Attention, Arousal, Orientation, and Cognition

Question 1

abnormalities can indicate deficits in…

Answer 1

orientation, memory, judgement, info processing, abstract reasoning, and learning

Question 2

alert

Answer 2

awake and attentive to normal levels of stimulation; interactions are normal and appropriate

Question 3

lethargic

Answer 3

appears drowsy; may fall asleep without stimulus; interactions get diverted; difficulty with focusing or maintaining attention

Question 4

obtunded

Answer 4

difficult to arouse from sleepy state and is confused when awake; repeated stimulus needed to maintain wakefulness; interactions largely unproductive

Question 5

stupor

Answer 5

semicoma; responds only to strong and noxious stimulus; returns to unconscious state when stimuli is removed; unable to interact even when aroused

Question 6

coma

Answer 6

unable to arouse regardless of stimuli; reflexive motor responses (+) or (-) (not all will have these reflexive responses)

Question 7

reliability of assessment

Answer 7

only when PT is alert; reduced when lethargic; non-existent in obtunded, stupor, and coma

Question 8

documentation

Answer 8

Specific component examined

Any slowness or hesitation in response: Latency

Duration and frequency of periods of inattention

Environmental conditions that contribute to or hinder inattention

Amount of required redirection or verbal cuing

If giving verbal cues to stay focused, make sure to document this.

Question 9

selective attention

Answer 9

screen and process relevant info about task and environment and screen out irrelevant data

Question 10

sustained attention (vigilance)

Answer 10

how long is Pt able to maintain attention on a particular task (time on task)

Question 11

alternating attention (attention flexibility)

Answer 11

Pt is asked to alternate back and forth between 2 tasks (add 2 numbers then subtract 2 numbers)

Question 12

divided attention

Answer 12

asking patient to perform 2 tasks simultaneously

Question 13

walkie talkie test

Answer 13

walk while locating object on the side; walking test and asking questions

Question 14

orientation

Answer 14

awareness of person, place, time, situation/circumstance

Question 15

cognition

Answer 15

deeper level of awareness; process of knowing; higher order cognition; executive function; includes both awareness and judgement

Question 16

3 areas of cognitive testing

Answer 16

fund of knowledge

calculation ability

proverb interpretation

Question 17

fund of knowledge

Answer 17

sum total of all learning and experiences in life: variable for each person
- what state is Boston in?
- where are the pyramids?

Question 18

calculation ability

Answer 18

basic calculations like 2+2

Question 19

acalculia

Answer 19

inability to calculate

Question 20

dyscalculia

Answer 20

difficulty in calculating

Question 21

proverb interpretation

Answer 21

examines patient’s ability to interpret words outside of their usual context or meaning (impacted by cultural differences)
- ask if they know what “glass half full” means

Question 22

MMSE

Answer 22

Valid, reliable quick screen of cognitive function
- 11 questions
- takes about 5-10 minutes
- cognitive only
- take into account wider context such as patient’s education