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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).
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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.
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.
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.
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.
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.