Semester 4 Exam 1 Flashcards
Promotes equality in human relationships and enables us
To act in our own best interests
To stand up for ourselves without undue anxiety
To express honest feelings comfortably
To exercise personal rights without denying the rights of others
Helps us feel good about ourselves and increases our self-esteem
Assertive behavior
Basic to assertive behavior and an accurate representation of feelings, opinions, or preferences that are expressed in a manner that promotes self-respect and respect for others
honesty
stating what one wants to convey with clarity and candor
direct communication
hinting and beating around the bush are ___ forms of communication
indirect
in accepting the 10 basic human rights an individual also accepts the ___ that accompany them
responsibilities
True or false: rights and responsibilities are reciprocal entities and to experience one without the other is inherently destructive to an individual
TRUE
individuals develop ___ of responding to others
- Watching other people (role-modeling)
- Being positively reinforced or punished for a certain response
- We learn how to respond or how not to respond by the way it is received
- Inventing a response
- Not thinking of a better way to respond
- Not developing the proper skills for a better response
- Consciously choosing a response style
patterns
what are the four common response patterns
- nonassertive
- assertive
- aggressive
- passive-aggressive
individuals who use this kind of behavior seek to please others at the expense of their own basic rights
sometimes called passive
nonassertive
individuals who use this kind of behavior
- Stand up for their own rights while protecting the rights of others.
- Feelings are expressed openly and honestly
- Self-respect and respect for others are maintained.
assertive
individuals who use this kind of behavior
- Defend their own basic rights by violating the basic rights of others.
- Feelings are often expressed dishonestly and inappropriately.
aggressive
individuals who use this kind of behavior
- Respond to others by appearing passive and accept other’s demands while behaving in ways that suggest anger and resentment are their true feelings
- Sometimes called indirect aggression, the behavior takes the form of passive, nonconfrontational action.
passive-aggressive
this pattern of communication is dishonest, manipulative, and sly and it undermines others with behavior that expresses the opposite of what they are feeling
This style of communication is associated with extremely low self-confidence
passive-aggressive
Two patients disagree on what movie to watch during free activity time. One patient says to the other, “I would like to watch the comedy instead of the murder mystery.” The nurse recognizes this as which form of communication response pattern? A. Nonassertive B. Assertive C. Aggressive D. Passive-Aggressive
B.
this assertive behavioral component conveys the message that one is interested in what is being said
intermittent eye contact
this assertive behavioral component of assertive behavior includes Sitting and leaning slightly toward other person in a conversation and suggests active interest in what is being said
body posture
this assertive behavioral component of assertive behavior describes the
Appropriate physical distance is culturally determined.
Invasion of personal space may be interpreted by some individuals as aggressive.
distance/physical contact
this assertive behavioral component of assertive behavior adds meaning to spoken word such as emphasis, warmth, depth, or power
gestures
this assertive behavioral component of assertive behavior can convey different messages but in assertive communication it is congruent with the verbal message
facial expression
this assertive behavioral component of assertive behavior conveys a message by its loudness, softness, amount and placement of emphasis, and evidence of emotional tone.
In assertive communication this conveys an acceptable volume to communicate confidence without being too loud or forceful
voice
A nurse is conducting an assertiveness training class. Which of the following characteristics of assertive behavior should the nurse include?
A. Eye contact should be steady and continuous.
B. Invasion of intimate space can be interpreted as assertive behavior.
C. While interacting, individuals should turn slightly away from the other person.
D. The facial expression is congruent with the verbal message.
D.
techniques that promote assertive behavior
“I have the right to express my opinion”
Standing up for one’s basic human rights
techniques that promote ___ behavior have been shown to be effective in responding to criticism and avoiding manipulation by others
assertive
techniques that promote assertive behavior
Saying I don’t want to go out with you tonight instead of saying I can’t
Assuming responsibility for ones own statements
techniques that promote assertive behavior
-assertively accepting negative aspects about oneself and admitting when an error has been made
agreeing assertively
techniques that promote assertive behavior persistently repeating in a calm voice what is wanted
responding as a broken record
techniques that promote assertive behavior
seeking additional information about critical statements
inquiring assertively
techniques that promote assertive behavior
changing the focus of the communication from discussing the topic at hand to analyzing what is actually going on in the interaction
shifting from content to process
techniques that promote assertive behavior
concurring with the critic’s argument without becoming defensive and without agreeing to change
clouding or fogging
techniques that promote assertive behavior
putting off further discussion with an angry individual until he or she is calmer
defusing
techniques that promote assertive behavior
putting off further discussion with another individual until one is calmer
delaying assertively
techniques that promote assertive behavior
Man: I bet you’re one of them so called women’s libbers aren’t you
Woman: Why yes thank you for noticing
Responding assertively with irony
techniques that promote assertive behavior
this allows an individual to take ownership for their feelings rather than saying they are caused by another person
using “I” statements
The individual practices interrupting negative thought processes with the word, “stop,” and shifting his or her thoughts to ones that are considered
Intended to eliminate intrusive, unwanted thoughts
pleasant and desirable.
thought-stopping techniques
assertive communication if part of a larger set of competencies referred to as
emotional intelligence
what are 4 sets of competencies included in emotional intelligence
- self-awareness
- social awareness
- self-management
- relationship management
what is the difference between self-concept and self-esteem
self-concept describes individuals’ thoughts and beliefs about themselves and self-esteem describes how individuals feel about themselves
what are the 3 components of self-concept
- body image
- personal identity
- self-esteem
this is the cognitive or thinking component of the self that evolves through dynamic interactions in the environment and personal reflection to develop a set of beliefs about oneself
self-concept
this is the degree of regard or respect that individuals have for themselves and is a measure of worth that they place on their abilities and judgements
self-esteem
True or False
The development of self-esteem is is largely influenced by perceptions about how one is viewed by significant others
TRUE
A patient with a new ileostomy tells the nurse, “I’m disgusting. This ileostomy makes me so ugly.” Which correctly written nursing diagnosis would be appropriately assigned to address this patient’s problem?
A. Situational low self-esteem related to disturbed body image evidenced by client statement “I’m disgusting”
B. Risk for complicated grieving related to loss of normal GI function evidenced by expressions of anger
C. Disturbed thought processes related to ileostomy evidenced by altered body image
D. Anxiety related to cancer of the colon evidenced by ileostomy
A.
Individuals who had ____ stability had higher self-esteem than those who had unstable emotions
emotional
Those with a desire to be thoughtful, careful, and to do the right thing, are associated with higher self-esteem
conscientiousness
the sense that one has a control over the forces affecting ones life and can differentiate between what they can control and the things out of their control are associated with high self-esteem
a high sense of mastery
true or false
low risk taking is correlated with higher self-esteem
TRUE
After his wife left him, the husband, diagnosed with depression, is admitted to a psychiatric unit. He states that he was proud of receiving job commendations that led to a promotion. Which condition that would affect self-esteem has contributed to the patient’s depression? A. The lack of power B. The lack of significance C. The lack of virtue D. The lack of competence
B.
Warren’s focus areas for parents and others who work with children to encourage self-esteem
- A sense of competence
- ___ love
- A sense of survival
- Realistic goals
- A sense of responsibility
- Reality orientation
unconditional
A mother berates her child for breaking a cup and says, “You are bad and so destructive.” This statement discourages the development of positive self-esteem by not meeting which parenting focus as described by Warren? A. A sense of competence B. Unconditional love C. A sense of survival D. Realistic goals
B.
What are Erikson’s eight transitional or maturational crises
Trust versus mistrust Autonomy versus shame and doubt Initiative versus guilt Industry versus inferiority Identity versus role confusion Intimacy versus isolation Generativity versus stagnation Ego integrity versus despair
One of Erikson’s crises
Development of trust results in a feeling of confidence in the predictability of the environment
Failure to achieve this results in the person experiencing emotional dissatisfaction with the self and suspicious of others
Trust vs. Mistrust
One of Erikson’s crises
The child begins active exploration and experimentation; achievement of this allows for a feeling of self-confidence in one’s ability to perform
autonomy vs. shame and doubt
One of Erikson’s crises
Positive self-esteem is gained through initiative when creativity is encouraged and performance is recognized and positively reinforced
Children develop a conscience and label behaviors as good or bad
initiative vs. guilt
One of Erikson’s crises
Self-confidence is gained at this stage through learning, competing, performing successfully, and receiving recognition from significant others
industry vs. inferiority
One of Erikson’s crises
Positive self-esteem in adolescence occurs when individuals are allowed to experience independence by making decisions that influence their lives
Identity vs. role confusion
One of Erikson’s crises
Intimacy is achieved when one is able to form a lasting relationship or a commitment to another person, a cause, institution or a creative effort
Intimacy vs. isolation
One of Erikson’s crises
Generativity promotes positive self-esteem through gratification from personal and professional achievements and from meaningful contributions to others
Generativity vs. Stagnation
One of Erikson’s crises
Ego integrity results in a sense of self-worth and self-acceptance as one reviews life goals, accepting that some were achieved and some were not
Individual has little desire to change how their life has progressed
Ego integrity vs. despair
Behaviors that reflect low self-esteem manifest themselves according to three types of stimuli which are
- focal stimuli
- contextual stimuli
- residual stimuli
this is the immediate concern that is causing the threat to self-esteem and the stimulus that is causing the current behavior
ex: termination of a relationship or job
focal stimuli
these are all the other stimuli present in the person’s environment that contribute to the behavior being caused by the focal stimulus
ex: preoccupation with guilt about the effects a divorce may have on one’s children
contextual stimuli
these are previous experiences that influence one’s maladaptive behavior in response to focal and contextual stimuli
ex: being reared in an atmosphere of ridicule and deprecation may affect current adaptation to divorce
residual stimuli
define and differentiate an individual’s physical and psychological space from the physical and psychological space of others.
Sometimes referred to as limits
boundaries
these are all types of physical \_\_\_ Physical closeness Touching Sexual behavior Eye contact Privacy Pollution
boundaries
these are all types of \_\_\_ boundaries Beliefs Feelings Choices Needs Time alone Interests Confidences Individual differences Spirituality
psychological
boundaries can be ___, ___ or ___
rigid, flexible, or enmeshed
individuals who have ___ boundaries have a hard time trusting others
Occur when people have a very narrow perspective and reject new ideas of experiences
rigid
healthy boundaries are __ . Individuals let go of their boundaries when appropriate and they must be aware of who is considered safe and when it is safe to let others invade their personal space
flexible
These boundaries occur when two people’s boundaries are so blended together that neither can be sure where one stops and the other begins
An individual is unable to differentiate his or her wants and needs from those of the other person.
enmeshed
True or false: Seclusion or restraint is discontinued as soon as possible regardless of when the order is scheduled to expire
TRUE
Orders for restraint or seclusion must be renewed every __ hours for adult
4
Orders for restraint or seclusion must be renewed every ___ hours for children and adolescents 9-17
2
Orders for restraint or seclusion must be renewed every ___ hour for children <9
1
An in-person evaluation needs to be conducted within __ hour of initiating restraint or seclusion
1
TRUE OR FALSE
Anger and aggression are the same thing
NO
This is an emotional state that varies in intensity from mild irritation to intense fury and rage
Anger
- this can be a behavioral response to anger intended to threaten or injure the victim’s security or self-esteem
- response aimed at inflicting pain or injury to objects or persons
- always designed to punish
Aggression
When anger is turned inward on oneself it can result in ___ and ___-___
depression and low self-esteem
when anger is expressed inappropriately it interferes with ____
relationships
when anger is suppressed in can turn into ___ which manifests in negative, passive-aggressive behavior
resentment
anger is a normal emotion and becomes a problem during what two scenarios
- when it is not expressed
2. when expressed aggressively
these are the fundamental points about ___
Anger is not a primary emotion; it is learned.
Anger is physiological arousal. (it instills feelings of power)
Anger and aggression are significantly different.
The expression of anger is learned.
The expression of anger can come under personal control.
anger
A client has not received what was expected for lunch and directs an angry verbal outburst at the nurse. What is an accurate description of this display of emotion?
A. Anger is a primary emotion that is automatically experienced.
B. Anger is a psychological arousal.
C. Expression of anger can come under personal control.
D. Expression of anger and aggression are closely related.
C.
- one of the strongest forms of learning.
- Evidence supports the role of television and video violence as a predisposing factor to later aggressive behavior.
role modeling
anger and aggression can be learned through ___ ___ which occurs when a specific behavior is positively or negatively reinforced
operant conditioning
a response to the specific behavior that is pleasurable or produces the desired results.
positive reinforcement
a response to the specific behavior that prevents an undesirable result from occurring.
negative reinforcement
Loss of function in the cortex Brain tumors Brain trauma Encephalitis Have all been implicated in predisposition to \_\_\_ and violent behavior
aggression
After repeated requests for a patient to unpack and get settled on the psychiatric unit, the patient states, “I have no intention of unpacking and staying on this unit.” To avoid a confrontation, the nurse unpacks the patient’s belongings. Which nursing behavior is exemplified? A. Positive role modeling B. Negative operant conditioning C. Assertiveness D. Aggressiveness
B.
these are the predisposing factors to anger and aggression
- modeling
- operant conditioning
- neurophysiological factors
- biochemical factors
- socioeconomic factors
- ____ factors
environmental
which hormone is identified as playing a key role in aggression
testosterone
true or false
poverty and exposure to violence has an impact on future tendencies toward aggression
TRUE
patients with a history of ___ are at risk to have more problems with anger and aggression
epilepsy
what 3 environmental factors have been shown to increase risk for aggression
- crowding
- discomfort in environmental temperature
- noise
abuse of these substances has been associated with ___
- cocaine
- steroids
- bath salts
- amphetamines
- weed
- PCP
aggression
what are the 3 best predictors of violent behavior are
- Alcohol intake
- History of childhood abuse
- History of violent acts with criminal activity or arrests
the goal of ___ management is to reduce both the emotional feelings and the physiological arousal that anger engenders
anger
true or false
when patients are angry try to empathize with their feelings and get them to speak about their feelings
“can you explain to me why you’re feeling…”
TRUE
When ___ is expressed passively aggressive or aggressive that is when it can result in conflict
anger
true or false
accidents that lead to unintentional harm or destruction are not considered aggression
TRUE
___ is key to managing aggressive or violent behavior
prevention
(risk factors)
schizophrenia, major depression, bipolar disorder and substance use disorders have a strong correlation with ___ behavior
violent
what are the 3 risk factors in identifying extent of risks for anger and aggression aggression
- past history of violence
- client diagnosis
- current behavior
Characterized by anxiety and tension, verbal abuse and profanity, and increasing hyperactivity which often leads to assaultive behavior
prodromal syndrome
Behaviors associated with this ___ stage
Rigid posture; clenched fists and jaws; grim, defiant affect
Talking in a rapid, raised voice; arguing and demanding
Using profanity and threatening verbalizations; agitation and pacing; and pounding and slamming
prodromal
what are some nursing diagnosis for clients expressing anger or aggression
- ineffective coping
- risk for self-directed or other directed violence
An angry patient states to the nurse, “You red-headed skinny witch. You can’t tell me what to do.” Which appropriate intervention would the nurse implement during this outburst?
A. Reprimand the patient for poor judgment and derogatory remarks.
B. Respond to angry expressions with matching verbalizations.
C. Offer support by the use of empathy and therapeutic touch.
D. Ignore initial derogatory remarks.
C.
evaluation of the following is used to determine the success of working with a patient exhibiting inappropriate expression of anger
Is the patient able to recognize when they are angry?
Can the patient take responsibility for these feelings and keep them in check without losing control?
Does the patient seek out staff or a support person to talk about feelings of anger when they occur?
as nursing intervention should you touch a patient when they become angry
NO
-client may view this as threatening and could become violent
after dealing with a situation in which a patient loses control it is important for staff to do what
debrief
the following is discussed in the ___
- factors that lead to the crisis
- factors that lead to the failure of less restrictive interventions
- staff thoughts about interventions
- discuss the situation with the client and others clients who saw the situation
debriefing
how often should the client be monitored to ensure circulation when they have restraints on
every 15 minutes
trust vs. mistrust develops during what years
birth to 18 months (infant)
autonomy vs. shame and doubt develops during what years
18 months to 3 years (toddler)
initiative vs. guilt develops during what years
3 to 6 years (preschool)
industry vs. inferiority develops during what years
6 to 12 years (school age)
identity vs. role confusion develops during what years
12 to 20 years (adolescence)
intimacy vs. isolation develops during what years
20 to 30 years
generativity vs. stagnation develops during what years
30 to 65 years
ego integrity vs. despair develops during what years
65 years and older
