Assertiveness Questionnaire and Knowledge Test [Student ID: Suzy Star]

Instance of: Assertiveness Knowledge Test (7-12)
Administered By: cruzen-hershberger, suzanne
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Grade: 10Gender: female Date Taken: 3/24/22
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This assessment measures two important components of assertiveness:
1. Express Myself: Do you express your own opinions, needs, and preferences?

2. Respect Others: Do you show respect to others, even if you disagree?

The self-reflection section highlights your strengths, and the quiz section lets you know your current knowledge of assertiveness concepts.



QuestionReversed?TopicVERY
like me		54321NOT
like me
1. I stand up to my friends if they are doing something I don't feel comfortable doing.Express Myself
2. I speak up when someone is not respecting my personal boundaries like 'no cheating off my homework' or 'I don't let friends borrow money.'Express Myself
3. I often have a hard time saying 'No.'YESExpress Myself
4. I express my opinions, even if others disagree with me. Express Myself
5. When an argument is over, I often wish I would have said what was really on my mind.YESExpress Myself
6. I tend to just go along with what everyone else wants instead of stating my own thoughts.YESExpress Myself
7. I sometimes avoid asking questions for fear of sounding stupid.YESExpress Myself
8. I tend to bottle up my emotions rather than talk about my feelings.YESExpress Myself
9. If I disagree with my teacher, I talk to him or her about it.Express Myself
10. If a person has borrowed money (or a game, clothes, or something else of value) and is overdue in returning it, I talk to the person about it.Express Myself
11. I'm usually able to tell people how I'm feeling.Express Myself
12. If I don't like the way someone is being treated, I speak up about it.Express Myself
13. I speak up about things I really care about.Express Myself
14. I am careful to avoid hurting other people's feelings, even when I feel that I have been wronged.Respect Others
15. I have a hard time controlling my emotions when I disagree with someone.YESRespect Others
16. I avoid attacking someone's intelligence when I disagree with their ideas.Respect Others
17. I listen to other people's opinions, even if I disagree with them.Respect Others
18. In disagreements, I make sure that I understand other points of view.Respect Others
19. In discussions, I communicate that I am listening through body language (nodding my head, avoiding rolling my eyes). Respect Others
20. Even in an argument, I don't interrupt the other person.Respect Others

Quiz Section

QuestionCorrect AnswerWere You Correct?
21. Choose the best definition of assertiveness.AYES
22. You tell your teacher, "You have to let me answer this text; it's from my mom!"AggressiveYES
23. Invading the personal space of othersAggressiveYES
24. Stating your ideas in an honest and direct mannerAssertiveYES
25. Glaring and staring at othersAggressiveYES
26. Apologizing over and overPassiveYES
27. Clear and reasonable toneAssertiveYES
28. InterruptingAggressiveYES
29. The best way to show someone that you are listening to his/her concerns is to:AYES
30. Which of these options best describes an assertive statement?CNO
31. Identify the best example of a 3-part assertive statement.CYES
32. Which of these actions or behaviors are NOT associated with assertiveness?BYES
33. Using the above scenario and what you've learned about assertiveness, choose the best option for how McKenzie should discuss this with her parents.BYES
34. When you lack assertiveness, you have a higher chance of becoming withdrawn and isolated or experiencing depression and anxiety.TrueYES
35. Personal boundaries are clear expectations of how others should act in various situations.FalseYES
36. Adults who lack assertiveness are more likely to experience unemployment.TrueYES
37. As students, we can control our emotions and some feelings are unnecessary.FalseYES
Multiple Choice Score:16/1794.1%