A nurse managing a patient with narcissistic personality disorder should primarily:

Correct option is B

Management of narcissistic PD requires firm but empathetic limit-setting and realistic rules, ensuring patient accountability without reinforcing grandiosity.
Explanation of options: (a) ✘ Direct confrontation worsens defensiveness. (b) ✔ Correct; structured boundaries maintain therapeutic relationship. (c) ✘ Excessive praise reinforces maladaptive traits. (d) ✘ Avoiding limits worsens manipulative behavior.