Final answer:
The nurse should first place a patient having a grand mal seizure on their side to maintain a clear airway and prevent aspiration. Subsequent actions include calling for help and following seizure protocols, while restraint is to be avoided.
Step-by-step explanation:
In a 20-year-old patient experiencing a grand mal seizure, the nurse's first action should be b) Place the patient on their side. This is to ensure that the airway remains clear and to prevent aspiration if the patient vomits. Keeping the patient safe and protecting them from injury is the priority during a seizure. Once the patient is on their side, the nurse should then proceed to call for help and follow seizure protocols, which may include monitoring the patient and preparing to administer medication if prescribed. Restraint should be avoided as it can cause injury to the patient. It is important for the nurse to remain calm, provide reassurance, and document the seizure's duration and characteristics for further evaluation by a physician.