Ms. Smith is a Psychiatric-Mental Health Nurse Practitioner...

Ms. Smith is a Psychiatric-Mental Health Nurse Practitioner working in an outpatient psychiatric clinic.  She is seeing Dale Knox, a 32-years old man for a psychiatric evaluation for the first time. Dale is currently separated from his wife, Sofie.  Dale and Sodie have been married for 9 years.  Dale has fully completed all of his pre-evaluation paperwork and he has signed the consent for treatment.  During the psychiatric evaluation, Ms. Smith observes that Dale is distraught, tearful and verbalizing feelings of worthlessness and no motivation for life in general.  He states directly that he is going to kill his wife and then kill himself tonight when she returns home from work because he can't stand the thought of being divorced and he knows she is preparing to leave him. Mr. Knox states he has a handgun in his car and has bought additional ammunition. 

Answer the following questions based on the case presentation: 

1. Discuss the importance of informed consent in psychiatric-mental health treatment. 
2. Would Mr. Knox meet the criteria for involuntary commitment, explain why or why not, and then discuss the involuntary commitment process for your state and if PMHNP is able to involuntarily commit a patient the state where you practice? 
3. Should the PMHNP notify Mrs. Knox about her husband's threat to kill her, or should the PMHNP protect the confidentiality of Mr. Knox treatment? 
4. What additional resources should you consider in this case for help for the patient and his family? 
5. What is the prevalence of suicide-related to someone who has a plan and the means?  Are there any other criteria that this patient meets that places him in a higher risk category for carrying out suicide?