MEDICAL COLLEGES OF NORTHERN PHILIPPINES

Alimannao Hills, Peñablanca, Cagayan

Telefax No. (078) 304-1010 Website: www.mcnp.edu.ph
E-mail Address: adminoffice@mcnp.edu.ph

COLLEGE OF NURSING

Subject code: NCM 117 SL

Subject Title: Care of Clients with Maladaptive Pattern of Behavior, Acute and
Chronic (LABORATORY)

Activity Title: Mental Status Examination

Group No. 3

Group Members

Pacis, Aphrill

Palle, Julie Ann

Palope, Jeremiah

Piedad, Katrina

Puyot, Angelica

Rabanal, Lea

Razon, Jubilee

Reyes, Crisel

Reyes, Kurt

Sabado, Mary Joy

Santiago, Charisse

Singueo, Stefanie

Suryu, Liana Marie

Tumaneng, Aubrey Nikolle

Utayde, Cassey

Uy, Jelaine

Clinical Instructor: MR. LUCKY ROAQUIN, RN, MSN

 MENTAL STATUS EXAMINATION

I. General Appearance
a. Dress
1. Appropriate 2. Inappropriate
b. Grooming, Hygiene
1. Appropriate 2. Inappropriate
c. Age Appearnce
1. Stated 2. Younger 3. Older

Remarks: The dress is not appropriate based on situation and age. He wears a vibrant
patterned button down polo with maroon 3/4 sleeve inside, has a crooked glasses and a wrist
watch in his left hand. His body built seems proportional with his height. Although grooming
was not directly assessed, it is still classified as inappropriate due to the fact that his hair is
messy. Patient, apparent age in his 40s/50s, not in line with actual age (36y/o).
II. Behavior
a. Manner of Relating
1. Cooperative 3. Withdrawn
2. Indifferent 4. Defensive

Remarks: The patient is defensive when the doctor ask him about substance abuse, he refused
to answer it and started to be irritable . Being indifferent is also noted. He doesn't what to
communicate with the doctor but he just keeps on taking about what he is interested in. Lastly,
withdrawn is also observed because he does not let the doctor to talk, he just keeps on talking.
b. Psychomotor Activity
1. Appropriate to situation
2. Hyperactivity
3. Retardation
4. Tremor
5. Purposeless activity
6. Posture a. Normal b. abnormal
7. Gait a. Normal b. abnormal
8. Repetitive behavior

Remarks:  We notice that the patient is hyperactive because of excessive talking and excessive 
physical movement especially on his hand and finger which cannot stay still. His posture 
  and gait is also abnormal because the patient is slouching when he is sitting.

c. Speech language
1. Intensity
a. Normal b. Loud c. Soft

2. Pitch
a. Normal b. Monotone c. Wide swings

3. Rate
 a. Normal b. Pressure c. Slow d. Halting

4. Spontaneity, Productivity
a. Normal b. Intrusive c. Decreased

5. Relevance and Coherence

a. Normal b. Incoherent c. irrelevant

6. Deviations
a. None
b. Aphasia
c. Neologism
d. Echolalia
e. Stammering
f. Clanging
g. Verbigeration
h. Perseveration
7. Vocabulary, diction, syntax
a. Appropriate to socioeducational background
b. Not appropriate to socioeducational background
Remarks: In terms of rate and spontaneity, productivity. we noticed that the patient talks with
pressure as shown in the video 0:36 wherein he talks fast and he always stutter. he is also
intrusive whenever he withdrawn from the interview which he interrupt the doctor as supported
in the time frame of 9:15. Incoherent speeches also noted as manifested by the patients
unclear statement during the interview as shown in the 00:55. but for us it still relevant
because he able to answer the questions appropriately. 4:32 stammering and clanging also
present in the patient during the video as shown in 5:20 and 1:15 timeframe. We observe also
Echolalia which he repeats phrases of the psychiatrist especially when asking as well as
perseveration which repeating also words but in excessive and obsessive manner.9:37 lastly
regarding to the patient's vocabulary, diction,syntax it is not appropriatte to his
socioeducational background because the patient is a mechanic as he stated but he cannot able
to pronounce or even know the word psychiatrist. instead he says trick cyclist as shown in the
time frame: 00:21

Affect
1. Appropriate to content
2. Apathetic
3. Inappropriate
4. Shallow
5. Blunted
6. Flattened
Remarks: The patient displays consistent expression appropriate to what he says. He does not
express blunted, shallow, or flattened affect.
III. Mood
1. Normal
2. Anxious
3. Sad, Depressed
4. Happy, Elated
 5. Worried, Perplexed
6. Labile
7. Mood and affect

Remarks: His emotional reactions are labile. Initially he is elated, but later he become irritable.
Thus, his affect mirrors his mood.
 IV. Perception
1. Hallucination
2. Illusion

Remarks: Visual and auditory hallucinations was noted. He said he heard God in his ears
and saying he is wonderful and fantastic. He described God as quite loud because He’s a big
bloke with big beard and he called him as beardy beardy and told that God doesn’t like it so
he call Him as Sir. No illusions noted.

V. Thought Process
1. Ambivalence
2. Circumstantial thinking
3. Clang association
4. Echolalia
5. Flight of ideas
6. Loose Association
7. Mutism
8. Neologism
9. Palilalia
10. Perseveration
11. Word salad
12. Stilted language
13. Tangential thinking
14. Thought blocking
15. Thought broadcasting
16. Thought insertion
17. Thought withdrawal

Remarks: His thought process somewhat shows clang association which makes word choices
based on the sound of the word rather than the meaning of the word. It may rely on using
rhymes and create sentences like his phrase "Doctor Who, diddly dang, woddly dang" and
"Name's a game" that don't make sense at all. He also has flight of ideas, circumstantial
thinking, loose association and tangential thinking which when he included a lot of unnecessary
and insignificant details in their conversation and he speaks rapidly and quickly shift between
loosely connected ideas when speaking. His ideas are connected, but he goes far off-topic and
does not return to the initial topic like - "How old...you're only as old as the woman you
feel...the way to a man's heart is through his stomach...food for the soul, a nice bit of sole". We
observe also Echolalia which he repeats phrases of the psychiatrist especially when asking as
well as perseveration which repeating also words but in excessive and obsessive manner. Word
salad is also very obvious because he has disorganized thinking which he struggles to create
consistent speech. He often creates new words or expressions while talking which is referred as
neologism.
VI. Thought content
1. Helplessness
2. Hopelessness
3. Worthlessness
4. Homicidal / Suicidal / thoughts or plans
 5. Compulsion
6. Delusion
7. Obsession
8. Phobia

Remarks: Delusion is noted, classifications are as follows:

 Religious delusions: God is communicating with him.
 Referential delusions: receiving clues or messages from the newspaper.
 Grandiose delusions: claimed to have special cancer-curing abilities, smarter than others,
and is able to converse with God.
Unable to comment on suicidal or homicidal ideation, obsessions, compulsions, and phobias, as
not directly asked.

VII. Sensorium (Not assessed in the video, unable to comment.)

1. Orientation
a. Time : _________
b. Place: ____________
c. Person: ______________
2. Memory
a. Recent: _______________
b. immediate: __________________________
c. Remote Memory: ________________
3. Attention and concentration
a. Digit Span (forward)
i. 372
ii. 4916
iii. 072807
iv. 04271971

b. Digit span (reversed)

i. 1622
ii. 5372
iii. 19386
iv. 359123
4. Abstraction
a. Proverbs
“Two heads are better than one”
 b. Similarities
Axe:saw: ________________________

Car: bicycle: ________________________

Remarks: