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Suicidal ideation — USMLE Step 3 MCQ

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ModeratePsychiatry (outpatient management)Suicidal ideationUSMLE Step 3

A 51-year-old man with depression tells his physician he plans to shoot himself tonight and has a firearm at home. He refuses to involve family. He is intoxication-free and understands the discussion but will not agree to safety planning. Which of the following is the most appropriate at this time?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Arrange emergency psychiatric evaluation and ensure immediate safety

Imminent suicidal intent with plan and means requires emergency intervention and safety measures, even if confidentiality must be breached.

Reference: AMA Code of Medical Ethics and patient safety principles: https://code-medical-ethics.ama-assn.org/