The mental health nurse at a community health center reviews the charts of the patients who present for appointments at the beginning of the day. Which patient will the nurse see first?
1. A college student who has been referred from the student health center for an ADHD evaluation
2. A 43-year-old woman with schizophrenia who reports she has stopped taking her medication because it makes her feel sick
3. A 35-year-old woman with bipolar disorder who requires a medication evaluation
4. A 25-year-old man with obsessive-compulsive disorder who reports a relapse of symptoms
Answer: 2
Explanation: The patient with schizophrenia who has stopped taking her medication is at risk for relapse and possibly risk for injury if symptoms such as delusions or hallucinations return. The nurse will see this patient first to assess the reasons for medication nonadherence and try to help motivate the patient to return to the treatment plan. The nurse should also see this patient first to ensure the patient does not leave if she lacks the motivation to wait. Patients with schizophrenia are also likely to have co-morbid conditions, so this patient's risk for injury may increase in the presence of a co-occurring medical illness if the patient is not following the treatment plan. The remaining patients the nurse can see in order of arrival.
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