A nurse is caring for a client who has dementia and is experiencing disorientation. Which of the following actions should the nurse take?

A. "If I were you, I would go to a few therapy sessions to give them a try": This statement is not appropriate because it places the nurse's personal perspective onto the client, potentially pressuring them. It does not respect the client's autonomy in making their own decisions.

B. "One of my friends went to group therapy and they improved significantly": Sharing personal experiences can make the client feel uncomfortable and may not be relevant to their own situation. It can also create a sense of comparison, which is not helpful.

C. "You have the right to refuse to attend group therapy": This statement is respectful of the client's autonomy and acknowledges their right to make decisions about their care. It empowers the client and maintains their dignity while respecting their refusal.

D. "You should go to group therapy if you want to get better": This statement may feel coercive, as it implies that the client "should" attend therapy to improve. It might lead the client to feel guilty or pressured rather than supported in their choice.

Rationale for correct choices:

• Remaining neutral: The nurse should remain neutral to avoid reinforcing or escalating the client’s grandiose beliefs. This helps maintain trust and creates space for self-reflection without judgment.
• Explaining that the client is not entitled to play on a professional team: Gently addressing the client’s unrealistic expectations helps them understand the reality of their situation and fosters a more grounded perspective on their goals.

Rationale for incorrect choices:

• Questioning the client's abilities: Directly questioning the client's abilities could be seen as confrontational and may increase defensiveness. A more constructive approach would focus on challenging unrealistic beliefs.
• Challenging the client's feelings of grandiosity: Challenging grandiosity directly can make the client feel attacked. It’s better to educate and explain the reality of their expectations in a supportive way.
• Supporting the client's fear of abandonment: The client does not appear to express abandonment fears in this case. The issue is more related to grandiosity, so focusing on this would be more effective.
• Suggesting another sport: Suggesting a different sport might divert attention from the core issue—grandiosity. Addressing the client's distorted self-image is more important before offering alternatives.