Final answer:
The day shift nurse should perform a comprehensive physical assessment of the client as the first action, then document the behavior in the medical record, consulting the healthcare provider and potentially contacting security if deemed necessary after the assessment.
Step-by-step explanation:
The day shift nurse should perform a comprehensive physical assessment of the client. This is the priority action. By assessing the client, the nurse can determine if there are any acute changes that require immediate intervention or if the behavior was an isolated incident related to a factor such as pain, medication side effects, or sleep deprivation. It is crucial to gather more information to assess the client's current status and needs accurately. Documenting the behavior in the client's medical record is also an essential step, as it provides a continuous record of the client's condition and any changes or patterns in behavior. Although consulting the on-call healthcare provider and notifying the security team might be necessary steps, they are not the first actions to take before the nurse has completed an assessment and has more information.