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A nurse is working with a forensic client on de-escalation techniques. Which activity would be most appropriate as a grounding physical activity?
- A. Drumming
- B. Rocking in a rocking chair
- C. Aerobic exercise
- D. Yoga
Correct Answer: B
Rationale: Rocking in a rocking chair (B) is a calming, grounding activity that helps reduce agitation in forensic clients. Drumming (A) and aerobic exercise (C) may be stimulating, and yoga (D) requires more focus, making them less effective for immediate de-escalation.
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A psychiatric nursing instructor is trying to explain to a group of students how clients identified as guilty but mentally ill (GBMI) and not guilty by reason of insanity (NGRI) differ. Which of the following would be most appropriate for the instructor to include in the discussion?
- A. GBMI clients are treated in a hospital setting, and they are often discharged sooner than NGRI clients.
- B. NGRI clients are treated in a correctional setting, and they are discharged sooner than GBMI clients.
- C. GBMI clients are treated in a hospital setting, and their discharge is handled through the correctional parole system.
- D. NGRI clients are treated in a hospital setting, and their discharge is determined by the courts.
Correct Answer: D
Rationale: NGRI clients are treated in a hospital setting with discharge determined by courts (D), as their mental illness prevented criminal responsibility. GBMI clients (A, C) are typically managed in correctional settings with parole oversight, not hospital discharge. NGRI clients are not discharged sooner (B).
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 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.
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.
The nurse is reviewing the medical record of a forensic client who has been found not guilty by reason of insanity. The nurse interprets this to mean which of the following?
- A. The client knows that he committed a wrongful act.
- B. The client is unable to control actions at the time of the crime.
- C. The client is unable to assist in his defense.
- D. The client?s mental illness is a factor in the crime.
Correct Answer: B
Rationale: Not guilty by reason of insanity (NGRI) means the client was unable to control actions at the time of the crime (B) due to mental illness, as per legal standards. Knowing the act was wrong (A) contradicts NGRI, inability to assist in defense (C) relates to competency to stand trial, and mental illness as a factor (D) is too vague.