Chapter 05: Mental Status Assessment

Chapter 05: Mental Status Assessment

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. During an examination, the nurse can assess mental status by which activity?

a.	Examining the patient’s electroencephalogram
b.	Observing the patient as he or she performs an intelligence quotient (IQ) test
c.	Observing the patient and inferring health or dysfunction
d.	Examining the patient’s response to a specific set of questions

 

 

ANS:  C

Mental status cannot be directly scrutinized like the characteristics of skin or heart sounds. Its functioning is inferred through an assessment of an individual’s behaviors, such as consciousness, language, mood and affect, and other aspects.

 

PTS:   1                    DIF:    Cognitive Level: Understanding (Comprehension)

REF:   p. 67               MSC:  Client Needs: Psychosocial Integrity

 

2. The nurse is assessing the mental status of a child. Which statement about children and mental status is true?

a.	All aspects of mental status in children are interdependent.
b.	Children are highly labile and unstable until the age of 2 years.
c.	Children’s mental status is largely a function of their parents’ level of functioning until the age of 7 years.
d.	A child’s mental status is impossible to assess until the child develops the ability to concentrate.

 

 

ANS:  A

Separating and tracing the development of only one aspect of mental status is difficult. 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. The other statements are not true.

 

PTS:   1                    DIF:    Cognitive Level: Understanding (Comprehension)

REF:   p. 68               MSC:  Client Needs: Psychosocial Integrity

 

3. The nurse is assessing a 75-year-old man. As the nurse begins the mental status portion of the assessment, the nurse expects that this patient:

a.	Will have no decrease in any of his abilities, including response time.
b.	Will have difficulty on tests of remote memory because this ability typically decreases with age.
c.	May take a little longer to respond, but his general knowledge and abilities should not have declined.
d.	Will exhibit had a decrease in his response time because of the loss of language and a decrease in general knowledge.

 

 

ANS:  C

The aging process leaves the parameters of mental status mostly intact. General knowledge does not decrease, and little or no loss in vocabulary occurs. Response time is slower than in a youth. It takes a little longer for the brain to process information and to react to it. Recent memory, which requires some processing, is somewhat decreased with aging, but remote memory is not affected.

 

PTS:   1                    DIF:    Cognitive Level: Analyzing (Analysis)

REF:   p. 68               MSC:  Client Needs: Psychosocial Integrity

 

4. When assessing aging adults, the nurse knows that one of the first things that should be assessed before making judgments about their mental status is:

a.	Presence of phobias
b.	General intelligence
c.	Presence of irrational thinking patterns
d.	Sensory-perceptive abilities

 

 

ANS:  D

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, which produces frustration, suspicion, and social isolation and makes the person appear confused.

 

PTS:   1                    DIF:    Cognitive Level: Analyzing (Analysis)

REF:    p. 68    MSC:   Client Needs: Psychosocial Integrity