1. Chapter 6 Assessing mental status and psychosocial developmental level

2. Mini-mental state examination tool
Time orientation
Place orientation
Registration of three words
Serial 7s as a test of attention and calculation
Recall of three words
Naming

3. Mini-mental state examination tool
Repetition
Comprehension
Reading
Writing
Drawing

4. Mental status Level of consciousness Posture and body movements Gait
Dress
Hygiene

5. Mental status Facial expressions Speech Behaviours Thought patterns
Mood, feelings, expressions

6. Question Is the following statement true or false?
Evaluating level of consciousness is part of a mental status exam.

7. Answer
True.
Evaluating level of consciousness is part of a mental status exam.

8. Five levels of consciousness
Alert and awake
Lethargy
Obtunded
Stupor
Coma

9. Question Which describes a patient who is stuporous?
Awakes to vigorous shake or painful stimulus but returns to unresponsive sleep
Remains unresponsive to all stimuli; eyes stay closed
Opens eyes to loud voice, responds slowly with confusion, seems unaware of environment
Opens eyes, answers questions and falls back to sleep

10. Answer
Awakes to vigorous shake or painful stimulus but returns to unresponsive sleep.
Stuporous patients awake to vigorous shake or painful stimulus but returns to unresponsive sleep. Coma remains unresponsive to all stimuli; eyes stay closed. Obtunded opens eyes to loud voice, responds slowly with confusion, seems unaware of environment. Lethargy opens eyes, answers questions and falls back to sleep.

11. Glasgow Coma Scale Eye opening response
Most appropriate verbal response
Most integral motor response (arm)

12. Cognitive ability Orientation Concentration Recent memory
Remote memory

13. Cognitive ability (cont.)
Use of memory to learn new information
Abstract reasoning
Judgement
Visual perceptual and constructional ability

14. Erikson’s developmental tasks
Young adult: Intimacy versus isolation
Middle-aged adult: Generativity versus stagnation
Older adult: Integrity versus despair

15. Question
Is the following statement true or false? The Erikson’s developmental task for young adult is intimacy versus isolation.

16. Answer
True. The Erikson’s developmental task for young adult is intimacy versus isolation.

17. Psychological developmental level
Mental and emotional health
Self-concept
Role development
Relationships
Coping
Stress patterns
Spiritual beliefs

18. Alzheimer’s disease 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
Doesn’t recognise and is confused about familiar people
Has difficulty with routine tasks such as paying bills
Neglects personal safety, hygiene and nutrition

19. Depression questionnaire
Falling asleep
Sleep during the night
Waking up too early
Sleeping too much
Feeling sad
Decreased or increased appetite
Decreased or increased weight

20. Depression questionnaire (cont.)
Concentration/decision making
View of oneself
Thoughts of death or suicide
General interest
Energy level
Feeling slowed down
Feeling restless