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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.
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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.
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.
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.
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 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).