Deck 14: Assertiveness Training

Question 1

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."

Answer 1

"Being assertive is the ability to stand up for yourself while respecting the rights of others."

Question 2

An emergency department nurse,who has worked 10 straight days,is pulled to the psychiatric unit.Which of the emergency department nurse's statements represent a passive-aggressive response?

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."

Answer 2

"Okay.I'll do it," then purposefully leaves paperwork undone when leaving the unit at 11 p.m.

Question 3

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

Answer 3

Defensive coping

Question 4

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?"

Question 5

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."

Question 6

Which is the best 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 to improve interpersonal relationships."

Question 7

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?" Which technique is the faculty member using to promote assertive behavior?

A)Standing up for one's basic human rights
B)Delaying assertively
C)Inquiring assertively
D)Responding assertively with irony

Question 8

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."

Question 9

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

Question 10

An aggressive nurse manager tells a staff nurse that 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."

Question 11

Which of the following are behavioral components of assertive communication?

A)Listening
B)"You" statements
C)Closed posture
D)Continuous direct eye contact

Question 12

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

Question 13

Two clients get into an intense argument regarding TV program selections.The nurse turns off the TV and asks the clients to go to their rooms to cool off,and tells them they will discuss and attempt to resolve the problem afterward.Which assertive technique is the nurse using?

A)Defusing
B)Clouding or fogging
C)Responding as a broken record
D)Shifting from content to process

Question 14

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."

Question 15

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

A)The nurse attempts to please others and apologizes for awkwardness in a new role.
B)The nurse becomes defensive and angry when peers offer suggestions for improvement.
C)The nurse has problems making decisions and tends to procrastinate.
D)The nurse is open and direct when asked by the nurse manager to complete assignments.

Question 16

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 or 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."

Question 17

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 does the 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.

Question 18

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

Question 19

A nursing 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."

Question 20

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."

Question 21

A client is experiencing high stress.The client states,"My boss treats me like a doormat and thinks nothing of demanding frequent overtime." Which nursing intervention is most appropriate?

A)To incorporate the family support system into the client's plan of care
B)To teach thought-reframing techniques
C)To encourage the client to seek other employment
D)To teach the client how to use "I" statements

Question 22

A nurse is caring for four clients.Which of the following clients are most likely to have difficulty being assertive? Select all that apply.

A)A 20-year-old woman who is completing college homework assignments for several peers
B)A 69-year-old widow who is socially isolated
C)A 17-year-old boy with conduct disorder
D)A 45-year-old successful executive
E)A 50-year-old diagnosed with narcissistic personality disorder