Assertiveness Training and Aggression Management

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Match the cues below to either anger or aggression.

Anger​ intense eye contact or avoidance of eye contact​ defensive response to criticism​ flushed face​ anxious, tense, angry facial expression (affect)​ Aggression​ verbal or physical threats​ threats of homicide or suicide​ destruction of property​ acts of physical harm toward another person

What can be causes of aggressive behavior? Select all that apply.

Excessive testosterone levels Head injury Alcohol intake Methamphetamine misuse

Which emotions are most likely to lead to anger? Select all that apply.

Frustration Fear Psychological pain

Based on the admission note and incident report, which are priority nursing diagnoses? Select all that apply.

Impaired social interaction Ineffective coping Risk for other-directed violence Non-compliance

Which measures should reduce the chance for injury to colleagues caring for this client?

Implement staff de-escalation training. Position the client furthest from the entry door. Give each caregiver a panic button that will alert security when an issue arises.

For each set of nursing actions in the left column, specify the nursing diagnosis those actions address by dragging the answer to the corresponding drop-zone.

Ineffective Coping Impaired Social Interaction Noncompliance Risk for other-directed violence

The nurse is preparing a care plan for a client who is exhibiting passive-aggressive behavior. Which nursing diagnosis matches each group of nursing actions? Drag and drop the following nursing diagnosis to the group of nursing actions that they best relate to.

Ineffective Coping Impaired Social Isolation Chronic or situational low self-esteem

Which nursing diagnosis directly relates to the client's history below?

Rudy did not want to know if anything was wrong with him (Ineffective coping) Rudy slammed his fist on the bedside table as he was yelling. (Impaired social interaction) "I'm leaving now! Get out of my way!" (Noncompliance) Rudy has a history of a boxer's fracture related to a bar fight. (Risk for other-directed violence)

Which statement best describes passive-aggressive behavior?

Saying they would work an extra shift, then calling in sick right before the shift start.

The provider ordered an inappropriately high dose of medication for a client. Where does the potential response by the nurse fall within the passive-aggressive continuum? For each response in the left column, specify if the response is passive-aggressive, assertive, or aggressive by selecting the corresponding column. Each response matches with one option.

"I understand you ordered this pain medicine. My book says this dose may be toxic and I don't feel comfortable giving it. " This is assertive behavior because the nurse sticks to facts and avoids "you" statements.​ "I don't understand how you can order this, but I am not giving it. You'll have to find someone else to give it." This is aggressive behavior because the nurse suggests blame and uses "you" statements.​ "I am not sure I am going to have time to give this before my shift is done. Can I give something different?" This is passive-aggressive behavior because the nurse avoids confrontation and suggests something different instead of acknowledging the nurse's concerns.​

Match the picture with the likely behavior.

A passive person generally will avoid eye contact, appear slumped and/or a closed body posture. They avoid making statements and may appear to lack confidence.​ An assertive person will look directly, has an open posture, and generally appears to take the time to listen to others.​ An aggressive person may have a forward stance, a furrowed brow or direct stare. They may also have body language like pointing or gesturing.​ A passive aggressive person can mimic an assertive person. It is difficult sometimes to tell the different between passive aggressive and assertive behavior.

Select the behavior that describes the definition. Assertive Aggressive Passive Passive-Aggressive

Assertive behavior: Communication behaviors that offer open and honest dialogue with others while maintaining respect for differing opinions and beliefs.​ Aggressive behavior: Impulsive or reactionary behavior which can show disrespect to the rights or desires of others. This behavior can potentially lead to physical or emotional harm. It may start with anger and lead to violence.​ Passive-Aggressive behavior: Actions that communicate indirect aggression towards others as a way of resisting requests or demands. This behavior does not show direct aggression, but rather tries to sabotage others.​ Passive behavior: Communication focuses on avoiding conflict and maintaining a closed and defensive stance due to fear of emotional or physical injury.

A client is standing in the middle of the room, yelling and threatening to hit anyone that attempts to stop them from leaving. Which priority actions will promote the nurse's safety in this situation?

Avoid touching the client. Note all clear physical exits that are available.

The nurse is working with an aggressive client. Review the electronic health record (EHR) before answering the question below.

Male Anabolic Steroids Slammed His Fist Boxer's Fracture

Based on the latest discharge note, how should the nurse evaluate the client's progress?

Met Not Met Met Met

Spot the Behaviors An elderly male has an order for an intravenous (IV) line to be placed. The nurse approaches the client to start the IV line. After describing the process, discussing the risks and benefits, the nurse sits down to start the IV, and asks the client to put his arm on the rail. The client doesn't move. The nurse asks if it is okay to start the IV, and the client replies, "Yes". The client continues to decline putting his arm up. This is an example of The nurse looks directly at the client and says, "I see that you're not putting your arm on the rail. A lot of people don't like IVs. Is there something that concerns you about the IV start?" This is an example of The client looks away from the nurse, puts his arm on the rail, and sighs. This is an example of

Passive-aggressive behavior Assertive behavior Passive behavior


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