Patients with major depressive disorder (MDD) should always be asked about suicidal thoughts or ideations. Since the patient has expressed feelings of worthlessness and is reaching her limit, this direct question is appropriate. The nurse should also follow this question up by asking whether the patient has a plan. Reflecting the patient’s feelings and facilitating discussion are appropriate techniques for getting the patient to open up but what the patient has already said should prompt direct questions to screen for suicidal thoughts. Promising a quick fix with medication is not appropriate. Reminding the patient of loving family members is not always helpful or accurate.