護理師評估一位因重度憂鬱入院的個案，個案表示：「我覺得我活不下去了。」護理師最恰當的提問為何？
A nurse is interviewing a client admitted for severe depression. The client states, 'I don't think I can go on anymore.' Which question is the most appropriate for the nurse to ask?
- AHave you thought about how you would do it?你有想過要怎麼做嗎？
- BEverything will get better, why are you so sad?一切都會好轉的，你為什麼這麼悲傷？
- CAre you planning to kill yourself?✓ 正解你打算自殺嗎？
- DWhat makes you feel that way?是什麼讓你會有這種感覺？
自殺風險評估的標準順序為：(1) 先確認是否有自殺意念（ideation） → (2) 評估是否有計畫（plan） → (3) 評估方法、工具、時間（method/means/timeline）→ (4) 評估意圖（intent）。當病人說「活不下去」時，C 直接詢問「你是否計劃要傷害自己？」是評估意念的標準切入點，符合 NCLEX 與 ASIST/QPR 等危機介入框架。選項 A 在未確認意念前直接問計畫細節，跳過評估順序；C「為什麼」可能帶有批判感；D 假性安慰否定病人感受。
The standard sequence for suicide risk assessment is: (1) first confirm suicidal ideation → (2) assess for a plan → (3) assess the method, means, and timeline → (4) assess intent. When the patient says "I can't go on living," option C — directly asking "Are you planning to harm yourself?" — is the standard entry point for assessing ideation and aligns with NCLEX and crisis intervention frameworks such as ASIST and QPR. Option A jumps to plan details before ideation is confirmed, skipping the assessment sequence; option D ("why") can feel judgmental; and option B offers false reassurance and dismisses the patient's feelings.
美國自殺風險評估多遵循 Columbia-Suicide Severity Rating Scale；台灣臨床亦廣泛使用此量表或各機構標準化自殺評估表。