A nursing instructor teaches students about the purpose of using the nursing process in the care of psychiatric clients. Which of the following statements by a student indicates that learning has occurred?

Choice A Reason:
This statement is an example of assertive communication because it acknowledges the client's feelings while also standing firm on the nurse's actions. Assertive communication is characterized by being direct, clear, concise, honest, confident, and respectful¹. It involves expressing thoughts and feelings in a considerate way that respects others, aiming to foster and maintain healthy relationships, rectify conflicts, and prevent resentment due to unexpressed needs.

Choice B Reason:
Telling a client to calm down can be perceived as dismissive and may not be considered assertive communication. It does not acknowledge the client's feelings and can come across as commanding or condescending, which may escalate the situation rather than resolve it.

Choice C Reason:
While this statement does convey the consequences of the client's actions, it lacks the empathy component that is crucial in assertive communication. It is important to balance directness with understanding when addressing sensitive issues.

Choice D Reason:
Asking why the client chose to behave negatively could be seen as confrontational and may put the client on the defensive. Assertive communication aims to avoid power games and foster clear outcomes, which is best achieved through statements that do not provoke or blame.

Choice A Reason:
Blunted affect refers to a significant reduction in the intensity of emotional expression. In the context of schizophrenia, a person with blunted affect may show less facial expression, have diminished expressive gestures, and a monotone voice. This symptom reflects a decrease in the expression of emotions, which is characteristic of the negative symptoms of schizophrenia.

Choice B Reason:
Delusions are a type of positive symptom of schizophrenia, not a negative one. They are false beliefs that are not based in reality, such as thinking one has superpowers or is being persecuted. Delusions represent an excess or distortion of normal functions.

Choice C Reason:
Poor judgment is not typically classified as a negative symptom of schizophrenia. It can be a consequence of cognitive impairments or positive symptoms like delusions but is not a negative symptom itself.

Choice D Reason:
Anhedonia is the inability to feel pleasure and is a core negative symptom of schizophrenia. Individuals with anhedonia may not enjoy activities that they used to find pleasurable, which can significantly impact their quality of life.

Choice E Reason:
Hallucinations, like delusions, are considered positive symptoms of schizophrenia. They involve experiencing sensations that are not present, such as hearing voices or seeing things that others do not see.