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Suicidal ideation — USMLE Step 3 MCQ

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HardPsychiatry (outpatient management)Suicidal ideationUSMLE Step 3

A 42-year-old man with major depressive disorder tells his primary care physician that he has thought about shooting himself. He has a firearm at home, has written a note, and drank heavily last night. He is tearful and says he cannot guarantee his safety. His wife is in the waiting room. Which of the following is the most appropriate at this time?

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

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Correct answer: C — Arrange emergency psychiatric evaluation and restrict access to lethal means

Active suicidal intent with plan, means, and inability to contract for safety requires urgent psychiatric assessment, safety planning, and lethal-means restriction.

Reference: APA practice guideline for suicidal behaviors