Neurological Diagnosis: Mental Status Evaluation

Question 1

Orientation

Answer 1

What’s your name?

Do you know where you are?

Do you know what day it is?

Question 2

Level of alertness, attention and cooperation

Answer 2

Can you spell the word SPINE forward and backward?

Can you repeat the numbers 3-6-9-12 forward and backward?

Can you name the days of the week forward and backward?

Question 3

Memory

Answer 3

Recent: Remember the words TREE, BOAT, FORK after 5 minutes

Remote: Where did you go to high school?

Question 4

Recent Memory

Answer 4

Can you recall the words Tree, Boat, Fork?

(After 5 mins)

Question 5

Remote Memory

Answer 5

Where did you go to high school?

Question 6

Language

Answer 6

Object Naming: Can you name the 3 shapes? Can you name the 3 colors?

Repetition: Can you repeat the sentence “Time flies when you’re having fun”?

Reading: Can you read the sentence?

Question 7

Object Naming

Answer 7

Can you name the 3 shapes?

Can you name the 3 colors?

Question 8

Repetition

Answer 8

Can you repeat the sentence “Time flies when you’re having fun”?

Question 9

Reading

Answer 9

Can you read the sentence?

Question 10

Calculations

Answer 10

Can you add 3 and 5 and then subtract 1?

(3+5) - 1 = 7

Question 11

Apraxia

Answer 11

Can you pretend to comb your hair?

Can you pretend to brush your teeth?

Question 12

Sequencing Tasks

Answer 12

Can you perform (rock, paper, scissors) as fast as you can?

Question 13

Abstraction

Answer 13

Can you interpret the sentence “The early bird get the worm?”