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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 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.
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 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 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.