Chapter 33: Forensic Nursing Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition MULTIPLE CHOICE 1. A person diagnosed with bipolar disorder ran out of money, did not refill a lithium
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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.
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ANS: C
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To increase medication adherence, reduce the risk of relapse, and prevent further criminal activity due to mental illness, the person’s awareness of community resources for medication refills and medication-related services is the most important outcome. Agreeing to take lithium, being reestablished on medication in the jail, and agreeing to follow-up mental health care are important, but none of these will address the primary reason for the criminal behavior: the relapse caused by inability to access medication in the community.
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PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Page 33-21 TOP: Nursing Process: Outcomes Identification MSC: Client Needs: Health Promotion and Maintenance
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2. An inmate was diagnosed with posttraumatic stress disorder (PTSD) caused by severe sexual
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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. ANS: D
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The correctional nurse recognizes that events occurring in the present reality are likely to be incorporated into a flashback, leading the inmate to become more frightened and desperate to escape. Even if no longer experiencing a flashback, persons will likely re-experience their original trauma if restrained, including the emotions experienced during that trauma, leading to increased fearfulness and resistance to the jail restraints. Restraints are not likely to calm the individual or reduce aggressiveness but instead increase the sense of helplessness and desperation.
PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 33-19, 21, 22 (Vignette) TOP: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity
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