Deck 9: The Mental Status Examination

Question 1

"Attitude toward the examiner" refers to:

A) The client's feelings toward the examiner.
B) How the client behaves in relation to the examiner.
C) The type of language the client uses with the examiner.
D) The client's opinions of the examiner.
E) All of the above

Answer 1

E

Question 2

Which of the following statements is/are true?

A) Dilated pupils are sometimes associated with drug intoxication
B) Pinpoint pupils are sometimes associated with drug withdrawal
C) Mustache style predicts personality disorder
D) All of the above
E) Only A and B

Answer 2

E

Question 3

Which of the following is the PRIMARY purpose of the mental status exam?

A) To make a firm diagnosis of the client's problem.
B) To accurately evaluate the client's current cognitive processing.
C) To gather enough information to be able to refer the client.
D) To plan treatment for the client.
E) All of the above

Answer 3

B

Question 4

What is the primary difference between affect and mood?

A) Affect is the client's self-reported emotional state, and mood is the emotional state observed by the interviewer.
B) Affect is the emotional tone observed by the interviewer, and mood is the client's self-reported emotional state.
C) Affect refers to thoughts as well as feelings, whereas mood refers only to feelings.
D) Affect always includes a wider range of emotional states than mood does.
E) Affect is more cognitive in nature than mood.

Question 5

Why is the mental status examination useful?

A) It is a standardized procedure for organizing clinical observations.
B) It allows clinicians to establish hypotheses about current cognitive functioning.
C) It allows mental health professionals to communicate information about clients in a format that is universally understood within psychiatry and medicine.
D) All of the above are true.
E) Only B and C are true.

Question 6

Which of the following is NOT an area of client functioning that's included during a mental status exam?

A) Appearance
B) Memory and intelligence
C) IQ score
D) Perceptual disturbances
E) All of the above must be assessed during a mental status exam

Question 7

Care should be taken when using MSEs with clients from diverse cultures because:

A) Specific cultural beliefs, especially spiritual beliefs, can sound like madness (or delusions) to outsiders
B) MSEs are likely to underestimate psychopathology for minority group members
C) Minority group IQ scores are notoriously low
D) Minority group members don't have specific mental deviances, such as perceptual disturbances
E) All of the above are true

Question 8

Which physical characteristics are commonly noted on a mental status exam?

A) Personal grooming
B) Mustache style
C) Make-up
D) Tattoos and piercings
E) All of the above and more

Question 9

An absence of emotion in clients is referred to as:

A) Blunted mood
B) Labile affect
C) Flat affect
D) Blank mood
E) None of the above

Question 10

"Euphoric," "labile," and "blunted" are words used to describe:

A) Attitude
B) Mood
C) Affect range
D) Affect content
E) Cognitions

Question 11

When interviewing a client and making a judgment of the client's attitude, the clinician should do which of the following?

A) Realize that an aggressive attitude is very common.
B) Judge the attitude only by the client's words.
C) Exercise caution before labeling the client.
D) Try to stir the client's feelings up to see the reaction.
E) Both A and B

Question 12

What strategy is recommended as a way for clinicians to resist the temptation of making single symptom generalization?

A) Dynamic sizing
B) Scientific mindedness
C) Cultural specificity
D) Mindfulness meditation
E) Cardio workouts

Question 13

The authors offer which of the following guidelines for avoiding making inappropriate overgeneralizations based on minimal symptoms?

A) When you notice a single-symptom of particular interest, begin the scientific mindedness process
B) Remember that hypotheses are not conclusions
C) Consult with supervisors/colleagues before making wild inferential leaps
D) All of the above
E) Only A and B

Question 14

Which statement is true when applied to studying humans?

A) It is possible to have complete objectivity but not complete emotional neutrality.
B) It is possible to have complete emotional neutrality but not complete objectivity.
C) It is not possible to have complete objectivity or complete emotional neutrality.
D) The MSE allows for an unbiased and objective assessment.
E) None of the above is true.

Question 15

Carlos meets with a new client. The client is unshaven. Which of the following is a reasonable hypothesis for Carlos to make?

A) The client is obviously depressed
B) The client is obviously a movie star
C) More information is needed before Carlos can make a reasonable hypothesis
D) The client will need social skills training
E) Carlos needs to shave less to be able to have rapport with this client

Question 16

What strategy is recommended as a way for clinicians to resist the temptation of making single symptom generalization?

A) Dynamic sizing
B) Scientific mindedness
C) Cultural specificity
D) Mindfulness meditation
E) Cardio workouts

Question 17

If a client begins crying while talking about her terminally ill son, what could the therapist conclude?

A) Her affect is appropriate with respect to her speech content.
B) Her mood is appropriate with respect to her speech content.
C) Her behavior is consistent with her mood.
D) Her affect is inappropriate with respect to the content of her speech.
E) None of the above

Question 18

Sophie is interviewing a new client. Sometimes the client refuses to answer questions. Other times he openly disagrees with Sophie. Sophie is left feeling as if she can't say anything that this client will agree with. Which statement might she use to describe the client's attitude toward the examiner?

A) The client's attitude toward the examiner was seductive
B) The client's attitude toward the examiner was indifferent
C) The client's attitude toward the examiner was cooperative
D) The client's attitude toward the examiner was ingratiating
E) None of the above appear accurate

Question 19

What behavioral or psychomotor activities do mental status examiners take note of?

A) Physical behavior isn't a part of the MSE
B) Eye movements
C) Excessive body movements
D) All of the above
E) Only B and C

Question 20

Which of the following describes a situation in which the administration of a mental status exam is appropriate?

A) For clients with a desire to know their intelligence level.
B) For all outpatient clients.
C) When there is an indication of significant client psychopathology.
D) Whenever a client has spent time in a medical setting.
E) All of the above are appropriate

Question 21

Which of the following is NOT true of hallucinations?

A) They can occur in any of the major sensory modalities.
B) They are most often auditory.
C) Clients with normal functioning never experience them.
D) Their presence may indicate a mood disorder or schizophrenia.
E) All of the above are true.

Question 22

Delirium refers to:

A) Shifting consciousness
B) Dissociation
C) Dementia
D) Loosening of associations
E) Word salad

Question 23

Flashbacks are a core symptom of:

A) Bipolar disorder
B) Post -traumatic stress disorder
C) Organic brain syndrome
D) Major depressive disorder
E) Obsessive-compulsive disorder

Question 24

Which of the following is a type of memory assessed in the mental status exam?

A) Remote
B) Recent
C) Immediate
D) All of the above
E) None of the above

Question 25

Clients who resist speaking openly and are resistant to direct questioning are referred to as having:

A) Speech dysprosody
B) Poverty of speech
C) Resistant speech
D) Speech dysarthria
E) None of the above

Question 26

Which of the following is NOT a true statement about obsessions?

A) They are recurrent ideas, thoughts, and images.
B) They seem rational to the one who is experiencing them.
C) They are characterized by a feeling of loss of control over one's thoughts.
D) They are always considered clinically significant.
E) All of the above are true

Question 27

Tom tells the interviewer that stars in the sky are in fact satellites tracking his every move and reporting back to the CIA. What does Tom appear to be experiencing?

A) Delusions of persecution
B) Loosening of associations
C) Obsessions
D) Delusions of alien control
E) None of the above

Question 28

If a client's speech is referred to as "pressured," how would the client be talking?

A) Softly
B) Quickly
C) Loudly
D) Anxiously
E) None of the above

Question 29

Ideas of references are most often associated with:

A) Paranoid delusions
B) Somatic delusions
C) Grandiose delusions
D) Could be any of the above
E) Only A and B

Question 30

Which of the following is true about flashbacks?

A) They are core symptoms of post -traumatic stress disorder
B) They are typically triggered by current sensory input
C) They may be fleeting and mild
D) All of the above are true.
E) Only A and C are true.

Question 31

Which of the following should you do when questioning clients about delusional or hallucinatory experiences?

A) Don't be afraid to let your personal reactions show.
B) Don't let the client off the hook about describing these experiences; probe this area diligently and aggressively.
C) Adopt a neutral stance and question the client gently.
D) Relate your own similar experiences to the client.
E) Do your best to convince the client that their experience is not reality.

Question 32

Which of the following describes the order in which disoriented clients usually become disoriented?

A) Place, time, situation, person
B) Situation, time, place, person
C) Person, place, time, situation
D) Place, person, situation, time
E) There is no particular usual order of disorientation.

Question 33

Robinson (2007) suggests a three-part approach to questioning clients about delusions and hallucinations that includes all of the following EXCEPT:

A) Greasing the wheels to make the client feel comfortable.
B) Uncovering the client's logic surrounding the delusion or hallucination.
C) Pointing out evidence contrary to the delusion or hallucination.
D) Determining the client's insight concerning the delusion or hallucination.
E) All of these were recommended by Robinson.

Question 34

The evaluation of speech during a mental status exam can have implications for which of the following?

A) Client thought process and content
B) Possible disturbances in brain functioning
C) The possibility of drug or alcohol use
D) All of the above
E) None of the above

Question 35

What does "la belle indifference" refer to?

A) An therapist's lack of concern for the interview.
B) A condition in which clients act out a wide range of emotional states.
C) A condition in which clients talk about severe problems with little emotionality.
D) A condition in which clients are excessively emotional about everything.
E) None of the above

Question 36

Anthony is working with Salim, a client who speaks English as a second language. He observes repeated long response latencies. Which of the following is a reasonable hypothesis?

A) Salim is being resistant or oppositional.
B) Salim is engaging in thought blocking.
C) Salim may be struggling to understand Anthony.
D) Salim is likely depressed.
E) Salim may be suffering from schizophrenia.

Question 37

Thought process constitutes the _________ of client thinking. Thought content constitutes the _________ of client thinking.

A) What; how
B) When; what
C) How; why
D) Why; what
E) How; what

Question 38

Which of the following is true of delusions?

A) They are defined as false beliefs.
B) They can be a healthy way to release emotions.
C) They are always "delusions of grandeur."
D) They usually are very temporary or time limited due to naturally occurring discrepancies between the client's beliefs and objective reality.
E) Both B and C are true

Question 39

Which of the following is NOT used to describe client speech in a mental status exam?

A) Rate
B) Volume
C) Amount
D) Appropriateness
E) Lability

Question 40

Which of the following is NOT related to orientation and consciousness?

A) Alert or clouded
B) Oriented times three
C) Questions about self, place, and time
D) Questions about events in the past
E) These are all related to orientation and consciousness

Question 41

Which of the following do therapists focus on to assess client cognitive abilities?

A) The focus is on specific social impairments.
B) The focus is strictly on remote and recent memory.
C) Neuropsychological tests are administered.
D) Memory and general intelligence are assessed.
E) Both C and D

Question 42

Reliability refers to:

A) Adaptive decision-making
B) Credibility and trustworthiness
C) Understanding of one's problems
D) Disorientation
E) None of the above

Question 43

Which of the following factors can affect performance on cognitive assessments such as digit span and serial sevens?

A) Native language
B) Education level
C) Cultural background
D) All of the above
E) Only A and C

Question 44

A therapist asks Hazel if she has any idea what might be causing her panic attacks, and Hazel states that she doesn't really know but maybe her new kitten has something to do with it. Hazel can be said to have poor:

A) Reliability
B) Judgment
C) Insight
D) Orientation
E) None of the above

Question 45

_______________ memory refers to events, information, and people from the distant past, and ______________ memory refers to events, information, and people from the past week or so.

A) Long-term; short-term
B) Distant; recent
C) Remote; immediate
D) Long-term; immediate
E) Remote; recent

Question 46

Which of the following is NOT associated with the assessment of client intelligence?

A) Congeniality
B) Distractibility
C) Serial sevens
D) Digit span
E) These are all used

Question 47

Which of the following statements is NOT true of intelligence?

A) Few people agree on one definition of intelligence.
B) Nearly everyone agrees on the definition of intelligence.
C) People can express their intelligence in many different ways.
D) In a mental status examination, intelligence should be measured cautiously using multiple dimensions.
E) All of the above are true.

Question 48

Confabulation presents a problem in which part of a mental status examination?

A) Assessment of remote memory
B) Assessment of consciousness
C) Assessment of intelligence
D) All of the above
E) None of the above

Question 49

Insight refers to:

A) Adaptive decision-making
B) Credibility and trustworthiness
C) Understanding of one's problems
D) Disorientation
E) None of the above

Question 50

Judgment refers to:

A) Adaptive decision-making
B) Credibility and trustworthiness
C) Understanding of one's problems
D) Disorientation
E) None of the above

Question 51

Mitra is assessing Jake's memory. After hearing Jake recall events in his childhood, she suspects that he either has a memory impairment or is fabricating stories. What could Mitra do to help her assess his remote memory?

A) Ask Jake about objective events that occurred during his childhood.
B) Obtain releases of information and then ask Jake's family to confirm historical information.
C) Ask Jake to count backwards by sevens from 100.
D) All of the above
E) Only A and B