On the psychiatric unit, a patient with schizophrenia has become manic, is frantic, and is naked. What should the RPN do first to protect safety while preserving dignity?

• A. Restrain the patient immediately to prevent harm
• B. Move the patient to seclusion
• C. Provide privacy and maintain safety in a calm, nonjudgmental manner
• D. Administer a sedative without consent

Answer: (C)

In a crisis like this, the first priority is safety implemented through a calming, least-restrictive approach that preserves the person’s dignity. Start by engaging in privacy-preserving, nonjudgmental communication: approach slowly and calmly, use a soft voice, and maintain an open, nonthreatening posture. Offer clothing and help to cover as needed, and guide the conversation to acknowledge the person’s distress without shaming them. Creating a private, quieter space and reducing stimuli can de‑escalate the situation and help the patient regain self-control. This approach protects safety while honoring autonomy, and only if the agitation continues or there is imminent risk would more restrictive measures be considered under proper policy and orders. Restraints, seclusion, or sedation without consent are higher-risk options that should not be the first step.