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A nurse is discussing follow-up care with a forensic client who is being discharged the following week. The client asks the nurse what problems to expect regarding his follow-up care. Which response by the nurse would be most appropriate?
- A. You probably won?t experience any difficulty in finding the care you need after you are discharged.
- B. You will have to find weekly transportation back to the inpatient forensic unit for your follow-up care.
- C. You may experience some difficulty in finding a community provider who will be willing to offer you care because providers generally have a long waiting list.
- D. You may experience some difficulty in finding a community provider to provide you care because of safety and liability concerns.
Correct Answer: D
Rationale: Forensic clients may face difficulty finding community providers due to safety and liability concerns (D) stemming from their criminal history. No difficulty (A) is overly optimistic, returning to the inpatient unit (B) is not typical, and long waiting lists (C) are less specific than safety concerns.
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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.
A client with mental illness and arrested has been found to be unfit to stand trial, and the client is admitted to a forensic mental health facility. The nurse understands that the client can be hospitalized for up to which duration to become fit?
- A. 3 months
- B. 6 months
- C. 1 year
- D. 5 years
Correct Answer: C
Rationale: Clients found unfit to stand trial may be hospitalized for up to 1 year (C) to restore competency, as per typical U.S. legal standards, with extensions possible if needed. Shorter durations (A, B) are insufficient, and 5 years (D) is excessive unless specified by the court.
A psychiatric nurse who works with forensic clients is describing the roles and responsibilities to a group of nursing students. Which of the following would the nurse emphasize as critical before initiating medication therapy for a forensic client?
- A. Court order for medication
- B. Determination of not guilty by reason of insanity
- C. Informed consent
- D. Identification of history for aggression
Correct Answer: C
Rationale: Informed consent (C) is critical before initiating medication therapy, even in forensic settings, to respect client autonomy unless overridden by a court order. A court order (A) is only needed if consent is refused, NGRI status (B) is unrelated, and aggression history (D) informs but does not precede consent.
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.
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.