When working with a client with a narcissistic personality disorder, the nurse would use which of the following approaches?

Choice A reason: A supportive approach may be helpful in many therapeutic relationships, but with narcissistic personality disorder, it can inadvertently reinforce manipulative or grandiose behaviors. These clients often exploit supportive interactions to maintain control. Choice B reason: A cheerful approach may be perceived as insincere or patronizing by clients with narcissistic traits. They may dismiss or devalue the nurse’s efforts, making this approach ineffective. Choice C reason: A friendly approach can blur professional boundaries. Clients with narcissistic personality disorder may manipulate friendliness to gain special treatment or attention, which undermines therapeutic goals. Choice D reason: A matter-of-fact approach is the most effective. It maintains professional boundaries, avoids feeding into the client’s grandiosity, and provides clear, consistent communication. This approach helps the nurse remain neutral and objective, which is essential in managing narcissistic behaviors.