For a client who lost 7-year-old twins in a house fire and is admitted for major depression, which action is most important to include in the care plan?

• A. Place the client on continuous observation
• B. Remove all items from the meal tray that can cause harm
• C. Schedule frequent aggressive therapy
• D. Encourage isolation

Answer: (A)

The main idea here is safety for someone with severe depression after a traumatic loss. A client who has just lost their twins in a house fire is at high risk for self-harm or suicide, so the most important part of the care plan is 1:1 or continuous observation to keep them safe, monitor for escalating risk, and react quickly if mood or risk factors change. This approach provides constant safety, supports timely assessment, and enables prompt interventions when needed. Removing items that could cause harm is helpful as part of safety precautions, but it doesn’t guarantee safety on its own without around-the-clock monitoring. Aggressive therapy isn’t appropriate in this acute phase and could hinder trust and progress, while encouraging isolation would worsen depression and reduce access to support. Continuous observation directly addresses the safety needs of someone in this situation.