Question 1

A nurse should assign which nursing diagnosis to a client needing assistance with assertiveness?
A) Disturbed personal identity
B) Disturbed thought processes
C) Defensive coping
D) Impaired verbal communication

Accepted Answer

Defensive coping reflects a self-protective pattern that defends against underlying perceived threats to positive self-regard.Clients who are utilizing defensive coping lack assertiveness skills.

Question 2

During an assertiveness training group,a nurse suggests using "I statements." The group questions the usefulness of this communication technique.Which explanation by the nurse is most appropriate?
A) "When 'I statements' are used, opinions are communicated without blaming others."
B) "When 'I statements' are used, anger is displaced by using indirect means."
C) "When 'I statements' are used, responsibility for one's behavior is attributed to another."
D) "When 'I statements' are used, eye contact is promoted."

Accepted Answer

"I statements" clearly state one's feelings and needs without blaming or demeaning others.

Question 3

The dean of nursing criticizes a faculty member about views on academic freedom.The faculty member states,"Are you upset because I believe in academic freedom or because you don't?" The faculty member is using which technique to promote assertive behavior?
A) Standing up for one's basic human rights
B) Delaying assertively
C) Inquiring assertively
D) Responding assertively with irony

Accepted Answer

This response reflects the use of inquiring assertively.Inquiring assertively is an attempt to seek additional information about critical statements.

Question 4

Which best describes a nurse's use of assertive behavior?
A) When a nurse attempts to please others and apologizes for awkwardness in a new role
B) When a nurse becomes defensive and angry when peers offer suggestions for improvement
C) When a nurse has problems making decisions and has a tendency to procrastinate
D) When a nurse is open and direct when asked by the nurse manager to complete assignments

Accepted Answer

This is an assertive response.There is clear expression of needs and feelings.

Question 5

While trying to control aggressive behavior,a client asks an assertiveness training nurse to give an example of an "I statement." Which of the following statements is the best example of this assertive communication technique?
A) "I would like to know why you came home late without calling me."
B) "I hate it when you think you can just come home late without calling anyone to let them know where you are."
C) "I feel angry when you come home late without calling."
D) "I think you don't care about me, because if you did, you'd call me if you were planning on coming home late."

Accepted Answer

This response clearly states feelings about a situation without blaming another.

Question 6

A client on an inpatient unit is angry with a peer.During lunch,when the peer is not looking,the client spits into his soup.How would the nurse document this interaction?
A) "Client is displaying assertive behaviors."
B) "Client is displaying aggressive behaviors."
C) "Client is displaying passive behaviors."
D) "Client is displaying passive-aggressive behaviors."

Accepted Answer

This response is passive-aggressive.The client's anger is expressed indirectly by spitting in the soup when the peer is not looking.

Question 7

A client continually waits more than an hour before being seen at the mental health clinic.The client approaches the nurse and states,"When I have to wait for more than an hour to be seen,I feel like my time is not important." The nurse recognizes this as what type of behavior?
A) Aggressive behavior
B) Assertive behavior
C) Passive-aggressive behavior
D) Passive behavior

Accepted Answer

This response is assertive.The client is openly expressing feelings and attempting to correct a stressful situation.

Question 8

A nurse has identified the following nursing diagnosis: "ineffective communication R/T lack of assertiveness skills AEB inability to state needs." Which statement encourages the client to acknowledge the priority of this problem?
A) "Are you having thoughts of harming yourself or others?"
B) "With whom are you least assertive?"
C) "On a scale of 1 to 10, rank the importance of being assertive."
D) "When are you available to attend the assertiveness training class?"

Accepted Answer

This nursing statement encourages the client to objectively evaluate the priority of being assertive.It is important in patient-centered care for the client to prioritize his or her goals for treatment.

Question 9

During an assertiveness training group,a client admits to aggressive behaviors.The client asks for suggestions for how to become more assertive and less aggressive.Which is the most appropriate nursing reply?
A) "Several techniques, including meditation and progressive muscle relaxation, appear helpful."
B) "There's not much that can be done about aggressive behavior because of biological responses."
C) "Certain types of medications have been proven effective in promoting assertive communication."
D) "There are several techniques, including 'I statements,' role playing, and thought stopping, that can help promote assertive behaviors and decrease aggressive behaviors."

Accepted Answer

These techniques promote assertive behaviors and would help diminish aggressive responses.

Question 10

An instructor is teaching about assertive rights.Which student statement indicates a need for further instruction?
A) "The right to be treated with respect is an assertive right."
B) "The right to say "no" without feeling guilty is an assertive right."
C) "The right to change your mind is an assertive right."
D) "The right to always put oneself first is an assertive right."

Accepted Answer

This is not an assertive right.An assertive right is "to consider others as well as yourself." This student statement indicates a need for further instruction.

Question 11

One nurse confronts another and says,"You are always so talkative in the meetings.I don't know why you can't stay quiet sometimes." Which reply by the other nurse reflects the technique of "clouding/fogging?"
A) "You're right. I do speak up a lot."
B) "Sounds to me like you're agitated and we need to talk. What are you truly angry about?"
C) "Are you offended that I speak up, or because my thoughts are in opposition to yours?"
D) "I have the right to express my opinion."

Accepted Answer

This response reflects the use of clouding/fogging.When clouding/fogging is used it concurs with the critic's argument without becoming defensive and without agreeing to change.

Question 12

A teenager gets a "C" in algebra.The mother angrily states,"All you ever do is listen to music and text your friends." The teenager replies,"What is it that you're really upset about,mom?" Which response pattern is the teenager expressing?
A) Clouding and fogging
B) Shifting from content to process
C) Delaying assertively
D) Assuming responsibility for one's own statements

Accepted Answer

This response reflects the use of shifting from content to process.The teenager is changing the focus of the communication from discussing the topic at hand to analyzing what is actually going on in the interaction.

Question 13

After vying for a nurse management position,nurse "A" is chosen over nurse "B." When nurse manager "A" calls for staff meetings,nurse "B" is chronically late or absent.Nurse "B" is exhibiting which type of behavior?
A) Passive
B) Assertive
C) Aggressive
D) Passive-aggressive

Accepted Answer

This response is passive-aggressive.The colleague is expressing anger indirectly by being late or absent from the meetings.

Question 14

Which is the most appropriate nursing reply when a client asks what the goal and benefit are of assertive skills training?
A) "It protects the client from others who express aggressive feelings."
B) "It gives reliable, expert information so that clients may correct faulty behaviors."
C) "It clarifies misperceptions that have caused clients to distort reality."
D) "It improves communication skills in order to improve interpersonal relationships."

Accepted Answer

Assertiveness training helps to develop satisfying interpersonal relationships by teaching people how to communicate in a manner to meet their own needs while respecting the rights and needs of others.

Question 15

Two clients are roommates on an inpatient psychiatric unit.At breakfast,client "A," who had been missing her gold locket,notices client "B" wearing it.Which should a nurse recognize as a nonassertive or passive behavioral response from client "A"?
A) Client "A" ignores the situation.
B) Client "A" discusses the situation with her nurse and develops a plan of action.
C) Client "A" immediately approaches client "B" and pulls the necklace off her neck.
D) Client "A" offers to wash client "B's" clothes and "accidentally" spills bleach in the water.

Accepted Answer

By ignoring the situation,client "A" avoids conflict,denies her feelings,and does not assertively resolve the problem.This is an example of nonassertive behavior.

Question 16

During a psychoeducational group on assertiveness training,a client asks,"Why do we need to learn about this stuff?" Which is the most appropriate nursing reply?
A) "Because your doctor requires you to attend this group."
B) "Being assertive is the ability to stand up for yourself while respecting the rights of others."
C) "Assertiveness training teaches you how to ask for what you want, when you want it."
D) "Assertive people place the needs and rights of others before their own."

Accepted Answer

Assertiveness training assists people to maintain their own self-respect and meet their needs while respecting the rights of others.

Question 17

An emergency department nurse,who has worked 10 straight days,is pulled to the psychiatric unit.Which represents a passive-aggressive statement by the emergency department nurse?
A) "Get someone else to work 3 to 11! I've been working 10 days straight, and I need a break!"
B) "Okay. I'll do it," then purposefully leaves paperwork undone when leaving the unit at 11 p.m.
C) "I have worked 10 days straight, and I cannot work tonight. I will work for you tomorrow if you need me."
D) "Yes, I'll do it. Anything to keep peace with the hospital administration is a good thing."

Accepted Answer

This response is passive-aggressive.The staff nurse's anger is expressed indirectly.

Question 18

Two clients get into a heated argument regarding TV program selections.The nurse turns off the TV and asks the clients to go to their rooms to cool off,after which they will discuss and attempt to resolve the problem.The nurse's action is promoting which assertive technique?
A) Defusing
B) Clouding or fogging
C) Responding as a broken record
D) Shifting from content to process

Accepted Answer

Defusing is a technique that delays further discussion with an angry individual until a calm demeanor has been achieved.In the situation presented,the nurse is allowing the clients to calm down prior to addressing their issues.

Question 19

An aggressive nurse manager tells a staff nurse she has no business rallying staff to change the schedule.What would be an example of a technique that the staff nurse could use to stand up for her basic human rights?
A) "What is the real reason that you don't want the schedule changed?"
B) "Sounds to me like you're threatened by this change."
C) "Are you upset because you don't want to redo the schedule?"
D) "I have the right to express my opinion about the schedule."

Accepted Answer

This response reflects the use of standing up for one's basic human rights.

Question 20

A nursing supervisor is scheduling holiday hours.When the supervisor tells the staff nurse that she needs to work Christmas day,the staff nurse calmly states,"I worked last Christmas and will not work this Christmas." When the supervisor says 'But I need you to work," the nurse repeats "I worked last Christmas and will not work this Christmas." This is an example of which assertive behavior technique?
A) Shifting from content to process
B) Standing up for one's basic rights
C) Responding as a broken record
D) Defusing

Accepted Answer

"Responding as a broken record" is an assertive behavior technique that consists of persistently repeating in a calm voice what is wanted.

Quiz 14: Assertiveness Training

A nurse should assign which nursing diagnosis to a client needing assistance with assertiveness?

During an assertiveness training group,a nurse suggests using "I statements." The group questions the usefulness of this communication technique.Which explanation by the nurse is most appropriate?

The dean of nursing criticizes a faculty member about views on academic freedom.The faculty member states,"Are you upset because I believe in academic freedom or because you don't?" The faculty member is using which technique to promote assertive behavior?

Which best describes a nurse's use of assertive behavior?

While trying to control aggressive behavior,a client asks an assertiveness training nurse to give an example of an "I statement." Which of the following statements is the best example of this assertive communication technique?

A client on an inpatient unit is angry with a peer.During lunch,when the peer is not looking,the client spits into his soup.How would the nurse document this interaction?

A client continually waits more than an hour before being seen at the mental health clinic.The client approaches the nurse and states,"When I have to wait for more than an hour to be seen,I feel like my time is not important." The nurse recognizes this as what type of behavior?

A nurse has identified the following nursing diagnosis: "ineffective communication R/T lack of assertiveness skills AEB inability to state needs." Which statement encourages the client to acknowledge the priority of this problem?

During an assertiveness training group,a client admits to aggressive behaviors.The client asks for suggestions for how to become more assertive and less aggressive.Which is the most appropriate nursing reply?

An instructor is teaching about assertive rights.Which student statement indicates a need for further instruction?

One nurse confronts another and says,"You are always so talkative in the meetings.I don't know why you can't stay quiet sometimes." Which reply by the other nurse reflects the technique of "clouding/fogging?"

A teenager gets a "C" in algebra.The mother angrily states,"All you ever do is listen to music and text your friends." The teenager replies,"What is it that you're really upset about,mom?" Which response pattern is the teenager expressing?

After vying for a nurse management position,nurse "A" is chosen over nurse "B." When nurse manager "A" calls for staff meetings,nurse "B" is chronically late or absent.Nurse "B" is exhibiting which type of behavior?

Which is the most appropriate nursing reply when a client asks what the goal and benefit are of assertive skills training?

Two clients are roommates on an inpatient psychiatric unit.At breakfast,client "A," who had been missing her gold locket,notices client "B" wearing it.Which should a nurse recognize as a nonassertive or passive behavioral response from client "A"?

During a psychoeducational group on assertiveness training,a client asks,"Why do we need to learn about this stuff?" Which is the most appropriate nursing reply?

An emergency department nurse,who has worked 10 straight days,is pulled to the psychiatric unit.Which represents a passive-aggressive statement by the emergency department nurse?

Two clients get into a heated argument regarding TV program selections.The nurse turns off the TV and asks the clients to go to their rooms to cool off,after which they will discuss and attempt to resolve the problem.The nurse's action is promoting which assertive technique?

An aggressive nurse manager tells a staff nurse she has no business rallying staff to change the schedule.What would be an example of a technique that the staff nurse could use to stand up for her basic human rights?