MUKTADHARA NURSING

INSTITUTION

LESSON PLAN ON
MENTAL STATUS EXAMINATION

POST BASIC B.Sc. NURSING I YEAR

IDENTIFICATION DATA :
Name -

Class -PBBSC II YEAR

Subject - Mental Health Nursing

Topic - Mental Status Examination

Time - 40 minutes

Place -PBBSC II year classroom

Group - PBBSC year students

Size of the group

Method of teaching -lecture cum discussion

A.V. Aids - Chalk Board, PPT

Language - English

Previous Knowledge of the group - Group does not have any knowledge about Mental Status Examination
GENERAL OBJECTIVES:

 At the end of the teaching, students will be able to gain in depth knowledge about Mental Status Examination.

SPECIFIC OBJECTIVES:

At the end of the teaching, students will be able to:

 define MSE.
 list down the purposes of MSE.
 describe the components of the MSE.
TIME SPECIFIC CONTENT TEACHING AV EVALUATION
OBJECTIVE LEARNING AIDS
ACTIVITIES

1min. To introduce Introduction:

the topic. The Mental Status Exam (MSE) is the psychological equivalent Lecture cum PPT
of a physical exam that describes the mental state and behavior discussion
of the person being seen. It includes both objective observations
of the clinician and subjective descriptions given by the patient.

Definition:
2min. To define a) A mental status examination is an assessment of a patient’s
MSE. PPT Define MSE.
level of cognitive ability (knowledge related), appearance, Lecture cum
emotional mood, speech and thought patterns at the time of discussion
evaluation.
b) MSE is a cross sectional, systemic documentation of the
quality of mental functioning at the time of interview.

Purposes:
2min. To list down  To reach a tentative diagnosis.
Chalk List down the purposes
the purposes of  To assess the presence and extent of a person’s mental Lecture cum
board, of MSE.
MSE. impairment. discussion
PPT
 It is the diagnosis of general cerebral functions.
 Important information can be taken from 1stsight also the
level of consciousness can be observed.

Components Of The Mental Status Examination

To describe the Lecture cum Chalk Enumerate the
30min components of 1. General Appearance and Behavior discussion board, components of the MSE.
. the MSE. 2. Speech PPT
3. Mood & Affect
TIME SPECIFIC CONTENT TEACHING EVALUATION
OBJECTIVE LEARNING
ACTIVITIES
4. Thought
5. Perception
6. Cognitive functions
7. Intelligence
8. Judgement
9. Insight

1.General Appearance and Behavior

 Appearance: Looking one’s age, Older/ younger
 Level of grooming: Normal/ Shabby/ Overdressed
 Level of Cleanliness: Adequate/ Inadequate/Overtly clean
 Level of consciousness: Fully conscious / Alert /Drowsy /
Stuporous/comatose
 Mode of entry: Came willingly / Persuaded/ Brought using
force
 Facial expression: Closed eyes/ Sad/ Happy/ Excited
 Co-operativeness: Normal/ More than so/ less than so
 Eye to eye contact: Maintained/ Difficult/ not maintained
 Psychomotor activity: Normal/ Increased/ Decreased
 Rapport: Spontaneous/ difficult/ Not established
 Gestures: Normal/ odd/ exaggerated
 Posture: Normal/ catatonic
 Catatonic Phenomenon: Automatic obedience/ Waxy
flexibility/ Negavitism/ excessive cooperation/ echoprexia/
echolalia.
 Compulsive act/Rituals: If any eg: Nail biting
 Sleeping and eating pattern-
TIME SPECIFIC CONTENT TEACHING EVALUATION
OBJECTIVE LEARNING
ACTIVITIES
 Hallucinating behavior- Smiling or crying without any
reason.

2. Speech:
 Initiation: Spontaneous/ Minimal/ Mute/ Speaks when
spoken to
 Reaction time: Normal/ Delayed/ shortened/ Difficult to
access
 Rate: Normal/ Slow/ rapid
 Productivity: Monosyllabic/ Elaborate replies/ Pressured
 Volume: Normal/ increased(loud)/ decreased(Soft)
 Tone: Normal/ High pitch/ Low pitch/ Monotonous
 Relevance: fully relevant/ off target/ irrelevant
 Speech activity: Usual Pattern/ unusual word
 Stream: Normal/ Tangential/ blocking/ flight of ideas
 Coherence: Fully coherent/ loosening of associations
 Others: rhyming/ echolalia/ neologism
 Speech pattern: Frightened/ commanding/ disturbed

3. MOOD:
 Subjective mood:
 Objective mood: Appropriate/ inappropriate/ Irritable/
Labile/ Blunt/ Flattened
 Intensity of happiness: Sad/ irritable/ anger/ worry/
suspiciousness/ Fearful/ Panic/ Cheerful/ Aggressive

4. THOUGHT:
 Stream: Normal/ racy thoughts/ poverty of thought/ thought
block/ unclear thoughts/ flight of ideas/ neologism
 Form: normal/ thought disorder
TIME SPECIFIC CONTENT TEACHING EVALUATION
OBJECTIVE LEARNING
ACTIVITIES
 Content:
o Delusions: Specify
o Ideas: Worthlessness/ helplessness/ hopelessness/
guilt/ suicidal ideas
o Thought alienation phenomena: thought insertion/
thought withdrawal/ thought broadcasting.
o Obsessional/ Compulsive phenomena: Thoughts/
images/ ruminations/ doubts/ impulsive rituals.
o Phobias (irrational fears):
o Any preoccupations

5. PERCEPTION:
.  Illusions:
 Hallucinations: auditory/ visual/ olfactory/ gustatory/ tactile

6. COGNITIVE FUNCTIONS:
 Level of consciousness: Conscious/ Cloudy/ Comatose/
Stupor/ Delerium
 Orientation: Time/ Place/ Person
 Attention: normally aroused/ Aroused with difficulty
o Digit forward: 1-100
o Digit backward: 100-1
 Concentration: Normally sustained/ sustained with
difficulty/ Distracted
o 100-7=?
o Backward name of months
o Forward name of months
 Memory:
o Immediate:
 o Recent: Last meal/ visitor
TIME SPECIFIC CONTENT TEACHING EVALUATION
OBJECTIVE LEARNING
ACTIVITIES
o Remote: personal event (birthday etc.)
Impersonal event: any event related day
Illness related events

7. INTELLIGENCE:
o General fund of information: eg: Who is the Prime
Minister of India?
o Arithmatic ability: eg: 2+2=4

8. JUDGEMENT:
o Rate/ Specify: Excellent/ Good/ Poor/ Impaired
o Personal judgement: Intact/ Impaired
o Social judgement: Intact/ Impaired
o Test judgement (Present the situation and ask their response
to the situation): Intact/ Impaired

9. INSIGHT:
o Rate/ Specify: Full/ complete/ Partial/ limited/ Poor/ Nil
o Awareness of abnormal behavior: yes/ maybe/ No
o Attribution of physical cause: yes/ maybe/ No
o Recognition of personal responsibility : yes/ maybe/ No
o Willingness to take treatment: yes/ maybe/ No
To summarize Lecture cum Chalk
2min. SUMMARY: discussion board
the topic.
Today, we have discussed about Mental Status Examination, its
definition, purposes and components.
3min. To conclude
CONCLUSION Lecture cum PPT
the topic.
The MSE is an important diagnostic tool in both neurological discussion
 and psychiatric practice. MSE is used to describe a patient’s
mental state and behaviors both quantitatively and qualitatively.
BIBLIOGRAPHY
 Sreevani R, A Guide to Mental health & Psychiatric Nursing, 3rd edition, Jaypee Brothers Medical Publishers (P) LTD. N.
Delhi, Page no. 326-28.
 Gupta Ram Kumar, A textbook of Mental Health and Psychiatric Nursing, edition, 2016, S. Vikas& Company Medical
Publishers, India, Page no. 44-47.