What should a nurse do first when caring for a client with paranoid-type schizophrenia who exhibits rapid pacing and muttering?

The best initial action for the nurse to take in this scenario is to observe the client's behavior and approach him in a nonthreatening manner. This response is essential in managing a client with paranoid-type schizophrenia, especially when the client is exhibiting signs of agitation, such as rapid pacing and muttering.

Establishing a nonthreatening interaction helps create a sense of safety and may reduce the client's paranoia by demonstrating that the nurse is not a threat. Observing the client's behavior allows the nurse to assess the situation further, determine the level of distress, and engage with the client appropriately based on their needs. Building rapport in a calm manner is crucial in psychiatric nursing, as it can help de-escalate a potentially volatile situation.

In terms of other options, administering medication might be necessary later on, but it should not be the first step without prior assessment of the client's current state and potential triggers. Calling for additional staff assistance could be warranted if the situation escalates; however, immediate intervention with a nonthreatening approach is often more effective in the early stages. Redirecting the client to another activity might also be helpful, but it is important to first ensure that the client feels safe and understood rather than overwhelmed or threatened.