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Answer 3
  1. Assess for suicide risk. Suicide is the leading cause of premature death among patients with schizophrenia, and the lifetime incidence of completed suicide among this population is 10% to 13%.2 Factors that increase the risk are single status, unemployment, and social isolation.2 The most important clinical information in this case is whether the patient is at risk of harming herself and whether hospitalization may be necessary. A pregnancy test and drug of abuse screen may also provide useful information but are less critical than assessment of suicide risk. A spinal tap and magnetic resonance imaging would not be indicated unless there was clinical evidence of an acute neurologic emergency.

    2. American Psychiatric Association. Practice guideline for the treatment of patients with schizophrenia. 2nd ed. American Psychiatric Association practice guidelines for the treatment of psychiatric disorders compendium 2002. Washington (DC): The Association; 2002:349-461.

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