A client that tells the nurse that they are upset because their partner no longer wants to continue the relationship. Which statement made by the client indicates that the end of the relationship is related to the client's narcissistic personality disorder?

Choice A reason: The statement "I just don't trust anyone and I don't believe what my partner tells me" reflects pervasive suspiciousness and interpersonal mistrust, which are the defining characteristics of paranoid personality disorder, not narcissistic personality disorder. Paranoid personality disorder is categorized under Cluster A and involves a pervasive pattern of unwarranted suspicion, hypervigilance, and misinterpretation of others' motives as malevolent. While narcissistic clients may exhibit some distrust in specific contexts, the global pervasive suspiciousness described in this statement is not consistent with the core diagnostic criteria of narcissistic personality disorder. Choice B reason: The statement "My partner says I am too dependent and can do anything for myself" reflects excessive reliance on others and difficulty functioning independently, which are the core features of dependent personality disorder (DPD). DPD is a Cluster C disorder characterized by pervasive and excessive psychological dependence on others, difficulty making decisions without reassurance, submissive behavior, and intense fear of separation. This client statement points toward dependency and inadequacy in self-management rather than grandiosity or entitlement, clearly differentiating it from the core features of narcissistic personality disorder. Choice C reason: The statement "My partner says I care for others more than I care for them" suggests altruism and other-centeredness, which are characteristics inconsistent with narcissistic personality disorder. NPD is defined in part by a marked lack of empathy and a pattern of exploiting others for personal gain. A client with NPD would be unlikely to be perceived by a partner as excessively caring for others. This statement more closely reflects attributes that might be associated with codependent behavior or, paradoxically, with manipulative self-presentation aimed at appearing selfless, but it does not reflect the grandiosity and entitlement central to NPD. Choice D reason: The statement "I won't be alone long; everyone wants to be with me because I am beautiful" is a direct and textbook manifestation of the grandiosity, sense of entitlement, and inflated self-importance that define narcissistic personality disorder. This statement reflects the client's belief in their own special attractiveness and desirability, an expectation that others will pursue them based on their perceived superiority, and an absence of distress about the loss of the relationship because of an entrenched belief in their own exceptional worth. This attitude reflects the NPD core feature of grandiose self-image and is highly consistent with the relationship problems that arise due to entitlement and lack of empathy in NPD clients.