Mental Status Exam

Question 1

• Used to evaluate the client’s current mental functioning
• Information can be gathered informally over the course of an interview/assessment or
  formally through direct questions.
• On the exam, you want to be mindful of not choosing ‘complete a BLANK’ as the answer unless there is a reason to do so in the question stem (such as the client having loose associations, not making sense in their speech, experiencing tangential thoughts, possible dementia, etc.).
• Age on its own is not a reason to do a BLANK; the test may offer this answer option
  with elderly clients to see if we incorrectly choose it based on age bias.

Answer 1

MSE

Question 2

Abstract Reasoning

Appearance

Attitude

Behavior

Mood/Affect

Speech

Thought Process

Thought Content

Perceptions

Cognition

Insight

Judgment

Answer 2

Elements of the Mental Status Exam

Question 3

Ask the client to interpret a proverb or identify a theme between 3 or 4 objects.

Answer 3

abstract reasoning

Question 4

Is the client cooperative? Resistant? Fearful?

Answer 4

attitude

Question 5

How does the client look? Dressed with attention to detail? Well groomed? Age appropriate?

Answer 5

appearance

Question 6

What is the client’s activity level? Are there tics or stereotyped movements? How alert is the
client? What are the client’s facial expressions? Do they match the content discussed?

Answer 6

behavior

Question 7

What is the client’s prevailing mood? Is there observable mood lability? Does the client show a range of affect? Is it appropriate to the content discussed?

Answer 7

mood/affect

Question 8

Is the client understandable? Are there any speech abnormalities (e.g., stuttering)? Is the client’s speech pressured?

Answer 8

speech

Question 9

Does the client exhibit delusions? Phobias? Obsessions? Is the client preoccupied? Does the
client have suicidal thoughts? Thoughts of harming others?

Answer 9

thought content

Question 10

Is the client’s thought process circumstantial? Tangential? Is there evidence of flight of ideas? Is there poverty of thought? Perseverations?

Answer 10

thought process

Question 11

Is the client experiencing hallucinations or illusions?

Answer 11

perceptions

Question 12

Is the client alert and oriented? Can the client demonstrate attention and concentration? Is the client’s memory (short- and long-term) intact?

Answer 12

cognition

Question 13

Does the client demonstrate the ability to make sound, responsible decisions?

Answer 13

judgement

Question 14

Does the client demonstrate understanding of his or her own symptoms or situation?

Answer 14

insight

Question 15

• a brief 30-point questionnaire that is used to test for cognitive impairment. It is often used to identify possible dementia and then to track changes in cognitive functioning over
  time, particularly in clients with Alzheimer’s dementia

Answer 15

Mini Mental Status Exam (MMSE)

Question 16

continuous diversion from the topic of focus with no return

Answer 16

tangential

Question 17

continuous change of topic w only BLANK between topics

Answer 17

loose associations

Question 18

overly detailed speech with eventual return to the topic of focus after many digressions- schizophrenia or dementia

Answer 18

circumstantial

Question 19

• jumping from topic to topic with no discernable associations.
• acute mania

Answer 19

flight of ideas

Question 20

• an incoherent mix of words and phrases.
• Wernicke’s area lesion, dementia, schizophrenia

Answer 20

word salad

Question 21

continued repetition of a word or phrase after it is no longer appropriate to respond in this way. For example, the patient may correctly answer ‘Monday’ when asked the day of the week and then answer all further questions with ‘Monday’.

Answer 21

preservation