CCN CCN Mental Health & Substance Abuse in Corrections 1 — Questions and Answers
Question 1: Which screening tool is most commonly used in correctional settings to identify inmates at risk for suicide upon intake?
- Columbia Suicide Severity Rating Scale (C-SSRS) (Correct answer)
- Beck Depression Inventory (BDI)
- PHQ-9
- Hamilton Anxiety Scale
Correct answer: Columbia Suicide Severity Rating Scale (C-SSRS)
The C-SSRS is widely adopted in correctional facilities for structured suicide risk screening at intake and throughout incarceration.
Question 2: A correctional nurse finds an inmate who is unresponsive after suspected opioid overdose. What is the priority intervention?
- Administer naloxone intranasally and call a code (Correct answer)
- Secure the cell and wait for custody staff
- Start IV fluids immediately
- Perform a full mental status exam
Correct answer: Administer naloxone intranasally and call a code
Naloxone reverses opioid-induced respiratory depression and is the priority life-saving intervention before any other assessment.
Question 3: Which of the following behaviors is a warning sign of imminent suicide risk in an incarcerated individual?
- Giving away personal possessions (Correct answer)
- Requesting extra recreation time
- Asking about visitation rules
- Reporting improved sleep
Correct answer: Giving away personal possessions
Giving away possessions indicates the individual may be preparing for death and is a classic behavioral warning sign of imminent suicide.
Question 4: An inmate experiencing alcohol withdrawal on day 2 of incarceration develops tremors, diaphoresis, and a heart rate of 120 bpm. Which tool should the nurse use to assess severity?
- Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) (Correct answer)
- CAGE questionnaire
- AUDIT-C
- DSM-5 withdrawal criteria checklist
Correct answer: Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar)
The CIWA-Ar is the validated standardized scale used to assess alcohol withdrawal severity and guide medication management.
Question 5: Under the principle of equivalence of care in correctional nursing, what does this standard require?
- Inmates must receive a level of care equivalent to what is available in the community (Correct answer)
- All inmates must receive identical treatment regardless of diagnosis
- Custody staff must approve all clinical decisions
- Mental health care is optional based on available funding
Correct answer: Inmates must receive a level of care equivalent to what is available in the community
The equivalence standard, supported by NCCHC and ACHC, holds that incarcerated individuals are entitled to the same standard of care available in the general community.
Question 6: Which medication is FDA-approved and most evidence-based for treating opioid use disorder in correctional settings?
- Buprenorphine/naloxone (Suboxone) (Correct answer)
- Methadone alone
- Naltrexone oral tablet
- Clonidine
Correct answer: Buprenorphine/naloxone (Suboxone)
Buprenorphine/naloxone is FDA-approved for opioid use disorder and the combination formulation reduces diversion risk, making it preferred in corrections.
CCN CCN Mental Health & Substance Abuse in Corrections 1
Which screening tool is most commonly used in correctional settings to identify inmates at risk for suicide upon intake?