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Chapter 7: Mental Status Assessment

1. When examining a patient, the nurse can assess mental status by:
2. examining the patient’s EEG.
3. observing the patient as he or she performs an IQ tests.
4. observing the patient and inferring health or dysfunction.
5. examining the patient’s response to a specific set of questions.

Cognitive Level: Comprehension

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 3

Rationale: Mental status cannot be scrutinized directly like the characteristics of skin or heart sounds. Its functioning is inferred through assessment of an individual’s behavior.

2. When assessing mental status in children, which of the following statements is true?
3. All aspects of mental status in children are interrelated.
4. Children are highly labile and unstable until the age of 2.
5. Children’s mental status is largely a function of their parents’ level of functioning until the age of 7.
6. Children’s mental status is impossible to assess until the child develops the ability to concentrate.

Cognitive Level: Comprehension

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 1

Rationale: It is difficult to separate and trace the development of just one aspect of mental status. All aspects are interdependent. For example, consciousness is rudimentary at birth because the cerebral cortex is not yet developed. The infant cannot distinguish the self from the mother’s body.

3. You are assessing a 75-year-old male. As you begin the mental status portion of your assessment you would expect:
4. he will have no decrease in any of his abilities including response time.
5. he will have difficulty on tests of remote memory since this typically decreases with age.
6. it may take him a little longer to respond but his general knowledge and abilities should not have declined.
7. he will have had a decrease in his response time due to language loss and a decrease in general knowledge.

Cognitive Level: Analysis

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 3

Rationale: The aging process leaves the parameters of mental status mostly intact. There is no decrease in general knowledge and little or no loss in vocabulary. Response time is slower than in youth. It takes a bit longer for the brain to process information and react to it.

4. In your assessment of aging adults, you know that one of the first things that you should assess prior to making judgments about their mental status is:
5. phobias.
6. general intelligence.
7. irrational thinking patterns.
8. sensory perceptive abilities.

Cognitive Level: Analysis

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 4

Rationale: Age-related changes in sensory perception can affect mental status. For example, vision loss (as detailed in Chapter 14) may result in apathy, social isolation, and depression. Hearing changes are common in older adults. This problem produces frustration, suspicion, social isolation, and makes the person look confused.

5. Which of the following statements is true with regard to the mental status examination?
6. A patient’s family is the best resource for information about the patient’s coping skills.
7. It is usually sufficient to gather mental status information during the health history interview.
8. It takes an enormous amount of extra time to integrate the mental status examination into the health history interview.
9. It is usually necessary to perform a complete mental status examination in order to get a good idea of the patient’s level of functioning.

Cognitive Level: Application

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 2

Rationale: The full mental status examination is a systematic check of emotional and cognitive functioning. The steps described here, though, rarely need to be taken in their entirety. Usually, you can assess mental status through the context of the health history interview.

6. Mrs. H. brings her husband to the clinic for an examination. She is particularly worried because after a recent fall, he seems to have lost a great deal of his memory of recent events. Which statement reflects your best course of action?
7. You should plan to perform a complete mental status examination.
8. It would be most appropriate to refer Mr. H. to a psychometrician.
9. You should plan to integrate the mental status examination into the history and physical examination.
10. You should reassure Mrs. H. that memory loss after a physical shock is normal and will subside soon.

Cognitive Level: Application

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 1

Rationale: It is necessary to perform a full mental status examination when you discover any abnormality in affect or behavior and in the following situation: family members are concerned about a person’s behavioral changes (e.g., memory loss, inappropriate social interaction).

7. In your interview with Mr. W. it will be important for you to ascertain some basic history information. Which of the following would you explore more fully with Mr. W.?
8. Mr. W. states that he “sleeps like a baby.”
9. Mr. W. states that he has no health problems.
10. Mr. W. states that he “never did too good in school.”
11. Mr. W. states that he is currently not taking any medication.

Cognitive Level: Analysis

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 3

Rationale: In every mental status examination, note these factors from the health history that could affect your findings: any known illnesses or health problems, such as alcoholism or chronic renal disease; current medications, the side effects of which may cause confusion or depression; the usual educational and behavioral level—note that factor as the normal baseline and do not expect performance on the mental status examination to exceed it; and responses to personal history questions, indicating current stress, social interaction patterns, and sleep habits.

8. Mrs. K. is admitted to your unit following an automobile accident. You begin her mental status examination and find that her speech is dysarthric and she is lethargic. Your best approach regarding this examination is to:
9. plan to defer the rest of the mental status examination.
10. skip the language portion of the examination and go on to assess mood and affect.
11. do an in-depth speech evaluation and defer the mental status examination to another time.
12. go ahead and assess for suicidal thoughts since dysarthria is often accompanied by severe depression.

Cognitive Level: Analysis

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 1

Rationale: In the following examination the sequence of steps forms a hierarchy in which the most basic functions (consciousness, language) are assessed first. The first steps must be accurately assessed to ensure validity for the steps to follow. That is, if consciousness is clouded, then the person cannot be expected to have full attention and to cooperate with new learning. If language is impaired, subsequent assessment of new learning or abstract reasoning (anything that requires language functioning) can give erroneous conclusions.

9. Ms. J., 19, comes to your clinic at the insistence of her brother. She is wearing black combat boots and a black lace nightgown over the top of her other clothes. Her hair is dyed pink with black streaks throughout. She has several pierced holes in her nares and ears and is wearing an earring through her eyebrow as well as heavy black makeup. You conclude:
10. Ms. J. probably doesn’t have any problems at all.
11. she is just trying to shock people and her dress should be ignored.
12. Ms. J. has manic syndrome due to her abnormal dress and grooming.
13. you will need to gather more information in order to decide whether her dress is appropriate or not.

Cognitive Level: Application

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 4

Rationale: Grooming and hygiene should be noted. The person is clean and well groomed, hair is neat and clean, women have moderate or no make-up, men are shaved or their beards or moustaches are well groomed. Use care in interpreting clothing that is disheveled, bizarre, or in poor repair because these sometimes reflect the person’s economic status or a deliberate fashion trend.

10. Mr. D. has been in the ICU for 10 days. He has just been moved to your floor and you are planning to perform a mental status examination on him. During the tests of cognitive function you would expect that he:
11. may display some disruption in thought content.
12. will state, “I am so relieved to be out of intensive care.”
13. will be oriented to place and person but may not be certain of the date.
14. may show evidence of some clouding of his level of consciousness.

Cognitive Level: Analysis

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 3

Rationale: You can discern the orientation of cognitive function through the course of the interview or ask directly, using tact. “Some people have trouble keeping up with the dates while in the hospital. Do you know today’s date?” Many hospitalized people normally have trouble with the exact date but are fully oriented on the remaining items.

11. In order to assess affect, you should ask the patient:
12. “How do you feel today?”
13. “Would you please repeat the following words?”
14. “Have these medications had any effect on your pain?”
15. “Has this pain affected your ability to get dressed by yourself?”

Cognitive Level: Application

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 1

Rationale: Judge mood and affect by body language, facial expression, and by asking directly, “How do you feel today?” or “How do you usually feel?” The mood should be appropriate to the person’s place and condition and change appropriately with topics.

12. You are going to assess recent memory with Mr. F. The best way to do this would be to:
13. give Mr. F. the FACT Test.
14. ask Mr. F. to describe his first job to you.
15. give Mr. F. the Four Unrelated Words Test.
16. ask Mr. F. to describe what TV show he was watching prior to coming to the clinic.

Cognitive Level: Application

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 3

Rationale: Assess recent memory in the context of the interview by the 24-hour diet recall or asking the time the person arrived at the agency. Ask questions you can corroborate. This screens for the occasional person who confabulates or makes up answers to fill in the gaps of memory loss. New learning—the Four Unrelated Words Test tests the person’s ability to lay down new memories. It is a highly sensitive and valid memory test.

13. Mrs. A., 45, is at your agency for a mental status assessment. In giving her the Four Unrelated Words Test, you would be concerned if:
14. she could not invent four unrelated words within 5 minutes.
15. she could not invent four unrelated words within 30 seconds.
16. she could not recall four unrelated words after a 30-minute delay.
17. she could not recall four unrelated words after a 60-minute delay.

Cognitive Level: Analysis

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 3

Rationale: The Four Unrelated Words Test tests the person’s ability to lay down new memories. It is a highly sensitive and valid memory test. It requires more effort than does the recall of personal or historic events. To the person, say, “I am going to say four words. I want you to remember them. In a few minutes I will ask you to recall them.” After 5 minutes, ask for the four words. The normal response for persons under 60 years is an accurate three- or four-word recall after a 5-, 10-, and 30-minute delay.

14. Which of the following questions would best assess a person’s judgment?
15. “Do you feel that you are being watched, followed, or controlled?”
16. “Tell me about what you plan to do once you are discharged from the hospital.”
17. “What does the statement, ‘People in glass houses shouldn’t throw stones,’ mean to you?”
18. “What would you do if you found a stamped, addressed envelope lying on the sidewalk?”

Cognitive Level: Application

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 2

Rationale: A person exercises judgment when he or she can compare and evaluate the alternatives in a situation and reach an appropriate course of action. Rather than testing the person’s response to a hypothetical situation, (e.g., “What would you do if you found a stamped, addressed envelope lying on the sidewalk?”), you should be more interested in the person’s judgment about daily or long-term goals, the likelihood of acting in response to delusions or hallucinations and the capacity for violent or suicidal behavior.

15. Which of the following individuals would you consider at highest risk for a suicide attempt?
16. A man who jokes about death.
17. A woman during an episode of major depression who has tried suicide in the past.
18. An adolescent who has just broken up with her boyfriend and states that she would like to kill herself.
19. An elderly man who tells you that he is going to “join his wife in heaven” tomorrow and plans to use a gun.

Cognitive Level: Comprehension

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 4

Rationale: When the person expresses feelings of sadness, hopelessness, despair, or grief, it is important to assess any possible risk of physical harm to himself or herself. Begin with more general questions. If you hear affirmative answers, continue with more specific questions. A precise suicide plan to take place in the next 24 to 48 hours using a lethal method constitutes high risk.

16. You are performing a mental status assessment on R., a 5-year-old girl. Her parents are undergoing a bitter divorce and are worried about the effect it is having on R. Of the following information, which statement might lead you to worry about R.’s mental status?
17. R. clings to her mother whenever you are in the room.
18. R. appears angry and will not make eye contact with you.
19. R.’s mother states that she has begun to ride a tricycle around their yard.
20. R.’s mother states that R. prefers to play with toddlers instead of kids her age while in daycare.

Cognitive Level: Analysis

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 4

Rationale: The mental status assessment of infants and children covers behavioral, cognitive, and psychosocial development and examines how the child is coping with his or her environment. Essentially, you will follow the same A-B-C-T- guidelines as for the adult, with special consideration for developmental milestones. Your best examination “technique” arises from thorough knowledge of developmental milestones as described in Chapter 2. Abnormalities are often problems of omission, e.g., the child does not achieve a milestone you would expect.

17. You would plan to use the Behavioral Checklist with a child who is:
18. 8 years old.
19. 16 years old.
20. 5 years old, just prior to kindergarten.
21. having difficulty with gross motor skills.

Cognitive Level: Knowledge

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 1

Rationale: For school-age children, ages 7 to 11, who have grown beyond the age when developmental milestones are very useful, the Behavioral Checklist is an additional tool that can be given to the parent along with the history.

18. You are assessing orientation in Mr. J., 79. Which of the following responses would lead you to conclude that Mr. J. is oriented?
19. “I know that my name is Mr. J. I couldn’t tell you where I am. I think it is 2000, though.”
20. “I know that my name is Mr. J., but to tell you the truth, I get kind of confused about the date.”
21. “I know that my name is Mr. J.; I guess I’m at the hospital in Spokane. No, I don’t know the date.”
22. “I know that my name is Mr. J. I am at the hospital in Spokane. I couldn’t tell you what date it is, but I know that it is February of a new year—2000.”

Cognitive Level: Application

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 4

Rationale: Many aging persons experience social isolation, loss of structure without a job, a change in residence, or some short-term memory loss. These factors affect orientation and the person may not provide the precise date or complete name of the agency. You may consider aging persons oriented if they know generally where they are and the present period. That is, consider them oriented to time if the year and month are correctly stated. Orientation to place is accepted with the correct identification of the type of setting (e.g., the hospital) and the name of the town.

19. You have decided to administer the Set Test to Mr. C., 70. To administer this test you should:
20. ask him to name ten fruits, animals, colors, and towns. Tell him that you will be available to help if he gets stuck.
21. ask him to name ten items based on the categories in the acronym FACT. Tell him that there is no hurry to do this.
22. ask him to name ten items based on the categories in the acronym FACT. If he has difficulty, you may prompt his memory.
23. ask him to name ten items based on the categories in the acronym FACT. Tell him this test is timed and he can only have 2 minutes to take it.

Cognitive Level: Application

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 2

Rationale: The Set Test was developed specifically for use with an aging population. The test is easy to administer and takes less than 5 minutes. Ask the person to name ten items in each of four categories or sets: fruits, animals, colors, and towns (FACT). Do not coach, prompt, or hurry the person.

20. Mrs. G. drifts off to sleep when she is not being stimulated. You can arouse her easily when you call her name but she remains drowsy during your conversation. The best description of Mrs. G.’s level of consciousness would be:
21. lethargic.
22. obtunded.
23. stuporous.
24. semi-alert.

Cognitive Level: Comprehension

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 1

Rationale: Lethargic (or somnolent) is when the person is not fully alert, drifts off to sleep when not stimulated, can be aroused when called by name in a normal voice but looks drowsy. He or she responds appropriately to questions or commands, but thinking seems slow and fuzzy. He or she is inattentive and loses the train of thought. Spontaneous movements are decreased.

21. Mr. S. has suffered a CVA (stroke). He is trying very hard to communicate with you. He seems driven to speak and says, “I buy obie get spirding and take my train.” What is the best way to communicate with Mr. S.?
22. Use speech, he will understand you even if you cannot understand him.
23. Abandon all attempts to communicate with Mr. S. His aphasia is irreversible.
24. Give him a pencil and paper since reading and writing abilities will not be impaired.
25. Support his efforts to communicate and use pantomime and gestures to communicate when you can.

Cognitive Level: Analysis

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 4

Rationale: This illustrates receptive aphasia. Speech is fluent, effortless, and well-articulated. Output has many paraphasias (word substitutions that are malformed or wrong) and neologisms (made-up words) and often lacks substantive words. Speech can be totally incomprehensible. Often there is a great urge to speak. Essentially, it is a defect of auditory comprehension. Repetition, reading, and writing are also impaired.

22. As you talk with your patient, he seems to repeatedly have difficulty coming up with a word. He says, “I was on my way to work and when I got there, the thing that you step into that goes up in the air, was so full that I decided to take the stairs.” You will note on his chart that he is using/experiencing:
23. blocking.
24. neologism.
25. circumlocution.
26. circumstantiality.

Cognitive Level: Comprehension

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 3

Rationale: Circumlocution is a round-about expression, substituting a phrase when one cannot think of the name of the object.

23. Which of the following statements is an example of flight of ideas?
24. “My stomach hurts. Hurts, spurts, burts.”
25. “Kiss, wood, reading, ducks, onto, maybe.”
26. “Take this pill? The pill is red. I see red. Red velvet is soft, soft as a baby’s bottom.”
27. “I wash my hands, wash them, wash them. I usually go to the sink and wash my hands.”

Cognitive Level: Comprehension

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 3

Rationale: Flight of ideas is demonstrated by an abrupt change, rapid skipping from topic to topic, and practically continuous flow of accelerated speech. Topics usually have recognizable associations or are plays on words.

24. Your patient describes feeling an unreasonable, irrational fear of snakes. It is so persistent, that he can no longer comfortably even look at pictures of snakes and has made an effort to identify all the places he might encounter a snake and avoids them. You explain to him that:
25. “You are suffering from a snake phobia.”
26. “You are a hypochondriac. Snakes are usually harmless.”
27. “You have what we call an obsession. In this case, it is with snakes.”
28. “You have a delusion that snakes are harmful. It must stem from an early traumatic incident involving snakes.”

Cognitive Level: Application

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 1

Rationale: A phobia is a strong, persistent, irrational fear of an object or situation; the person feels driven to avoid it.

25. Your patient is schizophrenic. During a recent interview, he shows you a picture of a man holding a decapitated head. He describes this picture as horrifying and laughs loudly at the content. This behavior is a display of:
26. confusion.
27. ambivalence.
28. depersonalization.
29. inappropriate affect.

Cognitive Level: Analysis

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 4

Rationale: An inappropriate affect is an affect clearly discordant with the content of the person’s speech.

26. Which of the following examples would be a hallucination?
27. A man believes that his dead wife is talking to him.
28. A woman hears the doorbell ring and goes to answer it, but no one is there.
29. A child sees a man standing in his closet. When the lights are turned on it is only a dry cleaning bag.
30. A man believes that the dog has curled up on the bed but when he gets closer he sees that it is a blanket.

Cognitive Level: Knowledge

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 1

Rationale: Hallucinations are sensory perceptions for which there are no external stimuli. They may strike any sense: visual, auditory, tactile, olfactory, or gustatory.

27. A 20-year-old construction worker has been brought into the emergency department with heat stroke. He is experiencing delirium secondary to the fluid and electrolyte imbalance. You would assess his:
28. affect and mood.
29. memory and affect.
30. thought processes and memory.
31. level of consciousness and cognitive abilities.

Cognitive Level: Comprehension

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 4

Rationale: Delirium is a disturbance of consciousness (i.e., reduced clarity of awareness of the environment) with reduced ability to focus, sustain, or shift attention. It is also a change in cognition (such as memory deficit, disorientation, language disturbance) or the development of a perceptual disturbance. The disturbance develops over a short period of time (usually hours to days) and tends to fluctuate during the course of the day.

28. Ms. L. has come to your agency to seek help with a substance abuse problem. She admits to using cocaine just prior to arrival. Which of the following describes what you would expect to find when you examine Ms. L.?
29. Dilated pupils, pacing, psychomotor agitation
30. Dilated pupils, unsteady gait, aggressiveness
31. Pupil constriction, lethargy, apathy, dysphoria
32. Constricted pupils, euphoria, decreased temperature

Cognitive Level: Comprehension

Jarvis Health Assessment Test Questions

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 1

Rationale: A cocaine user’s appearance includes pupillary dilation, tachycardia or bradycardia, elevated or lowered blood pressure, sweating, chills, nausea, vomiting, and weight loss. The person’s behavior includes euphoria, talkativeness, hypervigilance, pacing, psychomotor agitation, impaired social or occupational functioning, fighting, grandiosity, and visual or tactile hallucinations

29. Mr. H. states, “I feel so sad all of the time. I can’t feel happy even doing things I used to like to do.” He also states that he is tired, sleeps poorly, and has no energy. In order to differentiate between dysthymic disorder and a major depressive disorder, what additional areas should you assess?
30. “Have you had any weight changes?”
31. “Are you having any thoughts of suicide?”
32. “How long have you been feeling this way?”
33. “Are you having feelings of worthlessness?”

Cognitive Level: Analysis

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 3

Rationale: Major depressive disorder is characterized by one or more major depressive episodes (i.e., at least 2 weeks of depressed mood or loss of interest accompanied by at least four additional symptoms of depression). Dysthymic disorder is characterized by at least 2 years of depressed mood for more days than not, accompanied by additional depressive symptoms.

30. Ms. P., 26, was robbed and beaten a month ago. She is returning to your clinic today for a follow-up assessment. You would want to be certain to ask Ms. P.:
31. “How are things going with the trial?”
32. “How are things going with your job?”
33. “Tell me about your recent engagement!”
34. “Are you having any disturbing dreams?”

Cognitive Level: Application

Jarvis Health Assessment Nclex Questions

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 4

Rationale: In posttraumatic stress disorder the person has been exposed to a traumatic event. The traumatic event is persistently re-experienced by recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions; recurrent distressing dreams of the event; and acting or feeling as if the traumatic event were recurring.

31. Which of the following statements is true regarding the assessment of mental status?
32. Mental status assessment diagnoses specific psychiatric disorders.
33. Mental disorders occur in response to everyday life stressors.
34. Mental status functioning is inferred through assessment of an individual’s behaviors.
35. Mental status can be assessed directly, just like other systems of the body (e.g., cardiac and breath sounds).

Cognitive Level: Comprehension

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 3

Rationale: Mental status functioning is inferred through assessment of an individual’s behaviors. It cannot be assessed directly like characteristics of the skin or heart sounds.

32. A 23-year-old patient in the clinic appears anxious. Her speech is rapid. She is fidgety and in constant motion. Which of the following questions or statements would be most appropriate to use in this situation to assess attention span?
33. “How do you usually feel? Is this normal behavior for you?”
34. “I am going to say four words. In a few minutes, I will ask you to recall them.”
35. “Please describe the meaning of the phrase, “Looking through rose-colored glasses.”
36. “Please pick up the pencil in your left hand, move it to your right hand, and place it on the table.”

Cognitive Level: Application

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 4

Rationale: Attention span is evaluated by assessing the individual’s ability to concentrate and complete a thought or task without wandering. Giving a series of directions to follow is one method used to assess attention span.

33. You are planning health teaching for Mr. Smith, age 65, who has suffered a CVA and is aphasic. Which of the following is it most important to use when assessing mental status in this situation?
34. “Please count back from 100 by seven.”
35. “I will name three items and ask you to repeat them in a few minutes.”
36. “Please point to articles in the room and parts of the body, as I name them.”
37. “What would you do if you found a stamped, addressed envelope on the sidewalk?”

Cognitive Level: Application

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 3

Rationale: Additional tests for persons with aphasia include the following: word comprehension—asking the individual to point to articles in the room or parts of the body; reading—asking the person to read available print; and writing—asking the person to make up and write a sentence.

34. A 30-year-old female patient is describing feelings of hopelessness and depression. She has attempted self-mutilation and has a history of prior suicide attempts. She describes difficulty sleeping at night and has lost 10 pounds in the past month. Which of the following is the nurse’s best response in this situation?
35. “Do you have a weapon?”
36. “How do other people treat you?”
37. “Are you feeling so hopeless that you feel like hurting yourself now?”
38. “Often times people feel hopeless, but the feelings resolve within a few weeks.”

Cognitive Level: Application

NCLEX: Psychosocial Integrity: Coping and Adaptation

Jarvis Test Bank Free

Correct answer: 3

Rationale: When the person expresses feelings of hopelessness, despair, or grief, it is important to assess for risk of physical harm to himself or herself. Begin this process with more general questions. If the answers are affirmative, continue with more specific questions.

35. Which of the following statements best describes the Mini-Mental State Examination?
36. Scores below 30 indicate cognitive impairment.
37. It is a good tool to evaluate mood and thought processes.
38. It is a good tool to detect delirium and dementia and to differentiate these from psychiatric mental illness.
39. It is useful for an initial evaluation of mental status. Additional tools are needed to evaluate cognition changes over time.

Cognitive Level: Comprehension

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 3

Rationale: The Mini-Mental State Exam is a quick, easy test of eleven questions. It is used for initial and serial evaluations and can demonstrate worsening or improvement of cognition over time and with treatment. It evaluates cognitive functioning, not mood or thought processes. It is a good screening tool to detect dementia, delirium, and to differentiate these from psychiatric mental illness.

36. A 45-year-old female is brought to the emergency department with a head injury after her car hit a tree. A few months after recovering from her injuries, she is unable to learn new information or recall previously learned information. This is an example of:
37. mania.
38. agnosia.
39. dementia.
40. amnestic disorder.

Cognitive Level: Application.

NCLEX: Psychosocial Integrity: Coping and Adaptation

Jarvis Physical Examination Pdf

Correct answer: 4

Rationale: The development of a memory impairment (inability to learn new information or recall previously learned information) in the absence of other significant cognitive impairments may be due to pathology such as closed head trauma.

37. Which type of aphasia is the most common and severe form—spontaneous speech is absent or reduced to a few stereotyped words or sounds?
38. Global aphasia
39. Broca’s aphasia
40. Dysphonic aphasia
41. Wernicke’s aphasia

Cognitive Level: Knowledge

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 1

Rationale: Global aphasia is the most common and severe form of aphasia. Spontaneous speech is absent or reduced to a few stereotyped words or sounds, and prognosis for language recovery is poor.

38. Your patient repeats, “I feel hot. Hot, cot, rot, tot, got. I’m a spot.” This is an illustration of:
39. blocking.
40. clanging.
41. echolalia.
42. neologism.

Cognitive Level: Comprehension

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 2

Rationale: Clanging is word choice based on sound, not meaning, and includes nonsense rhymes and puns.

39. During your interview, you note that the patient gets up several times to wash her hands even though they are not dirty. This is an example of:
40. social phobia.
41. compulsive disorder.
42. generalized anxiety disorder.
43. posttraumatic stress disorder.

Cognitive Level: Comprehension

NCLEX: Psychosocial Integrity: Coping and Adaptation

Correct answer: 2

Rationale: Repetitive behaviors, such as handwashing, are behaviors that the person feels driven to perform in response to an obsession. The behaviors are aimed at preventing or reducing distress or preventing some dreaded event or situation.