Mental Status Assessment

Question 1

Physical appearance and behavior

Answer 1

Significance:

How to assess: Grooming, emotional status, body language.

Question 2

Cognitive abilities

Answer 2

Significance: Estimate cognitive function, and document changes
How to assess: Orientation (x4, person, place, time, and purpose), State of consciousness (confused, lethargic, delirious, stuporous, comatose) Glascow Coma Scale, Mini-Mental State Exam

Question 3

Emotional stability

Answer 3

Significance: Evaluate when patient is not coping well or does not have adequate resources available.
How to assess: Moods and feeling, thought process and content, perceptual distortions and hallucinations

Question 4

Speech and language skills

Answer 4

Significance: certain characteristics relate to specific psych disorders.
How to assess: Voice quality, articulation, comprehension, coherence

Question 5

Alertness and orientation

Answer 5

Significance: If patient is NOT oriented x4 (normal), document where they are going wrong.
How to assess:

Question 6

Compare and contrast a full mental status examination and a “Mini-Mental State” examination

Answer 6

A full mental status 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.

A “mini-mental state” 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 7

5 major areas tested by the “Mini-Mental State” test and indicate the maximum score passible on the “Mini-Mental State” test

Answer 7

1. Orientation-”What is the date”
2. Registration- say 3 words and have the patient repeat the words back to you
3. Attention and Calculation- serial 7’s, ask patient to count backwards from 100 by sevens
4. Recall- Ask for the name of the 3 words used in #2 at a later point in the examination
5. Language- point to something like a pencil or watch and have the patient tell you what it is

The maximum possible score is 30 points

Question 8

Usefulness of administering the “Mini-Mental State” test serially over time

Answer 8

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.