The nurse is working with a female client incarcerated for ...

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The nurse is working with a female client incarcerated for helping her boyfriend rob a convenience store.
 
  She has an Axis II diagnosis of dependent personality disorder. Psychotherapy to help build independence and self-esteem is too time intensive and long term to be supported within budgetary constraints. In considering how to begin addressing her dependency issues, the nurse should do which of the following?
  A) Avoid the topic altogether since personality characteristics are inflexible.
  B) Refer her to a clinical psychologist on her release.
  C) Consult the multidisciplinary team for approval and advocate for changes in the funding structures.
  D) Encourage her to express her feelings of dependency when addressing acute care physical needs.

Question 2

In a forensic practice setting, the nurse must learn to be alert to one of the most dominant barriers to building a therapeutic relationship with forensic clients, which is the fact that:
 
  A) Clients commonly struggle with trusting others.
  B) Clients frequently are transferred to other forensic institutions.
  C) The lifestyle of the incarcerated client is solitary.
  D) Nurses often transgress professional boundaries with the clients.

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Answer to Question 1

Ans: D
Feedback:
Defining and delineating the problems experienced by many clients in the forensic setting is one way to target resources while providing a comprehensive health-promotion program. Women offenders in particular are interested in their own health, and a discussion about contraception and birth control can be an opportunity to express feelings related to abuse, powerlessness, or social awkwardness.

Answer to Question 2

Ans: A
Feedback:
Recurring themes of power and control, negotiation, and trust building dominate therapeutic interventions in this setting; clients have, in varying degrees, learned to adapt to an environment that rewards distrust, manipulation, and deceit. The criminal history, the frequent diagnoses of antisocial and borderline personality disorder, and the aggressive interpersonal style of many forensic clients can evoke strong emotional responses, and countertransference and splitting reactions are common.

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Gracias!

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