Suicide risk assessment, acute agitation management, and involuntary hold criteria scenarios tested on USMLE Step 2 CK.
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- What is the single strongest predictor of a future completed suicide?
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A prior suicide attempt.- Which sex has a higher rate of completed suicide in the United States?
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Male.- Which sex has a higher rate of suicide attempts in the United States?
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Female.- What is the most common method of completed suicide in the United States?
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Firearms.- Which age and sex group has the highest suicide rate in the United States?
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Elderly white men (men over 65).- Does directly asking a patient about suicidal thoughts increase their risk of attempting suicide?
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No, asking about suicide does not increase risk.- What living or marital situation is associated with increased suicide risk?
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Living alone (divorced, widowed, or never married).- During what time period after psychiatric hospital discharge is suicide risk highest?
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The first week to month after discharge.- Which substance use disorder most significantly increases suicide risk?
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Alcohol use disorder.- What type of hallucination specifically raises concern for imminent self-harm?
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Command auditory hallucinations telling the patient to hurt themselves.- Name one key protective factor that lowers suicide risk.
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Strong social support, such as family, religious involvement, or children at home.- A patient reports a detailed suicide plan and has access to a firearm at home. What is the required disposition?
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Immediate hospitalization, since this represents high acute risk.- What is the first-line, non-pharmacologic step in managing an acutely agitated patient?
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Verbal de-escalation.- What is the first-line medication class for agitation in a patient without psychotic features?
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Benzodiazepines.- What is the preferred medication class for agitation caused by acute psychosis?
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Antipsychotics, such as haloperidol.
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