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  #1  
Old 12-15-2012
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Default Beh. Q

A 19-year-old female, who recently moved from her family's home in another state, is hospitalized for attempting suicide by taking an overdose of antidepressant medications. On the third day of her hospital stay, she insists, under threat of a lawsuit, that her medications be stopped and that she be discharged from the hospital so she "can go home and finish the job." Her sensorium is clear. Her physician should

A. discharge her against medical advice (AMA)

B. honor her request and release her immediately

C. obtain an emergency order of detention

D. release her to go back to her parents' home

E. sedate her
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  #2  
Old 12-15-2012
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"Finish the job" implies suicidal tendency...meaning she isn't competent...So C?
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Old 12-15-2012
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i guess A... released her against her medical advise but not sure
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  #4  
Old 12-15-2012
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Quote:
Originally Posted by abcxyz View Post
A 19-year-old female, who recently moved from her family's home in another state, is hospitalized for attempting suicide by taking an overdose of antidepressant medications. On the third day of her hospital stay, she insists, under threat of a lawsuit, that her medications be stopped and that she be discharged from the hospital so she "can go home and finish the job." Her sensorium is clear. Her physician should

A. discharge her against medical advice (AMA)

B. honor her request and release her immediately

C. obtain an emergency order of detention

D. release her to go back to her parents' home

E. sedate her
Suicide attempt + having the plan

C. obtain an emergency order of detention
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Old 12-15-2012
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I have seen this question somewhere...May be UWorld.

Wasn't the answer E. Sedate her????

I personally think it should be C , which looks more appropriate.But You never know with USMLE.

I hope someone will confirm this.
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  #6  
Old 12-15-2012
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Correct Answer Correct answer

C: is the answer.

It is C because suicide threat is a clear reason for hospitalisation for psychiatric evaluation and treatment. It does not matter what the sensorium is in this case. Remember she has already attempted suicide.

A - It cannot be A because of the threat of suicide
B - It cannot also be B because she has attempted and is also threatening suicide
D - We cannot release her under her parents' care because she is not a minor and has chosen to move away from them
E - We do not need to sedate her since she is not aggressive actively and is not a immediate danger to herself or others.
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  #7  
Old 12-16-2012
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Default Answer: C

The correct answer is C. The physician should obtain an emergency order of detention, regardless of her threats of a lawsuit. The woman clearly still has suicidal intent, demonstrated by her expressed verbalizations, and is therefore a danger to herself.

Choices A, B, and D clearly place her in a position where she can carry out her plans to terminate her life.

Sedating her (choice E) is the second best choice since it will prevent her from taking her life; however, sedation does not give therapists the opportunity to address the underlying motivations for her suicidal ideation.
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