It’s not aggressive but serious. It lets the other person know you are being serious and calm. It gets your point across without using any attacking words. Remember, the goal is to effectively but seriously get your point across. Not argue or fight. Hence why being assertive is more effective than aggressive.
The nursing intervention that reduces the clients risk of increased intracranial pressure or ICP is to administer a stool softener as ordered. To avoid the client from straining at the stool that may possibly cause a Valsalva maneuver that increases intracranial pressure, the nurse must institute a regular bowel program that take account of use of a stool softener.
I think it is D, performance standards.