Test Bank Forensic and Correctional Nursing Nies: Community/Public Health Nursing, 7th Edition

1. Which best describes how the prevalence of violence and violent crimes has changed theprofessional practice of health care providers? a. Vulnerable groups are now assessed for evidence of abuse. b. The focus has now shifted from patient care toward more personal safety. c. It is now recognized that new specialties continue to be created. d. Each patient is now routinely screened for violence. ANS: D All persons should be assessed for evidence of abuse, not just vulnerable groups. Screeningfor violence is now considered to be a minimum standard of care for all clients. DIF: Cognitive Level: Understand (Comprehension) 2. If a forensic nurse was employed in the most widely recognized subspecialty in forensicnursing, which would be the nurse’s primary tasks? a. Be employed by insurance companies to review and interpret medical records b. Complete the death certificate, including causes of death c. Do a history and physical assessment and collect evidence d. Review the crime scene for insights with police officers ANS: C Sexual assault forensic examNinUerR(SSAINNEG)TisBth.eCmOoMst widely recognized subspecialty in forensic nursing. The SANE assesses and documents detailed examination findings, collects forensic evidence related to a reported crime, and frequently testifies as an expert witness atsubsequent trials. DIF: Cognitive Level: Understand (Comprehension) 3. A forensic nurse is responsible for conducting a thorough examination, including a history,performing a physical assessment, and collecting forensic evidence on a female client following a rape. In which subspecialty of forensic nursing is this nurse practicing? a. Sexual assault nurse examiner (SANE) b. Nurse coroner c. Legal nurse consultant d. Forensic nurse death investigator ANS: A Chapter 32 Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :56:48 GMT -05:00 A SANE is a specially trained registered nurse who applies the nursing process during forensic examinations to victims or perpetrators of sexual assault. The SANE collects forensicevidence related to a reported crime and frequently testifies as an expert witness at subsequenttrials. If the client is medically stable, the SANE is responsible for conducting a thorough examination, including obtaining a history, performing the physical assessment, and collectingforensic evidence. The nurse coroner would be responsible for ensuring that appropriate measures were taken to perform death investigations and certify death certificates. Legal nurseconsultants provide assistance within the legal system using specialized nursing knowledge and expertise when interactions of law and health issues arise. The forensic nurse death investigator evaluates the death scene from a holistic nursing perspective and might interpret the scene differently. DIF: Cognitive Level: Understand (Comprehension) 4. Which cause of death on a death certificate would need correction by the forensic nurse? a. Accident b. Homicide c. Natural d. Suicide e. Untimely ANS: E The National Association of Medical Examiners identifies five acceptable options for recording manner of death: (1) natural, (2) accident, (3) suicide, (4) homicide, and (5)undetermined. DIF: Cognitive Level: RememN ber R (Kn I owl G edge B ) .C M U S N T O 5. Which skill can a forensic nurse, serving in the elected office of coroner, bring to the situationcompared with other professionals? a. Extensive knowledge of medicine b. Knowledge of the law c. Previous experience in testifying in court d. Superb communication and empathy skills ANS: D Nurse coroners exhibit communication skills when dealing with grieving families. Nurses areeducated in therapeutic communication and practice those skills in any setting. Nurses are acutely aware of the importance of using openended questions, attentively listening, and being fully present with family and friends. DIF: Cognitive Level: Understand (Comprehension) Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :56:48 GMT -05:00 6. The legal nurse consultant (LNC) was surprised to find that former friends were no longerinterested in a colleague relationship and one even accused the LNC of trashing clinical nursing practice in the courtroom. Which would be the best response by the LNC? a. “I’ve just accepted a position that pays an incredible amount more than staffnursing in a hospital.” b. “I’m not part of clinical nursing; I’m part of the legal system now.” c. “I’m defending the expertise and experience of skilled nursing clinicians byhelping remove dangerous practitioners from the field.” Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :56:48 GMT -05:00 d. “I’m helping clients who were hurt by poor practice to obtain revenge.” ANS: C Some practitioners have differing opinions regarding LNCs and nurse attorneys. They may beperceived as either defending the profession or prosecuting peers by testifying against professional colleagues. Many law firms hire LNCs to review and interpret medical records and charts, provide objective opinions based on standards of care, and possibly to testify in court as expert witnesses. LNCs are able to provide the link between clinical nursing and the legal system to help keep the practice field safe from dangerous practitioners. In contrast, meticulous practitioners who are wrongfully accused of negligence will be defended. The salary of the position does not address the accusation of the LNCs former friends. The purpose of LNCs is not to help clients obtain revenge if they were harmed by poor care. DIF: Cognitive Level: Apply (Application) 7. The legal nurse consultant (LNC) was asked to submit an affidavit to both the prosecutor’sand the defendant’s office. Which information needs to be included? a. List of all literature reviewed in preparation for being paid as an expert witness b. Notarized signature on a summary of the LNC’s education and clinical experience c. Summary of nurse’s educational and experiential credentials and an analysis of thecase d. An opinion under oath as to what happened in the crime situation ANS: C The LNC may submit an affidavit, which is a written statement explaining the expert’s credentials, background, and licensing or certification(s). It also provides a list of the materials read and considered in the case, and the findings of the review are summarized into a case analysis. NU RS IN GT B.CO M DIF: Cognitive Level: Apply (Application) 8. The legal nurse consultant (LNC) felt more than a little stressed after being cross-examined byboth the prosecuting attorney and the defendant’s attorney in intricate detail at a deposition. Which action should be taken next by the LNC? a. Get together with friends and share the experience b. Go out and have a stiff drink to relax and get over the stress c. Pray the case does not go to trial when the LNC will have to go through all thisagain d. Review the written transcript for accuracy ANS: D Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :56:48 GMT -05:00 During the deposition, the LNC will present the facts of the case and be questioned by attorneys from both sides. This process may be quite lengthy and stressful. It is essential thatthe LNC be prepared, having reviewed the case and all related materials very thoroughly. Following this process, the LNC will be given a written transcript of the deposition; this needsto be carefully reviewed for accuracy. It is not appropriate for the LNC to share this experience with friends. Consumption of alcohol will not help the nurse address the stressors that are being encountered. Reviewing the transcript for accuracy should decrease the level of stress experienced by the nurse and decrease the worry about this case going to trial. DIF: Cognitive Level: Apply (Application) Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :56:48 GMT -05:00 N R I G B.C M 9. The female nurse was called to the emergency department (ED) to help with a woman whohad been beaten and raped. Which are the nurse’s responsibilities as a forensic nurse? a. Discuss with police officers what is known and what needs to be known to closethe case b. Initiate the proper collection, preservation, and chain of custody of evidence withappropriate documentation c. Serve as chaperone while the physician completes the physical examination d. Be empathetic and supportive to the victim ANS: B It is imperative that ED registered nurses identify forensic cases and initiate the proper collection, preservation, and chain of custody of evidence and provide accurate documentationfor this unique population. This collection of evidence plays an important role in the investigation of crimes and can have a major impact on legal decisions. Accurate collection ofevidence is the primary responsibility of the nurse and needs to be completed before any additional action is taken. The recognition, collection, and documentation collected within the emergency department may play an important role in the investigation of crimes and can have a major impact on legal decisions. It is important for the nurse to collect the necessary evidence whereas it is the responsibility of the legal system to prosecute and close the case. The primary role of the female forensic nurse would not be to serve as a chaperone to thephysician or provide support to the victim. DIF: Cognitive Level: Apply (Application) 10. An emergency department nurse was not sure whether there was enough evidence one way orthe other to suspect child abuse with a child client, because there was not much evidence of physical harm. The forensic nuUrseSagreNed Tto see thOe child. Which would be the forensic nurse’s primary focus? a. Ask the child whether the family has any secrets b. Assess for old injuries or injuries in the process of healing c. Observe the child’s appearance and behavior and how the child interacted withother children and adults d. Question the parents concerning the child and any discipline problems ANS: C The nurse obtains a thorough history and assessment, focusing on several facets of abuse andneglect. These include child–parent interaction, the child’s appearance and behavior, child–child interaction, and the environment. DIF: Cognitive Level: Apply (Application) Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :56:48 GMT -05:00 11. Which is most likely to physically abuse elderly Americans? a. A partner or spouse b. A caregiver c. A stranger d. An adult child ANS: A Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :56:48 GMT -05:00 U S N T O In a study by Acierno et al. (2009), 1.6% of subjects report physical mistreatment, with familymembers accounting for 76% of the mistreatment, and specifically 57% was conducted by a partner or spouse. DIF: Cognitive Level: Remember (Knowledge) 12. Which is the most common form of elder abuse? a. Emotional abuse by caregivers b. Financial abuse when resources are used without the elder’s consent c. Neglect by self or caregivers d. Physical mistreatment resulting in injuries ANS: C Neglect is the most common form of elder abuse, whether it is caregiver neglect or self-neglect. Neglect is more likely to occur than emotional abuse, financial abuse, or physicalmistreatment resulting in injuries. DIF: Cognitive Level: Remember (Knowledge) 13. Which describes a responsibility of the forensic psychiatric nurse? a. Assisting with the deposition b. Collecting evidence to be used in future legal proceedings c. Judging intent or diminished capacity of the client during the incident d. Preparing to testify in court ANS: C Forensic psychiatric nurses collect evidence by determining intent or diminished capacity inthe client’s thinking at the timNe oRf thIe inGcideBn.t. CTo dMo this, they often spend several hours interviewing and observing the client, carefully documenting conversations and observations. DIF: Cognitive Level: Understand (Comprehension) 14. A prisoner was bleeding where another inmate had attacked him with a fork. Which would bethe correctional nurse’s first and most crucial responsibility? a. Perform a complete physical assessment, specifically looking for internal injuries b. Maintain an escape route to help ensure personal safety c. Report the incident to administration, indicating who was responsible for injuringthe inmate d. Stop the bleeding, apply an antibiotic, and bandage the wound ANS: B Unlike any other care setting, clients are inmates, and care is negotiated and provided with recognition of safety and security issues for the nurse. The nurse must maintain an escape route, should a situation of personal violence be imminent. If the nurse is able to maintain anescape route, the nurse would then Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :56:48 GMT -05:00 be able to complete a physical assessment, stop the bleeding, and then report the incident to administration. DIF: Cognitive Level: Understand (Comprehension) Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :56:48 GMT -05:00 N R I G B.C M 15. A 14-year-old was found guilty of beating and raping a 73-year-old neighbor. The prosecutorhad successfully argued for the child to be tried as an adult. The jury is considering a long adult prison term. Which would the nurse most likely suggest when called on as an expert witness? a. The child must be mentally ill to have done such a thing and should be in a mentalhospital. b. The child should be in a juvenile facility to avoid the high risk of sexual assaults,beatings, and suicide in adult prison. c. The child should be given a long adult prison sentence to protect society from sucha predator. d. The child must be given an opportunity to complete high school while incarceratedin the adult prison. ANS: B Adult correctional facilities are not generally equipped to deal with the challenges of adolescent development. Adolescents in an adult correctional facility are the highest at risk than any other group. Juveniles in adult correctional facilities are 36 times more likely than the adult population to commit suicide. Thus, it is in the best interest of the adolescent to be placed in a juvenile facility. The placement of an adult prison or mental hospital would not bein the best interest of this child. DIF: Cognitive Level: Apply (Application) 16. The correctional nurse was completing an admission physical for a newly incarcerated prisoner. The nurse realized the prisoner was talking to someone other than the nurse. Whichdoes the nurse need to remember? a. Cell phones, including those with ear phones, are commonplace among everyone. b. It is common for persons toUtalSk toNtheTmselvesOor think out loud. c. Prisons have become the residence for a very large number of persons who havemental illnesses. d. Prisoners get very lonely and often talk to mirrors or inanimate objects. ANS: C In the late 1950s and early 1960s, deinstitutionalization moved people with mental illness out of state hospitals into communities that were often ill-prepared to care for them. As a result, many people with a mental illness reside in nursing homes, residential homes, prisons, or jails.People with mental illness are often jailed for crimes committed in response to the symptoms of mental illness. Approximately 34% of state inmates, 24% of federal inmates, and 17% of jail inmates received treatment for mental health problems. Thus, it is highly likely that this prisoner has a mental illness. It is less likely that the prisoner is using a cell phone or purposefully talking to himself. DIF: Cognitive Level: Apply (Application) Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :56:48 GMT -05:00 17. Which is considered appropriate preparation for engaging in forensic nursing specialtypractice? a. Adequate number of continuing education credits plus licensure as a registerednurse b. Baccalaureate nursing program and previous community health experience c. College-based educational program including supervised clinical hours andinternship Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :56:48 GMT -05:00 d. Interest in and willingness to be employed in the field ANS: C Simply completing a continuing education course is not adequate. Several colleges and universities offer a variety of programs to educate practitioners. During the formal programsof study, the student usually completes a minimum specified number of supervised clinical hours; a clinical internship or fellowship also may be required. DIF: Cognitive Level: Understand (Comprehension) 18. A correctional nurse was preparing to give an inmate his psychotropic drug when the prisonerhit the nurse’s arm, sending the medication flying, and yelled, “No more. I’m not taking that poison anymore!” The prisoner is obviously mentally ill. Which action should be taken by thenurse? a. Inject the medication rather than debate taking the oral pill with the inmate b. Recognize the prisoner’s right to refuse treatment c. Throw the medication away, obtain another pill, and try to persuade the prisoner totake the drug d. Force the medication down the prisoner’s throat with the assistance of two prisonguards ANS: B Nurses practicing in correctional settings must recognize that involuntary medical treatment isnot undertaken until after internal review and judicial proceedings. DIF: Cognitive Level: Apply (Application) MULTIPLE RESPONSE NU RS IN GT B.CO M 1. With whom would the forensic nurse primarily interact during the day in addition to clients?(Select all that apply.) a. Case managers b. Officers of the court c. Physicians d. Police officers e. Psychologists f. Social workers ANS: B, D The International Association of Forensic Nurses explains that forensic nursing is the practiceof nursing where the health and legal systems intersect (ANA, 2009). Thus, the forensic nurse’s role provides a vital link between the health Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :56:48 GMT -05:00 care system, the investigative process, and courts of law (Lynch, 2011). Officers of the court and police officers would be two key populations with whom the nurse would interact. The nurse would be less likely to interact with case managers, physicians, psychologists, and social workers. DIF: Cognitive Level: Understand (Comprehension) 2. Which would most likely be the result of a medicolegal death investigation? (Select all thatapply.) a. Clarification of the unnatural circumstances in which death occurred Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :56:48 GMT -05:00 b. Court testimony as to cause of death based on evidence c. Consultation with defendant’s attorney for a fee d. Consultation with prosecuting attorneys for a fee e. Death certificate with cause and manner of death f. Permission to use deceased organs for transplant ANS: A, E Medicolegal death investigations are usually conducted to clarify the sudden, unexpected, andoften nonnatural circumstances in which death occurred. One of the outcomes of death investigation is death certificates. Outcomes of medicolegal death investigations do not typically involve court testimony, consultation with the defending or prosecuting attorneys fora fee, or permission to use the deceased organs for transplant. DIF: Cognitive Level: Understand (Comprehension) 3. Which best describes how a legal nurse consultant (LNC) would best prepare for testifying incourt as an expert witness? (Select all that apply.) a. By carefully analyzing the client’s medical record and related documents b. By creating a PowerPoint slide presentation to help educate the jury c. By helping to examine all the witnesses in preparation for the court trial d. By personally doing or observing the autopsy on the deceased e. By preparing charts and tables illustrating the important legal points f. By summarizing the literature regarding the standard of care ANS: A, F LNCs perform many different services and activities, including organizing and analyzing medical records and related materials; preparing chronologies of health care events; and identifying standards of care.NIUt iRs eSsIseNntGiaTl tBha.tCthOe MLNC be prepared, having reviewed the case and all related materials very thoroughly. The LNC would probably not create a PowerPoint slide presentation, examine all witnesses in preparation for the trial, personallycomplete the autopsy, or prepare charts and tables to illustrate the important legal points. DIF: Cognitive Level: Understand (Comprehension) 4. Which best explains why the infection rate of communicable diseases is so high amongpersons who are incarcerated? (Select all that apply.) a. Airborne transmission of disease because of lack of cleanliness b. Ignorance by staff about how infectious diseases are transmitted c. Engagement in tattooing and drug use d. Lack of access to health care while incarcerated e. Failure to use condoms during sexual intercourse f. Poor nutrition and lack of exercise while incarcerated ANS: C, E Community Public Health Nursing 7th Edition Nies Test Bank This study source was downloaded by from CourseH on :56:48 GMT -05:00 N R I G B.C M The high rate of communicable disease in this population is associated with high-risk behaviors common among inmates, including current and previous drug use, unprotected sexual intercourse, and tattooing. Most prisoners receive a health screening at admission. Prisoners have a constitutional right to receive adequate and timely health care. Adequate foodand exercise are available as the goal is to ensure a safe, secure, and humane environment for inmates. Most communicable diseases that are experienced by incarcerated individuals are not spread via airborne transmission. The prison and legal system are aware of how these diseasesare transmitted, but some of these high-risk behaviors that this population engages in occur when they are not incarcerated. DIF: Cognitive Level: Understand (Comprehension) 5. Which statements about women in prison are correct? (Select all that apply.) a. Women prisoners with a mental health diagnosis are likely to have reported ahistory of abuse. b. Women prisoners receive similar quality of health care when compared to men. c. Women prisoners are likely to be victims of violence while incarcerated. d. Women prisoners are likely not provided routine gynecological care when enteringthe correctional facility. e. Women prisoners should receive education about healthy eating and regularphysical activity. f. Women prisoners should receive counseling about parenting skills. ANS: A, D, F Approximately 8 in 10 women with a prior mental health diagnosis reported physical or sexual abuse before imprisonment: 57.2% were physically abused and 39% sexually abused (CSOSA, 2014). Unfortunately, health care providers in correctional facilities have limited experience and training to meeUt theSheNalthTcare neOeds of women in prison, and quality of care is adversely affected. The National Commission on Correctional Health Care (NCCHC, 2014)confirms that routine gynecological examinations are not consistently apart of health screening for women upon entry into a correctional facility or a routine part of ongoing healthcare. Comprehensive health care services should be available to incarcerated women that givespecial consideration to the reproductive health needs of women, the high rate of victimizationamong incarcerated women, counseling related to parenting issues, and accessibility to drug or alcohol treatment. The text does not address violence related to women while incarcerated or that women prisoners need information specific to healthy eating and regular exercise. DIF: Cognitive Level: Understand (Comprehension)