Deck 33: Forensic Psychiatric Nursing

Question 1

A psychiatric forensic clinical specialist is working with a defendant as competency evaluator.A staff member at the mental hospital asks her,"Why are you spending so much time with that guy? You spend one-to-one time with him and even go to activities with him.And I have seen you writing volumes.Usually we just give these people medication for a while and return them to the court." What response by the psychiatric clinical specialist would be most appropriate?

A) "My role is to become an advocate for the defendant,so I have to know him well and build a trusting relationship with him."
B) "The specialized assessments I make on behalf of the court require very lengthy and detailed interviews,so it takes a lot of time."
C) "My focus is providing intensive psychotherapy to ensure the defendant has become competent before he returns to court."
D) "I spend the time observing,assessing,and documenting his competency,write a report,and prepare expert testimony for the court."

Answer 1

"I spend the time observing,assessing,and documenting his competency,write a report,and prepare expert testimony for the court."

Question 2

When asked by student nurses wishing to learn about correctional nursing,the correctional nurse would characterize the health problems of inmates as:

A) primarily routine infections and minor trauma.
B) chronic medical and psychiatric disorders.
C) similar to the nonincarcerated population.
D) injuries acquired during arrest or incarceration.

Answer 2

chronic medical and psychiatric disorders.

Question 3

Which question would the psychiatric forensic nurse examiner ask to obtain data with which to assess legal sanity?

A) "Tell me about what you were thinking at the time of the alleged crime."
B) "What would you do if you heard a fire alarm going off where you live?"
C) "At this time,are you having any experiences that others might think strange?"
D) "Do you feel as though you would like to harm anyone at the present time?"

Answer 3

"Tell me about what you were thinking at the time of the alleged crime."

Question 4

Which quality would be most likely to disqualify a nurse from employment as a forensic psychiatric nurse?

A) Desire to punish the perpetrators of crime
B) Incorporation of "street smarts" into clinical practice
C) Discomfort with serving someone other than the patient
D) Prepared at a basic rather than an advanced practice

Question 5

Which statements would be appropriate to use to explain forensic nursing to the prison staff? Select all that apply.

A) Forensic nurses work exclusively with the alleged perpetrators of criminal activities.
B) The needs of the court or attorneys determine how the forensic nurse interacts with inmates.
C) Forensic nurses often assess the inmate's competence,sanity,risk,and dangerousness.
D) Psychiatric forensic nurses become advocates for defendants in all legal proceedings.

Question 6

The highest degree of credibility is required by a nurse who provides testimony before the court as a(n):

A) expert witness.
B) fact witness.
C) correctional nurse.
D) emergency department trauma nurse.

Question 7

In which case would the psychiatric forensic nurse examiner assess the alleged perpetrator as competent to proceed with trial?

A) The defendant believes the FBI had paid assassins to kill him.
B) The accused hears voices commanding him to kill the president.
C) The defendant is developmentally disabled with an IQ of 70.
D) The accused understands the charges and the trial procedures.

Question 8

The psychiatric forensic nurse examiner has been asked by the defendant's lawyer to determine the patient's legal sanity.The priority task of the nurse will be to:

A) determine if the defendant understands the charges and can assist in his own defense.
B) reconstruct the defendant's mental state and motives at the time of the crime.
C) complete a risk assessment to determine if he is a danger to self or others.
D) collect and compile evidence to determine whether a crime was committed.

Question 9

The mental health corrections nurse assesses a new prisoner who is beginning his incarceration for committing a sex crime.The prisoner speaks in a low voice,is tearful,and tells the nurse that his life may as well be over,because there is no hope that he will ever be able to fit into society after he is released from prison.He states his family has disowned him and wherever he goes,his reputation will follow him.The priority response would be to:

A) advise the guards to place him in solitary confinement.
B) offer to contact his family and his judge to convey his remorse.
C) meet with him weekly to discuss feelings and how he might cope.
D) warn the guards of his risk to self,and implement suicide precautions.

Question 10

An inmate with schizophrenia does not respond when the guard tells him to ask the desk officer for a mop and bucket,then get water from the shower area and mop the center aisle.The guard becomes angry and cancels the inmate's recreation break.Which response by the corrections nurse would be most appropriate?

A) Document the patient's response as indicating that he is resistant and would benefit from a behavior modification plan.
B) Suggest to the jail psychiatrist that when he next does rounds,he reevaluate the patient's medications and talk to the inmate about cooperating.
C) Explain to the guard that schizophrenia makes it hard to follow multistep instructions,and suggest assigning one action at a time.
D) Do not intervene,because it would be inappropriate for a corrections nurse to serve as a patient advocate.

Question 11

An inmate suffers from PTSD caused by severe sexual abuse during which she had been restrained by the perpetrator's girlfriend.One day she sees an inmate who reminds her of the perpetrator's girlfriend and has a flashback,during which she attacks the inmate.Correction officers place her in restraints per the jail's protocol.Which short-term response by the nurse would likely be most therapeutic?

A) Support the use of restraints as needed to control violent outbursts and assure the safety of all inmates.
B) Plan to meet with the patient to debrief her and help her calm after she is released from the required period of restraint.
C) Contact a supervisor authorized to make an exception to the restraint policy and explain that an alternate response is needed to calm this particular inmate.
D) Confront the corrections officers who initiated the restraints,explain the inappropriateness of this action,and request the inmate's release.

Question 12

In which circumstance would a psychiatric forensic nurse examiner determine that it would be appropriate for the defendant and his attorney to consider the legal insanity defense?

A) The defendant experienced auditory hallucinations that he perceived as the voice of God commanding him to drown his child.
B) The accused tampered with the brakes of his wife's car after discovering she had had an affair.
C) The charged inmate shot the drug dealer who refused to give her cocaine when she had no money to buy it.
D) The defendant,frightened because his house had been robbed the night before,assumed his son was a burglar and shot him.

Question 13

The correctional mental health nurse learns that prior to arrest,an inmate with bipolar II disorder had run out of money and had not refilled her lithium prescription,leading to relapse.While psychotic she had assaulted several people in a convenience store and was arrested,tried,convicted,and sentenced.Which outcome would be most important to achieve prior to release? The patient:

A) agrees in writing to take lithium in the community.
B) lists community resources for medication assistance.
C) is reestablished on an appropriate dosage of lithium.
D) agrees to make a follow-up appointment in the clinic.

Question 14

The psychiatric forensic nurse describes her work as follows: "I apply my knowledge of psychopathology as I investigate and reconstruct the crime and attempt to understand the criminal's reasoning process.This allows me to compile information on the type of individual who most likely would have committed the crime." The work the nurse describes is that of the:

A) forensic examiner.
B) competency therapist.
C) hostage negotiator.
D) criminal profiler.

Question 15

Which of the following statements about corrections and correctional nursing is accurate?

A) The majority of inmates are younger than 40 years of age and as a result have lower rates of chronic illnesses than the general population.
B) There are more mentally ill persons incarcerated in state prisons than being treated in state hospitals.
C) Correctional nurses work primarily with medically ill persons rather than with psychiatric or substance abuse disorders.
D) If one is a correctional nurse working with mentally ill persons,he/she is also a forensic psychiatric nurse.

Question 16

A mental health nurse working in a large city jail assesses all new inmates who report that they take psychotropic medication or who present with symptoms of psychiatric disorders.Because of the high number of newly incarcerated individuals the nurse sees,which nursing skill would be a priority for the nurse?

A) Document information that could be used as trial evidence.
B) Quickly and skillfully assess for risk of suicide and violence.
C) Have a comprehensive understanding of community resources.
D) Counsel inmates to promote successful adaptation to incarceration.

Question 17

An inmate suffers from PTSD caused by severe sexual abuse during which she had been restrained by the perpetrator's girlfriend.One day she sees an inmate who reminds her of the perpetrator's girlfriend and has a flashback,during which she attacks the inmate.Corrections officers place her in restraints per the jail's protocol.The corrections nurse should anticipate that the patient will react to the restraints by:

A) gradually calming and returning from the flashback to reality.
B) becoming even more frightened,agitated,and combative.
C) becoming less likely to assault others during future flashbacks.
D) committing to counseling to reduce the incidence of flashbacks.

Question 18

When a defendant is arraigned,she demonstrates bizarre behavior,talking to unseen people,failing to respond to questions asked by the judge,and shouting obscenities during the proceedings.The judge orders an evaluation by a forensic nurse examiner.The information of highest priority the examiner will be asked to provide for the court is an assessment of:

A) the defendant's competence to proceed with trial.
B) the cause of the defendant's courtroom behavior.
C) the defendant's mental state at the time of the crime.
D) the defendant's history and cognitive abilities.

Question 19

A correctional nurse is called to testify about care received by a specific patient in the 8 hours before his successful suicide.The nurse responds to questions about what he saw and heard and the interventions he performed and documented during the work shift.In what capacity was this nurse testifying?

A) Forensic nurse examiner
B) Consultant
C) Expert witness
D) Fact witness