Deck 14: Assertiveness: Your Responsibility

Question 1

A staff nurse enters the room in which you're giving care to a patient in traction. She calls you aside and states, "I've watched you all morning. You don't seem to know how to do anything right. Look at you now! You're bathing the patient and it's almost time for lunch." An assertive approach would be to say

A) "You're right. I am still bathing the patient. She was in pain earlier. I waited until her narcotic made her more comfortable."
B) "I'm sorry you think I give poor care. I'm still pretty new, and I'm trying hard to learn."
C) "I've watched you, too. You've criticized every student. Is this some game you play?"
D) "I hope you won't report this to my instructor."

Answer 1

"You're right. I am still bathing the patient. She was in pain earlier. I waited until her narcotic made her more comfortable."

Question 2

The intervention that is most effective at reducing patient violence against nurses is

A) teaching nurses to communicate respect for patients and confidence in themselves.
B) requiring nurses to work in groups rather than alone.
C) having security personnel stationed on all units.
D) assigning only male nurses to care for psychiatric or chemical dependency patients.

Answer 2

teaching nurses to communicate respect for patients and confidence in themselves.

Question 3

The student nurse has a goal to become a more assertive person. To achieve this, the student nurse must be willing to

A) keep a daily journal.
B) be disliked by others.
C) put down other people.
D) take a positive stand.

Answer 3

take a positive stand.

Question 4

A nursing student's mother states, "I need you to watch your younger siblings while I play bingo." The nursing student had planned to prepare for a unit examination. An assertive approach would be to say

A) "What you're asking isn't fair. I have an exam to study for. You never win at bingo anyway."
B) "OK. If your bingo means more to you than my passing a big exam, I'll watch the kids."
C) "I'll make a deal with you. I'll watch the kids if you'll cook my favorite meal tomorrow night."
D) "I'm sorry, but I won't be able to babysit. I have an exam tomorrow. I need the time tonight to study."

Question 5

The instructor tells a nursing student to hurry with the assignment in order to help a classmate who is behind with work. The student has promised a patient she'd return in 15 minutes to polish the patient's nails. Which response would be considered assertive?

A) "Why me? I'm still busy with my own patients. Ask one of the others who are standing around at the nurses' station."
B) "I suppose I can, if you insist."
C) "I've promised one of my patients that I'll come back to polish her nails. I'd like to be able to keep that promise. Can you possibly ask someone else?"
D) "I'll be glad to help." Then go and apologize to the patient saying the instructor won't let you polish her nails.

Question 6

The nurse is assigned to park in a newly created parking lot that is far from the hospital building. Some of the lights in the new parking lot have not been installed. As the nurse is about to leave, she notices several young men loitering near the walkway she must take. The nurse should

A) take a deep breath and walk rapidly toward the parking lot.
B) try to use friendliness by greeting the young men as she passes them.
C) wait inside the hospital until the young men leave.
D) call for a security guard to serve as an escort to the car.

Question 7

A newly graduated LPN/LVN who is orienting to the unit tells a peer, "You should have seen that new associate degree RN trying to take care of three patients! She was so disorganized that it made me glad I'm an LPN/LVN." The LPN/LVN is demonstrating

A) manipulation.
B) assertiveness.
C) projection.
D) passiveness.

Question 8

Which behavior should be considered an early sign that a co-worker may have the potential for violence?

A) Verbalization of a wish to harm someone
B) A suicidal threat
C) Destruction of agency property
D) Lack of cooperation with supervisors

Question 9

A nurse demonstrates assertive behavior by doing which of the following?

A) When a patient asks the nurse to stop and feed the patient's cats on the way home, the nurse frowns but agrees to do so.
B) The nurse feels the team leader's assignment is unfair, so the nurse drops hints to co-workers about feelings of unfairness.
C) When the patient asks about the nurse's personal life, the nurse answers the questions out of fear of not being liked for not answering.
D) When working with a patient who is critical of the nurse, the nurse sits down with the patient and listens attentively to the patient's concerns.

Question 10

A nurse demonstrates assertive behavior by doing which of the following?

A) When the physician yells at the nurse in front of the patient, the nurse is angry but refrains from speaking about it.
B) The nurse plans on seeking new employment out of fear of approaching the supervisor to tell his or her side of what happened.
C) When working with a patient who has had the call light on repeatedly, the nurse tells the patient, "Do not put your call light on again."
D) When unexpected visitors arrive to visit the patient during breakfast, the nurse asks whether the patient would prefer to eat now or visit.

Question 11

A nurse demonstrates assertive behavior by doing which of the following?

A) When making an error, the nurse overexplains and overapologizes and is unaware of the right to make a mistake.
B) When asked by the charge nurse to accept an admission, the busy nurse hesitantly responds by saying, "Well, I guess I could."
C) When the nurse is very busy and needs help with an assignment, the nurse says nothing and refrains from expressing the need for help.
D) A patient complains of pain when ambulating and asks not to walk. The nurse respects the patient's feelings and medicates the patient as ordered for pain while supporting the need to carry out the physician's order.

Question 12

A male nurse has been assigned to mentor a newly hired female nurse. Several times during the day, the new nurse perceives her mentor as touching her inappropriately. In the afternoon the mentor tells the new nurse, "I think we should meet after work for a drink. I could give you the lowdown on other staff, and we could get our relationship off to a good start. With my help, you'll be able to get raises and promotions regularly." The new nurse thinks, "I don't want this man's help." The new nurse can correctly determine that these behaviors suggest

A) assault.
B) assertiveness.
C) manipulation.
D) sexual harassment.

Question 13

A student nurse is assigned to care for a patient who is known to be angry. During the caregiving process, the patient hits the student nurse. The action the student nurse should initially take is to

A) indicate that he does not like being hit and continue to provide care to the patient.
B) leave the patient in a safe situation and immediately report the event to the instructor.
C) immediately leave the room and call the patient's physician for an order to medicate the patient.
D) go to the telephone and call the local police to report the incident.

Question 14

A nurse demonstrates assertive behavior by doing which of the following?

A) Limiting contact with a patient who is dying, because it causes the nurse to feel depressed
B) Routinely telling patients who have questions about their medications to ask the physician
C) When asked about something unfamiliar, admitting to not knowing but agreeing to find out
D) Telling another nurse how ridiculous a doctor is for ordering hourly vital sign assessments

Question 15

A nurse demonstrates nonassertive behavior by doing which of the following?

A) When a patient asks about the nurse's personal life, the nurse responds to the patient's questions out of fear of not being liked by the patient.
B) When a patient asks about the nurse's personal life, the nurse says that the information is personal and chooses not to discuss it.
C) When a nurse feels the team leader has been unfair, the nurse approaches the team leader and asks to speak privately at a time that is convenient for the person.
D) When pressured by staff members to help with their assignments, the nurse, who is too busy to help, refuses without feeling guilty but leaves the door open to help at a future date.

Question 16

When a nurse is the target for unwanted behavior that she perceives as sexually harassing, she should first

A) resign from the job.
B) assertively tell the person that the behavior is unwanted.
C) report the behavior to the nursing supervisor.
D) report the behavior to the union representative.

Question 17

When a nurse tells a peer, "You have to watch out for the charge nurse. Sometimes she's OK, but sometimes she's just plain unreasonable. The best thing to do is to tell her off the first time she gets on your back about something. Keep me posted and I'll try to help you." An assertive reply would be

A) "Thanks for the warning. I'll be careful."
B) "You take care of yourself, and I'll watch out for myself."
C) "I think it would be best for me to work on my relationship independently."
D) "It seems to me that you're playing a manipulative game and giving out poor advice."

Question 18

Which nonverbal behavior is most congruent with a nurse's assertive verbal statement?

A) Firm voice, erect posture, direct eye contact
B) Soft voice, shoulders relaxed, eyes down
C) Loud voice, back stiff, eyes glaring
D) Smile while speaking, touch person's arm, eyes lowered

Question 19

A nurse demonstrates assertive behavior by doing which of the following?

A) Assuming a patient would like to skip the bath when the patient's spouse comes to visit
B) Being unable to continue suctioning a patient because she is concerned the patient will not like her for doing it
C) Experiencing a feeling of devastation when the patient questions her ability to insert an intravenous catheter
D) Requesting to speak with the physician privately when she feels that the physician has ordered an inappropriate treatment

Question 20

Which statement shows a personal commitment to work on the goal of devoting more time to coursework for the LPN/LVN program?

A) "My friends have to stop asking me to do time-consuming favors for them."
B) "My family needs to take on more responsibility for household tasks so I have more time to study."
C) "The charge nurse should stop asking me to work overtime and instead ask other CNAs."
D) "I will say 'no' when people ask me to do things that take time away from my studies."

Question 21

Which of the following measures are most helpful to the nurse who makes a personal commitment to practice violence prevention in the workplace? (Select all that apply.)

A) Get to know co-workers and look out for them.
B) Treat patients and co-workers with courtesy and respect.
C) Become familiar with policies relating to violence and harassment.
D) Assume individuals will not act on threats they make.
E) Interject opinions while attempting to clarify issues.
F) Set clear, firm limits on unacceptable behavior.

Question 22

What are the expected outcomes of using assertive communication in the nursing workplace? (Select all that apply.)

A) It enmeshes the person and the issue.
B) It promotes positive relationships.
C) It is clear and unequivocal.
D) It respects the rights of oneself and others.
E) It is focused on the personal needs of the nurse.
F) It guarantees the user will get his or her way.

Question 23

A nurse is appointed to a workplace committee to plan changes in the emergency department. The committee's task is to make recommendations that will provide an environment that deters violence. Which recommendations are consistent with this goal? (Select all that apply.)

A) Install bullet-resistant glass in the nurses' station.
B) Install security alarm devices in examining rooms.
C) Institute a limited toleration of violence policy.
D) Develop a minimum safe staffing policy.
E) Change security officers' uniforms to shirt, tie, blazer, slacks.

Question 24

Which statements about manipulation would be useful to the nurse who interacts with both patients and peers? (Select all that apply.)

A) Manipulation usually disregards the feelings and needs of others.
B) Manipulation exploits the weaknesses of others.
C) A divide-and-conquer strategy is often used by those who manipulate.
D) Firm limit-setting rarely protects against manipulation.
E) Manipulation often results in individuals being treated as objects.
F) Manipulation should be permitted if it is consistent with the nurse's needs.

Question 25

A nurse experiences potential danger from a patient who is highly suspicious and fears being harmed. Which behaviors by the nurse will help alleviate the threat of violence? (Select all that apply.)

A) Stand in the doorway of the room.
B) Maintain an open position with the hands in view.
C) Occasionally touch the patient gently on the forearm.
D) Turn away from the patient to demonstrate lack of fear.
E) Speak in a quiet, controlled voice.