Question 1

A student nurse has been asked by the psychiatric-mental health instructor to plan educational interventions for a forensic client. The client is scheduled for a court hearing. Which activity would be most important for the student nurse to include in the plan?

Accepted Answer

An understanding of the legal proceedings is essential for any person charged with crimes. Court process counseling educates mentally ill clients about impending legal procedures and prepares them for courtroom appearances. This intervention is used for all forensic clients, including those preparing for their fitness to stand a trial hearing, as well as those preparing for discharge. Factual information such as roles and functions of key courtroom personnel, potential pleas that might be offered in court, and the nature of the legal process are basic to this intervention. Fitness issues are discussed as appropriate.

Question 2

A client with mental illness who has been arrested has been found 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?"

Accepted Answer

An individual who is found to be unfit to stand trial cannot be "unfit" forever. If fitness cannot be attained within one year, a hearing must be held, during which the facts of the alleged crime are presented to a judge who rules on the case. If the charges are dismissed, the judge could order a civil commitment. If there is sufficient evidence to convict, the individual could be sent back to the hospital for further treatment to attain fitness. The maximum length of this additional treatment is based on the severity of the charge.

Question 3

The nurse is reviewing the medical record of a forensic client who has been found not guilty by reason of insanity. Which statement represents the meaning of this outcome?

Accepted Answer

A possible outcome or disposition of a hearing or trial is not guilty by reason of insanity (NGRI). The accused person is judged to not know right from wrong or to be unable to control his or her actions at the time of the crime. A defendant is found unfit to stand trial (UST) if, because of a mental or physical condition, he or she is unable to understand the nature and purpose of the proceedings or to assist in the defense. Guilty but mentally ill (GBMI) is a criminal conviction in which mental illness is considered a factor in the crime, but not to the extent that the individual is incapable of knowing right from wrong or controlling his or her actions.

Question 4

A nurse is caring for a forensic client who is unfit to stand trial. After one year of hospitalization, which intervention is next for this client?

Accepted Answer

An individual cannot be "unfit" forever. If fitness cannot be attained within one year, a hearing must be held and the facts of the alleged crime are presented to a judge who rules on the case. If the charges are dismissed, the judge could order a civil commitment. If there is sufficient evidence to convict, the individual could be sent back to the hospital for further treatment to attain fitness. The maximum length of this additional treatment is based on the severity of the charge.

Question 5

A nursing instructor is preparing a class discussion on the topic of self-determinism. Which topics would the instructor expect to include? Select all that apply.

Accepted Answer

Self-determinism is defined as being empowered or having the free will to make moral judgments. Personal autonomy and avoidance of dependence are key values. A self-determined individual is internally motivated to make choices based on personal goals, not to please others or be rewarded. It is the right to choose one's own health-related behaviors and refuse treatment.

Question 6

A psychiatric-mental health nurse is providing care to a client diagnosed with dementia. The client has been deemed competent. The nurse understands that the client would demonstrate which behaviors? Select all that apply.

Accepted Answer

A client who is competent should be able to: communicate choices (repeat what he or she heard); understand relevant information (able to paraphrase understanding of the treatment); appreciate the situation and its consequences (discuss the disorder, need for treatment, likely outcomes, and reason treatment is being suggested); and use a logical thought process to compare the risks and benefits of treatment options (discuss the logical reasons for the treatment choice).

Question 7

A psychiatric-mental health nurse is providing care to a client at a community mental health center. When documenting the client's care, which statements would be most appropriate to include? Select all that apply.

Accepted Answer

When documenting care, all entries should be clear, well written, and void of jargon. Judgmental statements, such as "client is manipulating staff" should not be included in records. Only meaningful, accurate, objective descriptions of behavior should be used. General, stereotypical statements, such as "had a good night" or "no issues" are meaningless and should be avoided. Statements depicting the client's behavior, such as refusing to participate in group therapy and answering questions clearly and completely, as well as direct patient statements are valid entries.

Quiz 4: Patient Rights and Legal Issues