A patient is admitted to a forensic psychiatric facility after being found not guilty by reason of insanity. Court records show that although the patient understood their actions were wrong, they were unable to control their behavior due to a severe mental illness. This legal decision is most consistent with which of the following standards?
Durham Rule
M’Naghten Rule
Tarasoff Rule
Irresistible impulse
The Correct Answer is D
Choice A reason: The Durham Rule holds that a defendant is not criminally responsible if their act was a product of mental disease. It is broad and does not specifically address the inability to control behavior despite knowing wrongfulness, making it less applicable than irresistible impulse.
Choice B reason: The M’Naghten Rule focuses on a defendant’s inability to understand the nature or wrongfulness of their actions due to mental illness. The scenario emphasizes inability to control behavior, not lack of understanding, making this choice incorrect.
Choice C reason: The Tarasoff Rule requires clinicians to warn potential victims of a patient’s threat, unrelated to insanity defenses. It addresses duty to protect, not the legal standard for criminal responsibility, making this choice irrelevant to the scenario.
Choice D reason: The irresistible impulse standard applies when a defendant understands their actions were wrong but cannot control their behavior due to mental illness. This matches the scenario, where the patient’s inability to control actions led to the insanity ruling, making this the correct choice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["D","E"]
Explanation
Choice A reason: A crowded room creates distractions and compromises patient confidentiality, hindering open communication during a psychosocial assessment. Effective assessments require a private, calm environment to foster trust and focus, as external stimuli can exacerbate anxiety or disrupt emotional disclosure, making this choice incorrect.
Choice B reason: Avoiding eye contact can signal disengagement or discomfort, undermining the therapeutic alliance needed for a psychosocial assessment. Appropriate eye contact fosters trust and encourages patients to share sensitive information, as it reflects attentiveness and empathy, making this choice incorrect for an effective assessment environment.
Choice C reason: A television on for background noise introduces auditory distractions, reducing the patient’s ability to focus and share openly during a psychosocial assessment. A quiet environment is essential to ensure clear communication and minimize sensory overload, which can affect emotional regulation, making this choice incorrect.
Choice D reason: Adequate lighting creates a comfortable, non-threatening environment for a psychosocial assessment, allowing the nurse to observe nonverbal cues like facial expressions, which are critical for assessing emotional states. Proper lighting supports patient comfort and accurate observation, making this a correct choice for the assessment setting.
Choice E reason: A quiet and private area ensures confidentiality and minimizes distractions, fostering a safe space for patients to discuss sensitive psychosocial issues. This environment supports emotional disclosure and reduces anxiety, enabling accurate assessment of mental health status, making this a correct choice for effective assessments.
Correct Answer is A
Explanation
Choice A reason: Inappropriate affect, where emotions like manic laughter mismatch the context of loss, is common in disorders like schizophrenia. It reflects limbic-prefrontal dysregulation, causing emotional responses to be incongruent with the situation, making this the correct choice for the described behavior.
Choice B reason: Flat affect involves minimal or no emotional expression, often in schizophrenia or depression. The patient’s manic laughter is an active, inappropriate response, not a lack of emotion, making this choice incorrect for the scenario described.
Choice C reason: Labile affect involves rapid emotional shifts, such as laughing to crying, seen in bipolar disorder. The scenario describes a single inappropriate response (manic laughter), not shifts, making this choice incorrect for the patient’s presentation.
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