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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.
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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 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.
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 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 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.