Ch. 32 Forensic Nursing
A client living independently had command hallucinations to shout warnings to neighbors. After a short hospitalization, the client was prohibited from returning to the apartment. The landlord said, "You cause too much trouble." What problem is the client experiencing? a. Grief b. Stigma c. Homelessness d. Nonadherence
b. Stigma
Which service would be expected to provide resources 24 hours a day, 7 days a week if needed for persons with serious mental illness (SMI)? a. Clubhouse model b. Cognitive-behavioral therapy (CBT) c. Assertive community treatment (ACT) d. Cognitive enhancement therapy (CET)
c. Assertive community treatment (ACT)
The parent of a seriously mentally ill adult asks the nurse, "Why are you making a referral to a vocational rehabilitation program? My child won't ever be able to hold a job." Which is the nurse's best reply? a. "We make this referral to continue eligibility for federal funding." b. "Are you concerned that we're trying to make your child too independent?" c. "If you think the program would be detrimental, we can postpone it for a time." d. "Most clients are capable of employment at some level, competitive or supported."
d. "Most clients are capable of employment at some level, competitive or supported."
Which statements most clearly indicate the speaker views mental illness with stigma? (Select all that apply.) a. "We are all a little bit crazy." b. "If people with mental illness would go to church, their problems would be solved." c. "Many mental illnesses are genetically transmitted. It's no one's fault that the illness occurs." d. "Anyone can have a mental illness. War or natural disasters can be too stressful for healthy people." e. "People with mental illness are lazy. They get government disability checks instead of working."
a. "We are all a little bit crazy." b. "If people with mental illness would go to church, their problems would be solved." e. "People with mental illness are lazy. They get government disability checks instead of working."
A client diagnosed with a serious mental illness (SMI) lives independently and attends a psychosocial rehabilitation program. The client presents at the emergency department seeking hospitalization. The client has no acute symptoms but says, "I have no money to pay my rent or refill my prescription." What is the nurse's best action? a. Involve the client's case manager to provide crisis intervention. b. Send the client to a homeless shelter until housing can be arranged. c. Arrange for a short in-client admission and begin discharge planning. d. Explain that one must have active psychiatric symptoms to be admitted.
a. Involve the client's case manager to provide crisis intervention.
A family discusses the impact of a seriously mental ill member. Insurance partially covers treatment expenses, but the family spends much of their savings for care. The client's sibling says, "My parents have no time for me." The parents are concerned that when they are older, there will be no one to care for the client. Which response by the nurse would be most helpful? a. Acknowledge their concerns and consult with the treatment team about ways to bring the client's symptoms under better control. b. Give them names of financial advisors that could help them save or borrow sufficient funds to leave a trust fund to care for their loved one. c. Refer them to crisis intervention services to learn ways to manage caregiver stress and provide titles of some helpful books for families. d. Discuss benefits of participating in National Alliance on Mental Illness programs and ways to help the client become more indepe
d. Discuss benefits of participating in National Alliance on Mental Illness (NAMI) programs and ways to help the client become more independent.
A homeless individual diagnosed with serious mental illness (SMI) and a history of persistent treatment nonadherence plans to begin attending the day program at a community mental health center. Which intervention should be the team's initial focus? a. Teach appropriate health maintenance and prevention practices. b. Educate the client about the importance of treatment adherence. c. Help the client obtain employment in a local sheltered workshop. d. Interact regularly and supportively without trying to change the client
d. Interact regularly and supportively without trying to change the client
An outpatient diagnosed with schizophrenia tells the nurse, "I am here to save the world. I threw away the pills because they make God go away." What does the nurse suspect is the client's reason for medication nonadherence? a. poor alliance with clinicians. b. inadequate discharge planning. c. dislike of medication side effects. d. thought disturbances associated with the illness.
d. thought disturbances associated with the illness.
Many persons brought before a criminal court have mental illness, have committed minor offenses, and are non-medication adherent. The judge consults the nurse at the local community mental health center for guidance about how to respond when handling such cases. Which advice from the nurse would be most appropriate? a. "Sometimes a little time in jail makes a person rethink what they've been doing and puts them back on the right track." b. "Sentencing such persons to participate in treatment instead of incarcerating them has been shown to reduce repeat offenses." c. "Arresting these people helps them in the long run. Sometimes we cannot hospitalize them, but in jail they will get their medication." d. "Research suggests that special mental health courts do not make much difference so far, but outpatient commitment does seem to help."
b. "Sentencing such persons to participate in treatment instead of incarcerating them has been shown to reduce repeat offenses."
A person diagnosed with a serious mental illness (SMI) enters a shelter for the homeless. Which intervention should be the nurse's initial priority? a. Find supported employment. b. Develop a trusting relationship. c. Administer prescribed medication. d. Teach appropriate health care practices.
b. Develop a trusting relationship.