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A positive PHQ-9 item 9 warrants immediate follow-up regardless of plan specificity. The APRN should assess ideation intensity, intent, prior attempts, access to means (firearms/medications), substance use, and protective factors. If moderate risk without imminent intent, create a written safety plan (warning signs, coping strategies, contacts, crisis numbers), restrict lethal means, engage supportive persons (with consent), and arrange urgent mental health referral; same-day evaluation is warranted if risk increases or ambiguity persists. Address modifiable drivers (pain, insomnia, anxiety, depression) and consider initiating evidence-based pharmacotherapy or psychotherapy referral. Close follow-up (within days) is essential. Ignoring the result (Option C) or deferring for weeks (Option A) is unsafe. Benzodiazepines alone (Option D) may worsen depression and suicidality risk and are not a primary treatment. Document assessment, plan, and patient education; coordinate with oncology to maintain treatment continuity while prioritizing safety.