Deck 32: Forensic Psychiatric Nursing

Question 1

Which specific task-oriented areas apply to the psychiatric forensic nurse's role?

A) Hostage negotiation
B) Management of violent behaviour
C) Administration of first aid
D) Therapeutic use of self
E) Pharmacological treatment orders

Answer 1

Hostage negotiation
Management of violent behaviour
Administration of first aid

Question 2

Select the best question for a psychiatric forensic nurse examiner to ask when assessing the fitness to stand trial of an individual charged with a crime.

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 yourself or anyone else at the present time?"

Answer 2

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

Question 3

The correctional nurse assesses a new prisoner beginning incarceration after committing a sex crime. The prisoner speaks in a low voice and tearfully tells the nurse, "My life might as well be over. There is no hope I will ever fit into society after I get out of prison. My family disowned me." Select the nurse's priority action.

A) Advise guards to place the inmate in solitary confinement.
B) Offer to contact the inmate's family to convey these feelings of remorse.
C) Alert the guards of the risk for suicide and implement suicide precautions.
D) Meet with the inmate weekly to discuss these feelings and explore coping strategies.

Answer 3

Alert the guards of the risk for suicide and implement suicide precautions.

Question 4

A psychiatric forensic nurse examiner was asked by a defendant's attorney to determine the defendant's fitness to stand trial. What is the priority task of the nurse examiner?

A) Determine if the defendant understands the charges and can assist the attorney with the defence.
B) Complete a risk assessment to determine if the defendant is a danger to self or others.
C) Complete a court-ordered evaluation of criminal responsibility.
D) Collect and compile evidence to determine whether a crime occurred.

Question 5

A person diagnosed with bipolar disorder ran out of money, did not refill a lithium prescription, and then relapsed. After assaulting several people in the community, this person was convicted and sentenced. Prior to parole, which outcome has priority for the correctional nurse to achieve?

A) The person agrees in writing to continue lithium therapy.
B) The person is re-established on an appropriate dose of lithium.
C) The person lists community resources for prescription assistance.
D) The person agrees to a follow-up appointment in an outpatient clinic.

Question 6

Which statement about the practice of correctional nursing is accurate?

A) Because the majority of inmates are younger than 40 years of age, most have lower rates of chronic illnesses than the general population.
B) Correctional nurses work primarily with medically ill people rather than people with psychiatric or substance abuse disorders.
C) Individuals with mental illness are over-represented in the Canadian criminal justice system.
D) Correctional nurses commonly provide holistic and comprehensive care for the incarcerated population.

Question 7

Which credential would be expected of forensic psychiatric nursing?

A) Three years of experience in an inpatient psychiatric facility
B) Ten years of experience in community health nursing
C) Educational preparation in theories of violence and victimology
D) Publication of five articles in peer-reviewed psychiatric nursing journals

Question 8

A correctional nurse working in a county jail assesses all new inmates who report taking psychotropic medication or have symptoms of psychiatric disorders. Because of the high volume of newly incarcerated individuals, which skill is most essential for this nurse?

A) Documenting information that could be used as trial evidence
B) Quickly and skillfully assessing risks for suicide and violence
C) Having a comprehensive understanding of community resources
D) Counselling inmates to promote successful adaptation to incarceration

Question 9

Which Correctional Service Canada treatment setting would necessitate the most restrictive care environment?

A) Institutional health unit
B) Reception centre
C) Regional treatment centre
D) Regional hospital

Question 10

Health problems most commonly encountered by correctional nurses are which of the following?

A) Routine infections and minor trauma
B) Chronic medical and psychiatric disorders
C) Similar to the non-incarcerated population
D) Injuries acquired during arrest or incarceration

Question 11

An inmate was diagnosed with post-traumatic stress disorder (PTSD) caused by severe sexual abuse. One day this inmate sees a person with similar characteristics to the perpetrator, has a flashback, and then attacks the person. Correctional officers place the inmate in restraint. Which action by the correctional nurse is most appropriate?

A) Plan to meet with the inmate for debriefing after release from the required period of restraint.
B) Support the use of restraints as needed to control violent outbursts and assure the safety of all inmates.
C) Contact a supervisor authorized to make an exception to the restraint policy and explain why an alternate response is needed.
D) Confront the correctional officers who initiated the restraint, explain the inappropriateness of this action, and request the inmate's release.

Question 12

A psychiatric clinical nurse specialist works with a defendant as a competency evaluator. A staff member asks, "Why are you spending so much time with that defendant? You spend one-to-one time and write volumes. Usually, we give defendants some medication and return them to court." Select the clinical nurse specialist's most appropriate response.

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

Question 13

The highest degree of credibility is required by a nurse who provides testimony before the court as which of the following?

A) Hostile witness
B) Expert witness
C) Correctional nurse
D) Critical care nurse

Question 14

A correctional nurse plans a health education series for male prison inmates based upon the greatest likelihood of experiencing which mental health disorder while incarcerated?

A) Mood disorder
B) Schizophrenia
C) Hallucinations
D) Bipolar disease

Question 15

During arraignment, a defendant behaves bizarrely, fails to respond to the judge's questions, and shouts obscenities. The judge orders an evaluation by a forensic nurse examiner. Which information provided by the examiner will be most important to the court at this time?

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

Question 16

A nurse testifies about care provided to a patient in the 8 hours before a successful suicide. The nurse responds to questions about observations regarding the patient's behaviour. In what capacity was this nurse testifying?

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

Question 17

A guard tells an inmate diagnosed with schizophrenia to ask the desk officer for a mop and bucket, and then get some water from the shower area and mop the kitchen and hall. The inmate does not comply. The guard becomes angry and cancels the inmate's recreation time. Which action by the correctional nurse is most appropriate?

A) Document the inmate's response as indicative of resistance and psychopathology.
B) Do not intervene. Intervention is not part of a correctional nurse's scope of practice.
C) Confer with the prison psychiatrist regarding re-evaluation of this inmate's antipsychotic medication regime.
D) Explain to the guard that this inmate has difficulty following multiple-step instructions. Suggest stating one idea at a time.

Question 18

What chronic condition is an individual that is incarcerated in a Canadian federal institution more likely to have than someone in the general population?

A) COPD
B) Diabetes
C) Multiple sclerosis
D) Cystic fibrosis

Question 19

An inmate was diagnosed with post-traumatic stress disorder (PTSD) caused by severe sexual abuse. One day this inmate sees a person with characteristics similar to the perpetrator, has a flashback, and then attacks the person. Correctional officers place the inmate in restraint. In what way should the correctional nurse anticipate that the inmate would react to restraint?

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

Question 20

In which circumstance would a psychiatric forensic nurse examiner determine it appropriate for a defendant and attorney to consider a "not criminally responsible" defence? At the time of the crime, the defendant did which of the following?

A) Shot a drug dealer who tried to overcharge for cocaine
B) Acted on auditory hallucinations of the voice of God commanding, "Kill the children."
C) Tampered with the brakes on his wife's car after discovering she had an extramarital affair
D) Was frightened because of a home robbery the preceding night, assumed a family member was another burglar, and shot him