Deck 32: Forensic Psychiatric Nursing

Question 1

Which treatment setting would necessitate the most restrictive care environment?

A) Partial hospitalization program
B) Geropsychiatric unit
C) Forensic hospital
D) Group home

Answer 1

Forensic hospital

Question 2

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 persons rather than persons with psychiatric or substance abuse disorders.
C) More persons diagnosed with mental illness receive treatment services in prisons than in inpatient psychiatric facilities.
D) Correctional nurses commonly provide holistic and comprehensive care for the incarcerated population.

Answer 2

More persons diagnosed with mental illness receive treatment services in prisons than in inpatient psychiatric facilities.

Question 3

Select the best question for a psychiatric forensic nurse examiner to ask when assessing the legal sanity 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 3

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

Question 4

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.

Question 5

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) Counseling inmates to promote successful adaptation to incarceration

Question 6

A guard tells an inmate diagnosed with schizophrenia to ask the desk officer for a mop and bucket,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 reevaluation of this inmate's antipsychotic medication regime.
D) Explain to the guard that this inmate has difficulty following multiple instructions. Suggest stating one idea at a time.

Question 7

Health problems most commonly encountered by correctional nurses are:

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 8

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 behavior
D) The defendant's history and cognitive abilities

Question 9

The psychiatric forensic nurse provides this description of work responsibilities: "I use knowledge of psychopathology as I investigate and reconstruct crimes and then try to understand a criminal's reasoning process.This allows me to compile information on what type of individual would have most likely committed the crime." The work the nurse describes is that of a:

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

Question 10

An inmate was diagnosed with posttraumatic 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.The correctional nurse should anticipate that the inmate would react to restraint by:

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

Question 11

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 12

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 behavior as well as interventions performed and documented during the shift.In what capacity was this nurse testifying?

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

Question 13

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

A) fact witness.
B) expert witness.
C) correctional nurse.
D) critical care nurse.

Question 14

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

A) Determine if the defendant understands the charges and can assist the attorney with the defense.
B) Complete a risk assessment to determine if the defendant is a danger to self or others.
C) Reconstruct the defendant's mental state and motives at the time of the crime.
D) Collect and compile evidence to determine whether a crime occurred.

Question 15

An inmate was diagnosed with posttraumatic 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 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 16

A psychiatric forensic nurse assigned to a hostage negotiation tactical team is deployed when an individual takes several hostages.Which tasks apply to the nurse's role on the team? Select all that apply.

A) Assess released hostages.
B) Negotiate with the perpetrator.
C) Direct strategies for police deployment.
D) Assess the mental status of the perpetrator.
E) Suggest communication techniques to a negotiator.

Question 17

In which circumstance would a psychiatric forensic nurse examiner determine it appropriate for a defendant and attorney to consider the insanity defense? At the time of the crime,the defendant:

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.

Question 18

Which credential would be expected of an expert witness in the area of forensic psychiatric nursing?

A) 3 years of experience in an inpatient psychiatric facility
B) 10 years of experience in community health nursing
C) Educational preparation of an associate degree in nursing
D) Publication of three articles in peer-reviewed psychiatric nursing journals

Question 19

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? The person:

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

Question 20

A correctional nurse plans a health education series for prison inmates.Which topic is most important for the nurse to include in this series?

A) Sleep hygiene
B) Personal grooming
C) Social skills training
D) Assertive communication

Question 21

Which characteristics best qualify a nurse for employment as a forensic psychiatric nurse? Select all that apply.

A) Incorporation of "street smarts" into clinical practice
B) Comfortable in a variety of practice settings
C) Desire to punish perpetrators of crime
D) Able to think clearly under stress
E) Autonomous and self-sufficient
F) Critical care skills