Which client should the nurse in the psychiatric unit see first?

A. A client who says the voices are telling him to hurt his roommate
B. A client who refuses to attend group therapy
C. A client with depression who is tearful after a phone call
D. A client asking for a snack

Show answer and rationale

Correct answer: A

Command hallucinations directing harm to others are a safety emergency. The other clients have needs but no immediate danger.

Source: Varcarolis' Foundations of Psychiatric-Mental Health Nursing, 10th ed.

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This question is one of 193 Management of Care items in NCLEXSim. On the NCLEX-RN, this category makes up 15–21% of the exam.

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Study tip

Work every 'who first' item through the same ladder: airway, breathing, circulation; then unstable before stable, acute before chronic, actual before potential.
Delegation: the RN keeps initial assessment, care planning, teaching, evaluation, and any unstable client. LPNs take stable, predictable clients. Assistive personnel take routine tasks such as vital signs on stable clients, hygiene, feeding without swallowing risk, and ambulation.

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Which client should the nurse in the psychiatric unit see first?

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