Mental Status/Nutrition/BMI

Question 1

2 things you look for when assessing mental health

Answer 1

Level of Consciousness

Orientation – time,
place and person and
remote memory

Question 2

• Normal voice – patient looks at you and responds fully and appropriately

Answer 2

Alert

Question 3

• Speak to patient in loud voice; appears drowsy, opens eyes and looks at you, responds to questions and falls asleep

Answer 3

Lethargic

Question 4

• Shake patient and speak in loud voice; opens eyes and looks at you but responds slowly and confused

Answer 4

Obtunded

Question 5

Apply painful stimuli or shake vigorously; arouses from sleep only after painful stimuli

Answer 5

Stupor

Question 6

Apply repeated painful stimuli; unarousable, no evident response

Answer 6

Coma

Question 7

Coma Type-Arms flexed, plantar flexed, arms move towards core

Answer 7

Decorticate

Question 8

Coma Type-One sided paralysis

Answer 8

Hemiplegia

Question 9

Coma Type- Extended limbs

Answer 9

Decerebrate

Question 10

Coma Type-No movement, completely flaccid

Answer 10

Vegetative

Question 11

usually caused by acute illness or drug toxicity and is a temporary state

Answer 11

Delirium

Question 12

Acute
Somnolent
Fully reversible when caught early
Fluctuates between lucidity and confusion

Answer 12

Delirium

Question 13

• Measures eye, verbal and motor response in patients with traumatic brain injuries
• Lower scores indicate a higher impairment

Answer 13

Glasgow Coma Scale

Question 14

Lowest-Highest score on Glasgow Coma Scale

Answer 14

3 (deep coma) to 15 (normal)

Question 15

loss of voice; affects larynx or nerve supply

Answer 15

Aphonia

Question 16

impairment in the voice, quality or pitch of the voice; hoarse or only able to whisper

Answer 16

Dysphonia

Question 17

lack of muscle control; affects the lips and tongue

Answer 17

Dysarthria

Question 18

can’t produce or understand language

Answer 18

Aphasia

Question 19

• Receptive
• Fluent
• Rapid Speech
• Sentences lack meaning
• Speech totally incomprehensible

Answer 19

Wernicke’s aphasia

Question 20

Wernicke’s aphasia originates in

Answer 20

• Posterior superior temporal lobe

Question 21

• Can speak and enunciate clearly but the sentences make no sense. “Word salad”

Answer 21

Wernicke’s aphasia

Question 22

• Expressive
• Nonfluent
• Slowed Speech
• Understands what is being said
• Struggles to speak

Answer 22

Broca’s aphasia

Question 23

Broca’s aphasia originates in

Answer 23

• Posterior inferior frontal lobe

Question 24

• Can understand speech but have a really hard time expressing the words

Answer 24

Broca’s aphasia

Question 25

* Orientation and short-term memory * 30 points; 24 is cutoff * Screens for dementia * Best for screening more severe cases of dementia

Answer 25

MMSE

Question 26

* Most popular-easier to use * Orientation, short term memory and executive decision making * COGNITIVE CHANGE OVER TIME * Screen for mild or early dementia * 30 points; dementia 21-26

Answer 26

SLUMS

Question 27

* Orientation, short term memory and executive decision making * Visual/Spatial awareness * 30 point scale; cutoff is 26

Answer 27

Montreal Cognitive Assessment

Question 28

* Best for mild impairment; SPECIFICALLY distinguishes between dementia and Alzheimer’s * Also has clock drawing test-critical thinking

Answer 28

Montreal Cognitive Assessment

Question 29

* Short term memory and executive decision making | * Brief screening tool to differentiate patients with dementia from those without it

Answer 29

Mini Cog

Question 30

* 3 minutes | * Includes a 3 item recall test and clock drawing test

Answer 30

Mini Cog

Question 31

* Acute onset, disorganized thinking | * Delirium screening tool

Answer 31

CAM

Question 32

Repeatedly asks the same questions Becomes lost or disoriented in familiar places Cannot follow directions Is disoriented as to the date or time of day

Answer 32

Alzheimer's

Question 33

Doesn’t recognize and is confused about familiar people Has difficulty with routine tasks such as paying bills Neglects personal safety, hygiene, and nutrition

Answer 33

Alzheimer's

Question 34

``` Falling asleep Sleep during the night Waking up too early Sleeping too much Feeling sad Decreased or increased appetite Decreased or increased weight ```

Answer 34

Depression

Question 35

``` Apparent State of Health Level of Consciousness Facial Expression Odors of the Body and Breath Dress, Grooming, and Personal Hygiene Posture, Gait, Motor Activity Speech Mood and Affect ```

Answer 35

General Survey

Question 36

Name the vital signs (excluding pain) and normal ranges

Answer 36

* Temperature – oral 96.4 – 99.5°F * Pulse – 60 – 100 beats/minute * Respirations 12 – 20 breaths/minute * Blood Pressure – 120/80

Question 37

What's the formula for waist to hip ratio, and what is normal for men and women?

Answer 37

Waist circumference Hip circumference = waist to hip ratio Females: less than or equal to 0.80 Males: less than or equal to 0.90

Question 38

Normal waist circumference for men and women?

Answer 38

Female: less than or equal to 35 inches (88cm) Male: less than or equal to 40 inches (102cm)

Question 39

IBW % formula

Answer 39

Actual Weight x 100 = % IBW | IBW

Question 40

Explain what each IBW % means

Answer 40

* Severe malnutrition: less then 70% * Moderate malnutrition: 70 – 80% * Possible malnutrition/Lean: 80 – 90% * Overweight: 10% above IBW * Obese: 20% above IBW

Question 41

Body Frame formula

Answer 41

Height in cm ___________ Wrist circumference in cm

Question 42

What are the small/medium/large body frame ranges for men and women

Answer 42

Body Frame Ranges Large Medium Small Men >10.4 10.4 – 9.6 <9.6 Women >10.9 10.9 – 9.9 <9.9

Question 43

IBW formula for women?

Answer 43

o 100lbs for the first 5 feet + 5lbs for every inch o -10% for small frame o +10 for large frame o Example: 5’ 6” = 100 + (5*6=30) = 130lbs for normal frame o Small frame 130*0.10 = 13 130 - 13 = 117lbs o Large frame 130 + 13 = 143lbs

Question 44

IBW formula for men?

Answer 44

o 106lbs for the first 5 feet + 6lbs for every inch o -10% for small frame o +10 for large frame o Example: 5’ 9” = 106 + (6*9=54) = 160lbs for normal frame o Small frame 160*0.10 = 16 160 - 16 = 144lbs o Large frame 160 + 16 = 176lbs

Question 45

For Glasgow Coma Scale, what is range for vegetative state?

Answer 45

<3

Question 46

Useful screening tool to facilitate assessment of depression in older adults

Answer 46

Geriatric Depression Scale

Question 47

Tool used to measure the impact headaches have on your ability to function on the job.

Answer 47

Headache Impact Test