Chapter 14. Assertiveness Training questions and answers

Chapter 14. Assertiveness Training questions and answers .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." ANS: B Assertiveness training assists people to maintain their own self-respect and meet their needs while respecting the rights of others. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity 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. ANS: A 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. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity 00:18 01:21 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." ANS: D This response is passive-aggressive. The client's anger is expressed indirectly by spitting in the soup when the peer is not looking. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity 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 ANS: B This response is assertive. The client is openly expressing feelings and attempting to correct a stressful situation. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity 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." ANS: D These techniques promote assertive behaviors and would help diminish aggressive responses. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity 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." ANS: A "I statements" clearly state one's feelings and needs without blaming or demeaning others. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity 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." ANS: C This response clearly states feelings about a situation without blaming another. KEY: Cognitive Level: Application | Integrated Processes: Implementation | Client Need: Psychosocial Integrity 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 ANS: D This response is passive-aggressive. The colleague is expressing anger indirectly by being late or absent from the meetings. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity 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 ANS: C 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. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Analysis | Client Need: Psychosocial Integrity 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 ANS: A 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. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity 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." 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." ANS: B This response is passive-aggressive. The staff nurse's anger is expressed indirectly. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity 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 ANS: D This is an assertive response. There is clear expression of needs and feelings. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity