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14. 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

ANS: A eBay: testbanks_and_xanax

The most common mental health symptoms experienced by inmates are insomnia and hypersomnia; therefore, sleep hygiene would address these needs. Sleep is a basic physiological need that must be met before higher needs are addressed.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Page 33-19 TOP: Nursing Process: Planning

MSC: Client Needs: Psychosocial Integrity

15. 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.

ANS: B

Correctional nurses provide care for inmates who have disproportionately high rates of mental illness, substance abuse, tuberculosis, AIDS, hepatitis, diabetes, and other chronic disorders and infections. The health problems of inmates are more complex and chronic, not similar to their non-incarcerated peers. Trauma is an important issue that affects inmate health, but it is not the primary health issue for this population as a whole.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Pages 33-17, 18 TOP: Nursing Process: Implementation

MSC: Client Needs: Physiological Integrity 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.

16. 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?

ANS: D

Correctional nurses, like most direct-care nurses outside of corrections, have a professional responsibility to advocate for inmates regarding needed care. A psychiatric nurse would have an understanding of schizophrenia and recognize that the inmate’s ability to process multistep instructions was impaired. Advocacy for the inmate is evident by educating the guard so he would not misperceive the reason the inmate did not respond. Documentation is needed for all nursing activities. Involving the psychiatrist might be of some value but is at best a passive form of advocacy, and again, as worded here, suggests that the nurse does not understand how schizophrenia contributed to the inmate’s not responding to complex instructions.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Page 33-8 TOP: Nursing Process: Implementation

MSC: Client Needs: Psychosocial Integrity eBay: testbanks_and_xanax a. “I am surprised by how challenging the position is and how many skills I have developed.” b. “I have told a few of my former classmates about my job but not my former nursing faculty.” c. “I plan to work here another year and then try again to get a position in a major medical center.” d. “I think it’s better not to post my position or name of my employer on my social network page.”

17. A new nursing graduate obtained licensure as a registered nurse. This nurse searched unsuccessfully for employment in desired settings and, after a year, accepted a position in a forensic facility. One year later, which statement by the nurse best demonstrates successful adaptation to the role?

ANS: A

The correct response demonstrates pride in skills obtained and the challenges of the role, both of which indicate successful adaptation to the role. The incorrect responses suggest the nurse is ashamed of the role or employment site.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Pages 33-3 to 5, 9, 17 TOP: Nursing Process: Evaluation

MSC: Client Needs: Psychosocial Integrity 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.

18. Which statement about the practice of correctional nursing is accurate?

ANS: C

When compared to the rates in the general population (11% of whom have a mental health problem, with approximately 55,000 individuals hospitalized at an inpatient psychiatric hospital on any given day), correctional facilities carry a disproportionate share of the burden for the provision of mental health services. Rates of chronic illness are higher among inmates than in the general population due to factors such as higher rates of poverty, lower educational status, higher rates of trauma, institutional living when incarcerated, reduced access to health care, poor health habits, and higher rates of high-risk behaviors such as IV drug abuse. Correctional settings provide adequate care of inmates, but it is rarely holistic or comprehensive.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 33-18 TOP: Nursing Process: N/A

MSC: Client Needs: Safe, Effective Care Environment a. 3 years of experience in an inpatient psychiatric facility b. 10 years of experience in community health nursing eBay: testbanks_and_xanax c. Educational preparation of an associate degree in nursing d. Publication of three articles in peer-reviewed psychiatric nursing journals

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

ANS: D

To establish credibility as an expert witness and have one's opinion given equal weight to that of other professionals in court, the forensic nurse specialist must have current clinical expertise, trustworthiness, and a professional presentation style. The expert witness is an authority in a specialty area. If the expert has conducted research and published in the area, it is an added strength. Expert testimony is based on evidence-based practice. Forensic nurses with advanced degrees are more likely to be called upon as expert witnesses.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Pages 33-14, 32 (Box 33-3) TOP: Nursing Process: N/A

MSC: Client Needs: Safe, Effective Care Environment

Multiple Response

1. 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.

ANS: A, D, E

The forensic nurse assigned to a hostage tactical team serves to assist the team and provide them with clinical information and assessments consistent with the nurse’s training and experience. This nurse does not negotiate with the perpetrator or direct actions of police officers. Assistance can include assessing the perpetrator, assisting the freed hostages, educating police officers on mental health-related topics, assessing the stress level of the negotiator, suggesting techniques that might be appropriate (particularly when the perpetrator is mentally ill), and serving as a go-between with local mental health agencies.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Pages 33-15, 16 TOP: Nursing Process: Implementation

MSC: Client Needs: Safe, Effective Care Environment 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

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

ANS: A, B, D, E

Forensic nursing requires the ability to address the issues and provide care in a truly neutral manner. All forensic nurses, whatever their specific title or responsibilities, must therefore be objective and not be motivated by any personal beliefs about what should or should not happen to patients involved in the criminal justice system. Street smarts can be a desirable trait in working with perpetrators, especially in hostage negotiation situations. Forensic nurses practice in a wide variety of nontraditional settings. While forensic nurses are often members of teams, autonomy and self-sufficiency are important traits. Forensic nurses do not need critical care skills.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Pages 33-2, 4, 5, 16 TOP: Nursing Process: N/A

MSC: Client Needs: N/A eBay: testbanks_and_xanax