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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.
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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 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.
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.
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.