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A nurse?s friend is considering going into forensic nursing and asks the nurse to explain the connection between mental illness and being convicted of a crime. Which response by the nurse would be most accurate?
- A. Mentally ill men are less likely than nonmentally ill men to be convicted of a crime.
- B. Mentally ill women are less likely than nonmentally ill women to be convicted of a crime.
- C. Women who are incarcerated are more likely to receive mental health services than men.
- D. African American offenders often receive more mental health treatment than other offenders.
Correct Answer: C
Rationale: Women who are incarcerated are more likely to receive mental health services than men (C), as studies show higher rates of mental health intervention for female inmates due to greater recognition of their needs. Mentally ill individuals (A, B) are not less likely to be convicted; mental illness often increases legal involvement. African American offenders (D) typically face disparities in access, not more treatment.
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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 has just transferred from a general psychiatric unit to work on a forensic psychiatric unit. The nurse finds it easier to communicate with these clients because, for the most part, their inappropriate behaviors and cognitive disorders have responded positively to treatment. Many of the clients have been on the unit for 3 or more years, and the nurse has been unable to note any indicators of psychiatric problems in several of the clients. The nurse has grown exceptionally close to one client who has gone out of his way to make the nurse feel welcome and appreciated. One afternoon in December, the client asks the nurse for her address so he can send her a Christmas card. Which response by the nurse would be most appropriate?
- A. Sure, let me write it down for you; it would be great to hear from you.
- B. I read that you molested a 4-year-old girl. I have a 2-year-old child. I would be crazy to give you my address.
- C. We need to get to know each other better before I would feel comfortable about giving you my address.
- D. It is inappropriate for me to give you my address because our relationship is professional rather than social.
Correct Answer: D
Rationale: Maintaining professional boundaries by stating the relationship is professional (D) is the most appropriate response, preventing inappropriate personal interactions. Sharing the address (A) violates boundaries, mentioning the crime (B) is unprofessional, and suggesting future closeness (C) blurs boundaries.
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.
A nurse is giving a public presentation on the topic of forensic psychiatric care at a community center in a community that is considering building a forensic facility. The nurse is explaining about how someone who is found to be unfit to stand trial is subsequently hospitalized in a forensic mental health facility. A member of the audience asks, 'What is the purpose of the hospitalization?' Which response by the nurse would be most appropriate?
- A. Basically, they are kept under protective custody as long as necessary.
- B. Efforts are focused on helping the client become ?fit? to stand trial.
- C. Treatment is focused on determining the correct diagnosis.
- D. The main purpose is holding the client until a new trial date can be set.
Correct Answer: B
Rationale: Hospitalization for those unfit to stand trial aims to restore competency (B) through treatment, enabling them to participate in their legal defense. Protective custody (A) is not the primary goal, diagnosis (C) is secondary, and holding for a trial date (D) oversimplifies the purpose.
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.