,Balzer Riley: Communication in Nursing, 10th Edition
Chapter 1: Responsible, Assertive, Caring Communication in Nursing
Test Bank
Multiple Choice
1. Which statement describes the affective aspect of learning effective
communication strategies?
a. “The nurse should use clear, direct statements using objective words.”
b. “The nurse uses body language that is congruent with the verbal message.”
c. “The nurse believes that positive communication strategies build confidence.”
d. “The nurse practices assertive and responsible communication strategies.”
ANS:C
Learning involves three domains: the cognitive aspects (understanding and meaning),
affective aspects (feelings, values, and attitudes), and psychomotor aspects (physical
capability).Learning basic communication skills involves the cognitive domain; building
confidence through a belief in the value and impact of positive communication is the
affective domain; and putting skills into action is the psychomotor domain.DIF:
Comprehension REF: p. 13 TOP: Integrated Process: Communication and
Documentation MSC: Psychosocial Integrity
2. The nurse manager asks the staff nurse to work an extra shift. Which response by
the staff nurse is assertive and based on rational beliefs?
a. “I don’t want you upset, so I will work extra.”
b. “Why do I always have to cover extra shifts?”
c. “I am not able to work an extra shift.”
d. “If you can’t find anyone else, I will do it.”
ANS:C
The staff nurse may turn down even a reasonable request; an assertive response avoids
irrational beliefs. Irrational beliefs occur as a result of being anxious about assertiveness
or focusing on possible negative outcomes.DIF: Analysis REF: p. 8 TOP: Integrated
Process: Communication and Documentation MSC: Safe and Effective Care
Environment: Management of Care
dr.j
,3. A nurse manager offers a staff nurse a choice between working 8- or 12-hour
shifts. Which statement, if made by the staff nurse, is nonassertive and may result in a
frustrated response from the nurse manager?
a. “I want to decide the shifts for all of the other staff nurses.”
b. “Do whatever you want. It doesn’t really matter to me.”
c. “Thank you for offering me a choice. I prefer 12-hour shifts.”
d. “You will never be able to give me what I really want to work.”
ANS:B
A statement that allows others to make decisions for a person is an example of a
nonassertive style of communication; the response of others to a nonassertive statement
may include disrespect, guilt, anger, or frustration. Statements that make choices for
others or that are accusations are examples of aggressive styles of communication; the
response of others to an aggressive statement may include hurt, defensiveness, or
humiliation. A statement that allows making one’s own decisions is an example of
assertive style of communication; the response of others to an assertive statement may
include mutual respect.DIF: Analysis REF: p. 7 TOP: Integrated Process: Communication
and Documentation MSC: Safe and Effective Care Environment: Management of Care
4. The nurse is providing care to a patient who was admitted with heart failure. The
patient has not been following the prescribed diet or taking the prescribed
medications. Which type of communication approach is most important for the nurse
to use with this patient to facilitate a change in self-care behavior?
a. Authoritative, honest, and outright communication
b. Assertive, responsible, and caring communication
c. Aggressive, sympathetic, and realistic communication
d. Positive, expert, and focused communication
ANS:B
Communication must be technically responsible, assertive, and caring to facilitate a
change in behavior.DIF: Knowledge/Comprehension REF: p. 13 TOP: Integrated
Process: Communication and Documentation MSC: Psychosocial Integrity
5. Which are examples of a nurse who is communicating responsibly? (Select all
that apply)
a. The nurse uses profanity to respond to a client who is intoxicated and verbally
abusive.
b. The nurse helps a client talk to family members about discontinuing
chemotherapy.
dr.j
, c. The nurse uses interpersonal strategies to help a client develop methods of coping.
d. The nurse provides a client’s health information to a close relative who is visiting.
e. The nurse listens carefully to the client’s concern about inadequate pain relief.
ANS:B, C, E
A nurse who communicates responsibly will perform the role of a client advocate, will
consider the world of the client and the client’s family, and will naturally focus on the
nursing process and problem-solving process. The nurse is responsible for maintaining
the professional conduct of the relationship. Examples of unprofessional conduct would
include breaching client confidentiality or verbally abusing a client.DIF: Application
REF: pp. 11-12 TOP: Integrated Process: Communication and Documentation MSC:
Psychosocial Integrity
6. According to Swanson’s theory, there are five caring processes, one of which is
“being with.” Which of the responses by the nurse portrays an understanding of the
concept of “being with” a client?
a. The nurse charting in the room to spend more time with the client
b. The nurse wearing locator badge so you can quickly respond any time patient
would call front desk and ask to page you
c. The nurse requesting one-on-one nurse staffing
d. The nurse being emotionally present to the client
ANS:D
Caring is an essential ingredient in life and must characterize the nurse–client
relationship…. Consider Swanson’s five caring processes (Swanson, 1993):1)
Maintaining belief—sustaining faith in the capacity of others to transition and have
meaningful lives2) Knowing—striving to understand events as they have meaning in the
life of the other3) Being with—being emotionally present to the other4) Doing for—
doing for others what they would do for themselves if possible5) Enabling—facilitating
the capacity of others to care for themselves and family members (Tonges and Ray, 2011,
p. 375)DIF: Application REF: p. 11 TOP: Integrated Process: CaringMSC: Physiological
Integrity: Basic Care and Comfort
7. According to Swanson’s theory, there are five caring processes, one of which is
“knowing.” What are the other four?
a. Communication, assertiveness, responsibility, and caring
b. Maintaining belief, being with, doing for, and enabling
c. Understanding, action, information, and comfort
d. Maintaining belief, being with, enabling, and supporting
dr.j
Chapter 1: Responsible, Assertive, Caring Communication in Nursing
Test Bank
Multiple Choice
1. Which statement describes the affective aspect of learning effective
communication strategies?
a. “The nurse should use clear, direct statements using objective words.”
b. “The nurse uses body language that is congruent with the verbal message.”
c. “The nurse believes that positive communication strategies build confidence.”
d. “The nurse practices assertive and responsible communication strategies.”
ANS:C
Learning involves three domains: the cognitive aspects (understanding and meaning),
affective aspects (feelings, values, and attitudes), and psychomotor aspects (physical
capability).Learning basic communication skills involves the cognitive domain; building
confidence through a belief in the value and impact of positive communication is the
affective domain; and putting skills into action is the psychomotor domain.DIF:
Comprehension REF: p. 13 TOP: Integrated Process: Communication and
Documentation MSC: Psychosocial Integrity
2. The nurse manager asks the staff nurse to work an extra shift. Which response by
the staff nurse is assertive and based on rational beliefs?
a. “I don’t want you upset, so I will work extra.”
b. “Why do I always have to cover extra shifts?”
c. “I am not able to work an extra shift.”
d. “If you can’t find anyone else, I will do it.”
ANS:C
The staff nurse may turn down even a reasonable request; an assertive response avoids
irrational beliefs. Irrational beliefs occur as a result of being anxious about assertiveness
or focusing on possible negative outcomes.DIF: Analysis REF: p. 8 TOP: Integrated
Process: Communication and Documentation MSC: Safe and Effective Care
Environment: Management of Care
dr.j
,3. A nurse manager offers a staff nurse a choice between working 8- or 12-hour
shifts. Which statement, if made by the staff nurse, is nonassertive and may result in a
frustrated response from the nurse manager?
a. “I want to decide the shifts for all of the other staff nurses.”
b. “Do whatever you want. It doesn’t really matter to me.”
c. “Thank you for offering me a choice. I prefer 12-hour shifts.”
d. “You will never be able to give me what I really want to work.”
ANS:B
A statement that allows others to make decisions for a person is an example of a
nonassertive style of communication; the response of others to a nonassertive statement
may include disrespect, guilt, anger, or frustration. Statements that make choices for
others or that are accusations are examples of aggressive styles of communication; the
response of others to an aggressive statement may include hurt, defensiveness, or
humiliation. A statement that allows making one’s own decisions is an example of
assertive style of communication; the response of others to an assertive statement may
include mutual respect.DIF: Analysis REF: p. 7 TOP: Integrated Process: Communication
and Documentation MSC: Safe and Effective Care Environment: Management of Care
4. The nurse is providing care to a patient who was admitted with heart failure. The
patient has not been following the prescribed diet or taking the prescribed
medications. Which type of communication approach is most important for the nurse
to use with this patient to facilitate a change in self-care behavior?
a. Authoritative, honest, and outright communication
b. Assertive, responsible, and caring communication
c. Aggressive, sympathetic, and realistic communication
d. Positive, expert, and focused communication
ANS:B
Communication must be technically responsible, assertive, and caring to facilitate a
change in behavior.DIF: Knowledge/Comprehension REF: p. 13 TOP: Integrated
Process: Communication and Documentation MSC: Psychosocial Integrity
5. Which are examples of a nurse who is communicating responsibly? (Select all
that apply)
a. The nurse uses profanity to respond to a client who is intoxicated and verbally
abusive.
b. The nurse helps a client talk to family members about discontinuing
chemotherapy.
dr.j
, c. The nurse uses interpersonal strategies to help a client develop methods of coping.
d. The nurse provides a client’s health information to a close relative who is visiting.
e. The nurse listens carefully to the client’s concern about inadequate pain relief.
ANS:B, C, E
A nurse who communicates responsibly will perform the role of a client advocate, will
consider the world of the client and the client’s family, and will naturally focus on the
nursing process and problem-solving process. The nurse is responsible for maintaining
the professional conduct of the relationship. Examples of unprofessional conduct would
include breaching client confidentiality or verbally abusing a client.DIF: Application
REF: pp. 11-12 TOP: Integrated Process: Communication and Documentation MSC:
Psychosocial Integrity
6. According to Swanson’s theory, there are five caring processes, one of which is
“being with.” Which of the responses by the nurse portrays an understanding of the
concept of “being with” a client?
a. The nurse charting in the room to spend more time with the client
b. The nurse wearing locator badge so you can quickly respond any time patient
would call front desk and ask to page you
c. The nurse requesting one-on-one nurse staffing
d. The nurse being emotionally present to the client
ANS:D
Caring is an essential ingredient in life and must characterize the nurse–client
relationship…. Consider Swanson’s five caring processes (Swanson, 1993):1)
Maintaining belief—sustaining faith in the capacity of others to transition and have
meaningful lives2) Knowing—striving to understand events as they have meaning in the
life of the other3) Being with—being emotionally present to the other4) Doing for—
doing for others what they would do for themselves if possible5) Enabling—facilitating
the capacity of others to care for themselves and family members (Tonges and Ray, 2011,
p. 375)DIF: Application REF: p. 11 TOP: Integrated Process: CaringMSC: Physiological
Integrity: Basic Care and Comfort
7. According to Swanson’s theory, there are five caring processes, one of which is
“knowing.” What are the other four?
a. Communication, assertiveness, responsibility, and caring
b. Maintaining belief, being with, doing for, and enabling
c. Understanding, action, information, and comfort
d. Maintaining belief, being with, enabling, and supporting
dr.j
