To manage a disruptive client with delusions of grandeur in a group setting, what is the nurse's best intervention?

In managing a disruptive client with delusions of grandeur in a group setting, setting verbal limits and having the client return to their room is an effective intervention. Establishing clear verbal boundaries can help maintain order and safety within the group, which is essential when a client’s behavior is disruptive and potentially affects others. Verbal limits serve to guide the client’s behavior toward more acceptable actions without directly confronting or invalidating their delusions, which could increase agitation or conflict.

Moreover, directing the client to their room offers them a temporary space away from the group, allowing both the individual and the group to reestablish a calm and controlled environment. This action also allows the client to reflect in a more peaceful setting, minimizing the immediate impact of their delusions on others.

Setting limits is crucial when dealing with delusions because attempts to directly challenge the delusions or argue against them, as might occur in other choices, can lead to conflict or escalation. Removing items that reinforce delusions could be seen as punitive or dismissive of the client’s experiences, while encouraging sharing those beliefs might further disrupt the group dynamic and intensify the client’s behaviors. Therefore, establishing clear boundaries and providing a supportive, structured response is the most appropriate intervention in this scenario.