mental assessment

Question 1

mental status assessment

Answer 1

• physical appearance and behavior
• cognitive abilities
• emotional stability
• speech and language skills
• alertness and orientation

Question 2

physician appearance and behavior

Answer 2

• grooming
• emotional status
• body language

Question 3

cognitive abilities

Answer 3

• can be evaluated as pt responds to Qs during HPI
• orientation (A&Ox4)
• state of consciousness (confused, lethargic, delirious, stuprous, comatose, GCS)

Question 4

Mini mental state examination (MMSE)

Answer 4

• standardized tool to quantitatively estimate cognitive function or to serially document cognitive changes.
• pt asked series of 11 questions

Question 5

A&Ox4

Answer 5

• alert and oriented x4

- person, place, time and purpose (who are you? where are you? what date is it? why are you here?)

Question 6

confused

Answer 6

-inappropriate responses to questions

Question 7

lethargic

Answer 7

drowsy, but appropriate when aroused

Question 8

delirious

Answer 8

confused with disordered perceptions

Question 9

stuporous

Answer 9

arousable to verbal or painful stimuli

Question 10

comatose

Answer 10

neither awake nor aware

Question 11

CGS (glasgow coma scale)

Answer 11

-often used to quantify the level of patient’s consciousness.
Other tests for cognitive abilities include: abstract reasoning, writing abilities, motor skills, memory span, attention and judgment.

Question 12

emotional stability

Answer 12

• to be evaluated when pt is not coping well or does not have adequate resources available
• mood and feelings (observe pt’s emotional appearance = affect, ask pt how they feel = mood)
• thought process and content
• perceptual distortions and hallucinations

Question 13

speech and language skills

Answer 13

• voice quality
• articulation
• comprehension
• coherence

Question 14

full mental status exam

Answer 14

• examination is the assessment of a patients mental status continuously throughout the entire interaction with the patient.
• This happens by evaluating the patients alertness, orientation, cognitive abilities, and mood.
• The patients physical appearance, behavior and, and responses to questions asked during the history should all be observed.

Question 15

alertness and orientation

Answer 15

A&Ox4

Question 16

Mini mental state exam

Answer 16

• examination is a standardized screening tool to assess cognitive function and to assess changes over time.
• Can be used to determine if referral for more extensive neuropsychiatric testing is required.
• Eleven items are measured over approximately 10 minutes. -A score of 24-26 of 30 points is considered a positive screen.
• The mini mental state examination has a sensitivity of 71% to 92% and a specificity of 56% to 96% for detection of dementia.

Question 17

5 major areas tests in mini mental state test

Answer 17

1) Orientation: Person, Place, Time, Purpose chart: A&Ox4
2) Registration: Patient repeats 3 items back to you (ex: apple, ball, cat)
3) Attention and calculation: count backwards from 100 by 7s or spell word backwards
4) Recall: Patient repeats 3 items in a few min (ex: apple, ball, cat)
5) Language: point at object, have patient tell you what it is.
* *max points = 30

Question 18

why administer mini mental state test serially over time?

Answer 18

• It is a useful test given because it is not very time consuming and can be given frequently to assess older adults mental and emotional status over time.
• The test is especially useful because patients scores can be compared over time to detect any changes in mental status.
• This helps start treatment early. -A score of 26-30 is intact functioning/questionable significance, 21-25= mild impairment, 11-20= moderate impairment, 0-10= severe cognitive impairment.
• However, scores do vary with age, education and ethnicity.