A client is on trial for a violent offense and the defense claims the client was legally insane at the time of the act. According to the M'Naghten Rule, which criterion must be met for the insanity defense to be valid?

The client was unable to distinguish right from wrong due to a mental disorder at the time of the crime.

The client had a documented history of mental illness prior to the crime.

The client was compelled by uncontrollable impulses to commit the act.

The client was unaware of the consequences of their actions due to intoxication.

Answer and Explanation

The Correct Answer is A

Choice A reason: The M’Naghten Rule requires proof that, due to mental illness, the person did not understand the nature of the act or could not distinguish right from wrong at the time of the offense. This is the key standard used in many jurisdictions for insanity defenses.

Choice B reason: Having a history of mental illness alone is not sufficient; the rule focuses on the client’s mental state during the offense, not prior diagnoses.

Choice C reason: Being driven by uncontrollable impulses is not part of the M’Naghten criteria. This falls more under the “irresistible impulse” test, which is separate.

Choice D reason: Intoxication, even if it impairs judgment, does not qualify under the M’Naghten Rule. Voluntary substance use generally excludes insanity defenses.

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Correct Answer is ["A","B","C"]

Explanation

Choice A reason: Avoiding judgmental remarks supports therapeutic rapport and prevents worsening anxiety or defensiveness.

Choice B reason: Teaching coping strategies like thought stopping helps the client begin to manage obsessive behaviors more effectively.

Choice C reason: Identifying triggers for obsessive behaviors allows the nurse and client to develop strategies for prevention and management.

Choice D reason: Removing magazines to prevent counting avoids addressing the underlying compulsion and may increase anxiety. This approach is not appropriate in the initial care plan.

A. "I need for you to get rid of these bugs that are crawling under my skin." B. "Those Martians are trying to poison me with the tap water." C. "Hear that? She told me to kill my father." D. "That song is a message sent to me in secret code."

Correct Answer is D

Explanation

Choice A reason: This describes tactile hallucinations, a false sensory experience, not a delusion of reference.

Choice B reason: This reflects a persecutory delusion, where the client believes they are being harmed or targeted, not a delusion of reference.

Choice C reason: This illustrates an auditory hallucination with command-type voices, not a delusion of reference.

Choice D reason: Believing that unrelated environmental cues (like a song) carry special, hidden meaning specifically for the client is the hallmark of a delusion of reference.

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A client is on trial for a violent offense and the defense claims the client was legally insane at the time of the act. According to the M'Naghten Rule, which criterion must be met for the insanity defense to be valid?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse plans care for a client newly admitted with obsessive-compulsive disorder who is repeatedly counting magazines in the commons room. Which of the following should the nurse include in the initial plan of care? (Select all that apply.)

Correct Answer is ["A","B","C"]

Explanation

The nurse on the mental health unit receives report about a client diagnosed with schizophrenia who has a delusion of reference. Which client statement supports this symptom?

Correct Answer is D

Explanation

During an interview, a patient attempts to shift the focus from self to the nurse by asking personal questions. The nurse should respond by saying:

A nursing student new to psychiatric mental health nursing asks a peer what resources he can use to figure out which symptoms are present in a specific psychiatric disorder. The best answer would be:

A recently widowed client becomes tearful at a routine clinic visit and states, "I just can’t get over my spouse’s death." Which of the following by the nurse are appropriate? (Select all that apply.)

A nurse is educating a client who has been prescribed phenelzine, an MAOI, for treatment-resistant depression. Which of the following instructions is most critical to prevent potentially life-threatening complications associated with this medication?

In psychoanalytic theory, the unconscious mind plays a significant role in influencing behavior and mental health. Which statement best describes the function of the unconscious mind in this context?

A nurse practicing Peplau’s Relations Theory is working with a newly admitted client who is withdrawn and reluctant to engage. According to Peplau’s working model, which nurse action best explains the orientation phase of the nurse-client relationship?