觉","马上约束双手防止他乱抓"],"answer":[1],"explanation":"知识点是失智症幻觉的应对。正确项用环境转换和情绪安抚降低恐惧。错误项A直接否定其感知，会加重不安；错误项C让有幻觉的老人独处，可能发生跌倒或走失；错误项D约束会加剧激越，且非必要措施。","tier":"挑战"},{"id":14,"type":"single","stem":"失智老人坚持要在冬天穿单衣出门，照护者最恰当的沟通策略是","options":["直接告诉他外面很冷不能穿","拿出厚外套说先穿上再一起看看天气","把单衣藏起来避免他找到","让他先出门感受一下冷再回来加衣"],"answer":[1],"explanation":"知识点是失智症拒绝配合时的迂回沟通。正确项用具体动作和陪伴引导，避免正面对抗。错误项A直接否定会引发争执；错误项C藏衣物会造成寻找和激越；错误项D让老人暴露在寒冷中有健康风险。","tier":"进阶"},{"id":15,"type":"single","stem":"评估失智老人跌倒风险时，属于可干预的环境因素是","options":["既往有跌倒史","走廊夜间照明不足","年龄超过八十岁","诊断为阿尔茨海默病"],"answer":[1],"explanation":"知识点是跌倒危险因素中可干预与不可干预的区分。正确项照明不足可通过改善环境干预。错误项A跌倒史是重要风险指标但已发生；错误项C年龄不可改变；错误项D疾病诊断不可改变，只能管理其影响。","tier":"基础"},{"id":16,"type":"single","stem":"失智老人进食时频繁把食物含在口中不咽，照护者下一步应","options":["轻拍其下颌并提醒吞咽","用勺子继续往嘴里送食","把食物打成全流质灌喂","停止进食并让其躺下休息"],"answer":[0],"explanation":"知识点是失智症吞咽障碍的进食支持。正确项用触觉提示帮助启动吞咽反射。错误项B继续送食会造成口腔积存和误吸；错误项C灌喂增加呛咳风险；错误项D直接停止可能造成摄入不足，应先尝试提示。","tier":"基础"},{"id":17,"type":"single","stem":"失智老人被怀疑发生急性谵妄时，与原有失智表现相比最突出的特征是","options":["记忆力比上月明显下降","症状在数小时至数天内波动","性格变得比以前更固执","走路速度比半年前变慢"],"answer":[1],"explanation":"知识点是谵妄与失智症的鉴别。正确项急性起病、病程波动是谵妄的核心特征。错误项A慢性记忆力下降更符合失智进展；错误项C性格改变缓慢出现，不特异；错误项D步态变慢多为慢性或运动问题，不是谵妄的关键鉴别点。","tier":"挑战"},{"id":18,"type":"single","stem":"失智老人傍晚反复整理衣物并说要上班，照护者正确的应对是","options":["告诉他已退休多年不用上班","陪他一起整理并聊过去的工作","把衣物收走让他无法整理","安排他立刻上床睡觉"],"answer":[1],"explanation":"知识点是日落综合征的应对。正确项顺应其行为并转移话题，减少焦虑。错误项A用现实纠正易引发争执；错误项C强行拿走物品会激越；错误项D在傍晚强行卧床常导致抵抗和徘徊加重。","tier":"基础"},{"id":19,"type":"single","stem":"失智老人误把洗衣液当饮料拿起，照护者预防此类事件最有效的日常措施是","options":["反复告知洗衣液不能喝","将清洁剂锁入柜中存放","在瓶身贴上大字标签","把洗衣液换成透明瓶子"],"answer":[1],"explanation":"知识点是失智症居家安全中的危险品管理。正确项物理隔离是预防误食最可靠的手段。错误项A口头告知老人记不住；错误项C标签对失智老人识别帮助有限；错误项D换透明瓶反而更像饮料，增加风险。","tier":"进阶"},{"id":20,"type":"single","stem":"照护人员发现失智老人把牙膏挤在梳子上梳头，此时最适宜的初始应对是","options":["递上梳子并示范梳头动作","纠正老人说牙膏不能梳头","把牙膏收走并带老人去洗手","大声提醒老人拿错了物品"],"answer":[0],"explanation":"知识点：失智症行为症状的非对抗性应对。正确项用示范引导替代纠正，可减少激越。错误项：B直接纠正会引发挫败与争执；C强行收走物品易触发抗拒；D大声提醒属对抗性沟通，会加重混乱。","tier":"挑战"},{"id":21,"type":"single","stem":"与中度失智老人交谈时，照护人员一次只问一个问题，主要是为了","options":["降低老人的理解与选择负担","避免老人用沉默来回避","让照护人员节省沟通时间","符合机构规定的问询流程"],"answer":[0],"explanation":"知识点：失智症沟通技巧。正确项因为失智老人信息处理容量下降，单问题可减轻认知负荷。错误项：B把沟通目的误解为防回避；C曲解为效率考虑；D与机构流程无关。","tier":"基础"},{"id":22,"type":"single","stem":"失智老人反复问“我妈妈什么时候来接我”，其母亲早已去世，照护人员较适宜的回应是","options":["告诉老人母亲已去世多年","顺着说妈妈晚点来并转移话题","反问老人妈妈现在住在哪里","假装打电话说妈妈马上就到"],"answer":[1],"explanation":"知识点：失智症沟通中的情感回应与转移。正确项先接纳情绪再用话题转移，避免反复伤害。错误项：A反复陈述死亡事实会造成二次悲伤；C反问会加重老人困惑与焦虑；D编造马上到达易引发持续守候和追问。","tier":"进阶"},{"id":23,"type":"single","stem":"失智老人傍晚出现坐立不安、来回走动并喊要回家，首先应排查的因素是","options":["老人是否饥饿或需要如厕","老人是否故意不配合照护","老人是否想更换照护人员","老人是否在考验机构管理"],"answer":[0],"explanation":"知识点：黄昏综合征的诱因排查。正确项先排除饥饿、如厕、疼痛等生理需求。错误项：B把症状归因于故意对抗；C与行为诱因无关；D把照护问题道德化，均会延误处理。","tier":"进阶"},{"id":24,"type":"single","stem":"为失智老人安排进餐座位时，减少其分心、促进进食的较适宜做法是","options":["安排在靠窗且能看到走廊的位置","安排在安静角落并减少桌面物品","安排在电视机正前方便于陪伴","安排在人流最多的中央餐桌"],"answer":[1],"explanation":"知识点：失智症环境调整与进食照护。正确项减少视觉听觉干扰，利于专注进食。错误项：A靠窗走廊人流会分散注意；C电视画面声音干扰进食；D中央餐桌刺激过多易致躁动。","tier":"进阶"},{"id":25,"type":"single","stem":"失智老人夜间起床游走，照护人员采用床旁感应地灯的主要目的是","options":["减少夜间定向障碍与跌倒风险","约束老人夜间下床活动","提醒家属老人已经起床","替代夜间巡视的全部工作"],"answer":[0],"explanation":"知识点：失智症安全照护中的夜间环境干预。正确项低照度地灯帮助定向又不刺激清醒。错误项：B地灯不具约束作用；C主要目的不是通知家属；D不能替代巡视，属过度推断。","tier":"基础"},{"id":26,"type":"multi","stem":"失智老人出现攻击行为时，照护人员可采取的处置包括","options":["保持一臂以上距离并侧身站立","用平静简短语句安抚老人","立即从正面抓住老人双手","移除周围可能伤人的物品","与老人争辩谁对谁错"],"answer":[0,1,3],"explanation":"知识点：失智症激越与攻击行为的现场处置。正确项A保持安全距离、B简短安抚、D清理危险物均能降低伤害。错误项：C正面抓握易被感知为威胁而升级冲突；E争辩会加重挫败与对抗。","tier":"进阶"},{"id":27,"type":"single","stem":"失智老人被怀疑误吸后出现剧烈呛咳，照护人员下一步最适宜的是","options":["让老人平卧休息观察","立即喂水缓解咳嗽","扶老人坐直并评估呼吸","拍背同时继续喂饭"],"answer":[2],"explanation":"知识点：误吸的识别与初步处置。正确项保持坐位、开放气道并评估呼吸状态。错误项：A平卧会增加误吸风险；B喂水可加重气道异物；D继续进食会让更多食物进入气道。","tier":"基础"},{"id":28,"type":"single","stem":"失智老人把遥控器放进冰箱，照护人员最适宜的长期管理策略是","options":["反复教育老人物品固定位置","将遥控器换成醒目的大号样式","把冰箱门加锁防止乱放","每天检查冰箱并批评老人"],"answer":[1],"explanation":"知识点：失智症物品归置问题的环境支持。正确项用高辨识度物品降低误放概率。错误项：A反复教育超出其记忆能力；C加锁影响冰箱正常使用且不解决根因；D批评会伤害自尊且无效。","tier":"基础"},{"id":29,"type":"single","stem":"照护人员协助失智老人穿衣时，为促进其参与，较适宜的做法是","options":["把衣服按穿着顺序摆好并一步步提示","一次性把全部衣服递给老人自行选择","替老人快速穿好以免其劳累","让老人自己穿直到完全穿对为止"],"answer":[0],"explanation":"知识点：失智症日常生活能力支持。正确项按顺序摆放加步骤提示，保留参与感。错误项：B多件选择造成决策负担；C完全代劳加速功能退化；D放任不管会带来挫败与受凉风险。","tier":"基础"},{"id":30,"type":"single","stem":"失智老人家属反映老人总说“有人偷我东西”，照护人员较适宜的沟通是","options":["明确告诉家属这是妄想不必理会","先回应老人的不安再协助寻找","当场指出老人记错了并纠正","要求家属搜查其他老人房间"],"answer":[1],"explanation":"知识点：失智症妄想的情感回应。正确项先安抚情绪，再陪同寻找，减少冲突。错误项：A忽视情绪会加重不安；C直接纠正会引发争执；D搜查他人房间侵犯隐私且激化矛盾。","tier":"进阶"},{"id":31,"type":"single","stem":"失智老人洗澡时突然大喊拒绝，照护人员最适宜的处理是","options":["暂停操作并询问是否水温不适","坚持完成洗澡以免着凉","叫来同事一起按住老人","批评老人不配合照护工作"],"answer":[0],"explanation":"知识点：失智症抗拒照护的应对。正确项暂停并排查水温、疼痛、害怕等诱因。错误项：B强行继续会升级抗拒；C按压属不当约束；D批评无助于解决诱因且伤害尊严。","tier":"挑战"},{"id":32,"type":"single","stem":"照护人员发现中度失智老人近期常在傍晚反复整理衣物并说要“回家找妈妈”，此时最恰当的应对是","options":["陪他一起叠几件衣服，顺势聊他小时候的事，再把话题引到晚饭","告诉他这里就是他的家，妈妈早就不在了，让他别再乱说","把他带到门口让他看清楚外面不是他原来的家","给他服用医生之前开的助眠药让他安静下来"],"answer":[0],"explanation":"知识点是失智症黄昏综合征与“回家”诉求的应对，正确项通过顺应其情绪、转移注意力来安抚，不与其争辩事实。B错在直接否定并提及其母亲去世，易引发激越；C错在用现实检验强行纠正，常加重焦虑；D错在照护人员不得擅自给药，且助眠药不针对情绪诉求。","tier":"挑战"},{"id":33,"type":"single","stem":"与失智老人交流时，为减少其理解负担，照护人员应采用的说话方式是","options":["一次只说一件事，句子短，语速放慢并配合手势","提高音量大声说，让他听得更清楚","用“咱们”开头，一次把三件事连着交代清楚","改用儿化音和方言，显得亲切自然"],"answer":[0],"explanation":"知识点是失智症沟通技巧，正确项强调单一线索、简短句、慢语速和视觉提示。B错在听力下降并非主因，大声易被感知为呵斥；C错在一次交代多件事超出其工作记忆容量；D错在语言切换可能增加理解难度，除非老人一贯使用该方言。","tier":"进阶"},{"id":34,"type":"single","stem":"失智老人夜间起床在房间里来回走动，照护人员首先应排查的常见诱因是","options":["是否存在尿意、疼痛、口渴或环境过亮过暗","是否白天睡得太少导致夜里精力过剩","是否晚饭吃得太多引起胃肠不适","是否房间朝向不对影响睡眠方向"],"answer":[0],"explanation":"知识点是失智症夜间游走的原因排查，正确项从生理需求与环境刺激入手，这是首要步骤。B颠倒昼夜规律，白天睡太少通常夜间更易入睡；C晚饭过量不是游走的首要常见诱因；D朝向与睡眠方向无科学依据，属伪因素。","tier":"进阶"},{"id":35,"type":"single","stem":"失智老人怀疑保姆偷了自己的钱，反复翻找并指责照护人员，正确的处理方式是","options":["陪他一起找，找到后把话题引到别处，不与其争论偷窃真假","当面搜保姆的包以证明清白，让老人放心","告诉他钱是他自己放丢的，让他承认记错","把钱包收走由家属保管，避免再次发生"],"answer":[0],"explanation":"知识点是失智症被害妄想的应对，正确项共情陪伴、转移注意，不卷入争辩。B错在搜查他人隐私既侵权又会强化妄想；C错在正面纠正记忆缺陷，易激化情绪；D错在未与家属及老人协商的单方处置，可能加剧被偷感。","tier":"进阶"},{"id":36,"type":"single","stem":"为预防失智老人走失，照护人员在交接班时最应确认的是","options":["老人当前所在位置、门窗状态和外出陪同安排","老人今天穿的衣服颜色和鞋码","老人今天的血压和血糖数值","老人家属最近一次探视的时间"],"answer":[0],"explanation":"知识点是失智症走失预防的交接要点，正确项聚焦位置、出口和陪同三项关键风险控制点。B错在衣着信息不能防止走失，仅便于事后寻找；C错在血压血糖与走失风险无直接关联；D错在探视时间不影响当班防走失措施。","tier":"基础"},{"id":37,"type":"single","stem":"失智老人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