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A group of nurses who have recently been hired to work in the mental health division of a large federal prison system are undergoing orientation. A nurse is discussing medication administration for the clients. Which statement would the nurse most likely include in this presentation?
- A. Our inmates have to take their medication; to facilitate this, most of our oral medications are dissolved in water before we hand them to a prisoner.
- B. Our inmates have the same rights as any clients do. If they refuse medications and become a danger to themselves, we still cannot give any medications.
- C. Our inmates have to take their medications; we routinely give them injections so they can?t cheek their medications.
- D. If our inmates refuse to take their medications, we have to get a court order that mandates compliance with prescribed medications.
Correct Answer: D
Rationale: In a prison setting, if inmates refuse medications, a court order may be required to mandate compliance (D), especially for mental health treatment in forensic clients. Dissolving medications (A) or using injections (C) to prevent cheeking is not standard practice, and inmates retain some rights to refuse (B) unless a court order is obtained.
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When preparing the plan of care for a forensic client, a nurse determines not to investigate the details of the crime. Which of the following best supports the rationale for the nurse?s decision?
- A. Knowing the crime details would be extremely frightening for the nurse.
- B. Denying the crime details will help to protect the nurse from undue anxiety.
- C. It will keep the nurse?s attitudes about the crime from influencing care.
- D. It will help maintain proper professional boundaries between the nurse and the client.
Correct Answer: C
Rationale: Avoiding crime details prevents the nurse?s attitudes about the crime from influencing care (C), ensuring unbiased, therapeutic treatment. Fear (A) and anxiety (B) are less relevant, and boundaries (D) are maintained through other professional practices, not just avoiding crime details.
A student nurse has been asked by the mental health nursing instructor to plan educational interventions for a forensic client with whom the student has been working. Which of the following would be most important for the student nurse to include in the plan?
- A. Explanation of the genetic and neurologic factors associated with criminal behavior
- B. Description of information about pertinent legal and court proceedings that are pending
- C. Explanation of how nutrition and exercise can promote physical and mental well-being
- D. A list of community providers the client?s family members can contact for assistance and support
Correct Answer: C
Rationale: Educating the client on how nutrition and exercise promote physical and mental well-being (C) is most relevant, as it empowers the client to manage health post-discharge. Genetic factors (A) are not directly actionable, legal proceedings (B) are outside nursing scope, and provider lists for family (D) are less client-focused.
A nurse is working with a forensic client on early recognition. On which area would the nurse and client focus?
- A. Medication side effects
- B. Aggressive behavior signals
- C. Violations of informed consent
- D. Discharge needs
Correct Answer: B
Rationale: Early recognition focuses on identifying aggressive behavior signals (B) to prevent escalation in forensic clients. Medication side effects (A), informed consent (C), and discharge needs (D) are important but not the primary focus of early recognition training.
A nursing instructor is explaining to a group of nursing students that in addition to facing the stigma associated with being mentally ill, forensic clients who are mentally ill also experience the stigma associated with being a criminal. One of the students asks the instructor how the stigma associated with criminality might influence nursing care. Which response by the instructor would be most appropriate?
- A. Nurses may be reluctant to care for mentally ill criminals because of unrealistic fears for their own safety and that of their other clients.
- B. Nurses may prefer to care for forensic clients because they do not believe criminals can be mentally ill.
- C. An example would be volunteering to work only with forensic clients because of the belief that forensic clients experience only mild mental health problems.
- D. An example would be unfounded fear of what such clients might do after they are discharged from treatment.
Correct Answer: A
Rationale: Stigma associated with criminality can lead nurses to be reluctant to care for forensic clients due to unrealistic safety fears (A). Option B is incorrect, as nurses do not typically deny mental illness in criminals. Option C misrepresents nurses? motivations, and option D focuses on post-discharge fears, which is less relevant to direct care.
The nurse is performing an admission assessment on a forensic client. Which of the following would be most important for the nurse to include when explaining the purpose of the assessment to the client?
- A. This is just a routine assessment, and we will be discussing specific events that have led to you being admitted to this unit.
- B. I will be asking you questions so we can determine how to best meet your needs.
- C. It is important during this initial assessment that you relate the specific details of the crimes of your case so we can effectively treat you.
- D. I will be asking you questions that will focus on mental health and behavioral issues rather than on the specific details of any crimes associated with your case.
Correct Answer: D
Rationale: Explaining that the assessment focuses on mental health and behavioral issues (D) is most appropriate, as it clarifies the therapeutic purpose and avoids delving into crime details, which could bias care. Routine assessment (A) is vague, discussing crime events (C) is inappropriate, and option B is less specific.