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Chapter 36 Forensic Psychiatry and Ethics in Psychiatry | Kaplan and Sadock

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Chapter 36 Forensic Psychiatry and Ethics in Psychiatry

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Chapter 36: Forensic Psychiatry and Ethics in Psychiatry

MULTIPLE CHOICE

1. What is the primary expected outcome when a victim of a violent crime is initially attended to
by a forensic nurse?

a. Their physical injuries will be assessed and treated.

b. The evidence of the assault from their body will be preserved.

c. The legal system will be provided with evidence of the crime.

d. Their long-term emotional health will be of primary concern.


ANS: B

Forensic nurses fill a gap where the health care system interacts with the legal system by meeting
the needs of victims and perpetrators of violent crimes through enhanced quality of care and
preventive services. Observation, documentation, preservation, and notification are critical for
determining the legal outcomes of cases that involve violence. Although it is true that the legal
system is supported, that is not the focus of care in these cases. The remaining options are not
responsibilities unique to the forensic nurse.

2. Which therapeutic outcome has resulted from the introduction of the specialized SANE nurse?

a. ED staff are no longer involved in the care of rape victims.

b. Retraumatizating of the rape victim has been decreased greatly.

c. The rights of both the rape victim and the rapist are preserved.

d. The rape victim is assured quality physical and mental healthcare.


ANS: B

The specialized attention of these nurses has addressed the long-standing issue of retraumatizing
victims. The ED staff may still be involved in the physical care of the victim. The focus is not on




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,the rights of the potential rapist. The physical and mental health needs of the victim are not the
sole responsibility of the SANE nurse.

3. When providing care to an assault victim, the forensic nurse will initially:

a. Notify the police that an assault has occurred.

b. Assess the individual for any resulting physical trauma.

c. Bag all clothing to preserve any relevant evidence.

d. Determine whether the victim as been sexually assaulted as well.


ANS: B

It is the role of the forensic nurse to immediately assess the assault victim for evidence of acute
physical injuries. The remaining options do not have the priority that the individuals physical
health needs demand.

4. Which intervention demonstrates the SANE nurses unique attention to the assessment of a
sexual assault?

a. Conducting the assessment in the most private exam room

b. Not directly questioning the patient about the attack or the attacker

c. Identifying that the patient is showing signs of anxiety by withdrawing

d. Meticulously assessing the patient for signs of any resulting physical trauma


ANS: C

Throughout the physical examination, the SANE nurse will be attuned to the victims mental
status and monitor him or her for signs and symptoms of anxiety, panic, and grief. The event and
the assailant are topics that must be discussed. The remaining options identify interventions that
are considered a nursing responsibility and not unique to the role of the SANE nurse.

5. To best address the assault victims psychosocial needs, the forensic nurse:

a. Warns the family that the patient will likely be suicidal




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, b. Suggests that the family provide continuous supervision of the patient for at least
30 days
c. Encourages the patient to discuss medication therapy with the physician prior to
discharge from the ED
d. Provides education to both the patient and the family regarding the signs of
posttraumatic stress disorder (PTSD)


ANS: D

These patients are at extreme risk for PTSD, depression, and anxiety disorders, making education
on such topics vitally important to their mental health. Although the patient may become
depressed and have an increased risk for suicide, it is not true that the patient is likely to attempt
such an act nor is it necessary to provide constant supervision. If such was needed, the patient
would be hospitalized. The need for medications will be determined by the physician.

6. Which nursing intervention demonstrates an understanding of the coping mechanisms often
used by individuals who are not receiving formal treatment for their symptoms of postassault
anxiety and stress?

a. Providing smoking cessation materials

b. Discussing the importance of safe sex

c. Assessing for the abuse of marijuana

d. Monitoring for weight gain since the assault


ANS: C

Rather than being engaged in formal treatment, 67% of a studys participants reported the use of
illicit substances, mainly marijuana. The primary purpose for this substance use is to aid in
numbing the victim from the effects of intrusive thoughts and to allow victims to self-medicate
for the treatment of insomnia and irritability. Although some individuals will use cigarette
smoking, sexual promiscuity, and eating as coping mechanisms, they do not appear to have the
affects that marijuana has on managing the symptoms of anxiety and stress.




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