In which circumstance would a psychiatric forensic nurse examiner ...

[pragya sharda]

In which circumstance would a psychiatric forensic nurse examiner determine that it would be appropriate for the defendant and his attorney to consider the legal insanity defense?
 
  a. The defendant experienced auditory hallucinations that he perceived as the voice of God commanding him to drown his child.
  b. The accused tampered with the brakes of his wife's car after discovering she had had an affair.
  c. The charged inmate shot the drug dealer who refused to give her cocaine when she had no money to buy it.
  d. The defendant, frightened because his house had been robbed the night before, assumed his son was a burglar and shot him.

Question 2

A newly admitted patient required seclusion immediately on entering the inpatient unit. What criteria would the nurse use to decide when to discontinue the use of seclusion?
 
  a. Seclusion can be discontinued when the patient seems calm.
  b. Discontinuation is based on outcomes developed for each patient.
  c. Seclusion continues until the patient has been calm for at least 4 hours.
  d. Seclusion lasts until the physician orders its discontinuation.

[bd5255]

Answer to Question 1

A
The defendant, demonstrating symptoms of psychosis and acting on the direction of command hallucinations, could use the defense of legal insanity because he was unable to recognize his action as wrong due to a psychiatric illness. The other options suggest the defendant knew right from wrong, had the capacity to know the nature and quality of the act, and had the capacity to form intent to commit the crime.

Answer to Question 2

B
Restraint and seclusion are treatments requiring a physician's order. As with any other treatment, they should be discontinued as soon as they have achieved their purpose. Since the reason for their use varies with each patient, the criteria for discontinuation should be based on improvement in the behavior that led to seclusion for that particularly patient. Typically this includes at least the patient's ability to follow direction and maintain safe behavior. Patient calmness can be misleading but should be a factor considered along with others. There is no minimum time that patients must be calm before being released. In most locales, an order to discontinue seclusion or restraint is not needed.