A 22-year-old college student is brought to the psychiatric unit by a roommate who reports that he is acting strangely and won't come out of their room. The most appropriate first intervention is to ...

A 22-year-old college student is brought to the psychiatric unit by a roommate who reports that he is acting strangely and won't come out of their room. The most appropriate first intervention is to ...

• A. Encourage participation in group therapy.
• B. Administer an injection of Thorazine.
• C. Assess the safety of the environment.
• D. Assess client's nutritional status.

Answer: (C)

When a young adult is acting strangely and won’t come out of the room, the immediate priority is safety. The first step is to assess and secure the environment to protect the patient and others from harm. This involves quickly identifying and removing or minimizing risks—loose cords, pills, sharp objects, or anything that could be used to hurt oneself or someone else. It also means arranging for appropriate supervision, staying calm, using a nonthreatening voice, and obtaining necessary help or backup so the patient isn’t left alone in a vulnerable situation. Establishing a safe plan lays the groundwork for a fuller mental status assessment and subsequent treatment decisions. After safety is established, other actions can be considered. Group therapy isn’t feasible when the person is acutely psychotic and disengaged. Administering an injection is a restraint/chemical intervention that isn’t the first step and should follow safety, assessment, and protocol with considerations of consent and need. Assessing nutritional status, while important, isn’t the immediate priority in this crisis compared with ensuring safety.

When a young adult is acting strangely and won’t come out of the room, the immediate priority is safety. The first step is to assess and secure the environment to protect the patient and others from harm. This involves quickly identifying and removing or minimizing risks—loose cords, pills, sharp objects, or anything that could be used to hurt oneself or someone else. It also means arranging for appropriate supervision, staying calm, using a nonthreatening voice, and obtaining necessary help or backup so the patient isn’t left alone in a vulnerable situation. Establishing a safe plan lays the groundwork for a fuller mental status assessment and subsequent treatment decisions.

After safety is established, other actions can be considered. Group therapy isn’t feasible when the person is acutely psychotic and disengaged. Administering an injection is a restraint/chemical intervention that isn’t the first step and should follow safety, assessment, and protocol with considerations of consent and need. Assessing nutritional status, while important, isn’t the immediate priority in this crisis compared with ensuring safety.