NR 548 Exam 3: (Latest 2026/2027 Update) Cognitive Assessment & Mental
Status Exam | Q&A | Grade A | 100% Correct (Verified Answers) –
Chamberlain University
Subject: Psychiatric-Mental Health Nurse Practitioner (PMHNP) – Cognitive Assessment, Attention
Testing, Mini-Cog, Mental Status Exam (MSE) Components, Documentation
Source: NR 548 Exam 3 / Chamberlain University / Clinical Assessment Guidelines (2026/2027 Update)
Format: Q&A Guide with Clinical Rationales | Grade A Guaranteed
1. What is the digit span test?
Correct Answer: An attention test in which a series of numbers is read to subjects and they are asked to
repeat forward and backwards. No studies show good results on this test.
1. Digit span assesses attention and working memory.
2. Forward digit span measures attention; backward digit span measures working memory.
However, this test has limited research support for validity.
2. What is the SSST (Serial Sevens Subtraction Test)?
Correct Answer: An attention test in which the patient is asked to count backwards from 100 by 7 until
told to stop. No studies show good results on this test.
1. Serial sevens measures attention and concentration.
2. It can be challenging for patients with lower education levels. Alternative: "world" spelled
backwards.
3. What is the months backward test (MBT)?
Correct Answer: An attention test in which the patient is asked to recite the months of the year
backwards. Should be able to complete in about 20 seconds. If not, strongly suggests cognitive
impairment. This test has shown to be fairly sensitive.
1. MBT is a sensitive screening tool for cognitive impairment.
2. Unlike serial sevens, it is not influenced by mathematical ability or education level.
4. What is the best way to assess attention and concentration in a patient?
Correct Answer: Simply talk to the patient. Observe whether they are able to concentrate on the
question and maintain a train of thought while answering. If so, their attention is intact.
1. Clinical observation during natural conversation is often the most valid attention assessment.
2. Formal tests supplement but do not replace clinical observation.
, 5. How is the Mini-Cog examination conducted?
Correct Answer: First, ask the patient to memorize 3 simple words. Second, ask them to draw a clock
showing the time 11:10. Once the clock is drawn, ask them to say back the 3 words.
1. The Mini-Cog takes only 3-5 minutes to administer.
2. Clock drawing assesses executive function and visuospatial skills; word recall assesses
memory.
6. How is the Mini-Cog scored?
Correct Answer: A total score of 0, 1, or 2 indicates higher likelihood of clinically important cognitive
impairment. A total score of 3, 4, or 5 indicates lower likelihood of dementia but does not rule out some
degree of cognitive impairment.
1. Score = 3-item recall (0-3) + clock drawing (0-2).
A score of 3-5 is reassuring for dementia but does not exclude mild cognitive impairment.
7. What are the elements of the Mental Status Exam (MSE)?
Correct Answer: Appearance, Behavior, Speech, Affect, Thought Process, Thought Content, Cognitive
Examination (includes insight and judgment).
1. The MSE is the psychiatric equivalent of the physical exam.
2. Each domain contributes essential diagnostic information.
8. What is assessed under Behavior in the MSE?
Correct Answer: How the client presents themselves during the examination. Assess eye contact,
psychomotor activity (increased or decreased), movements, mannerisms, stereotypies, posturing, gait,
and how the client responds to the exam (responses appropriate? sit still?).
1. Psychomotor agitation suggests mania or anxiety; psychomotor retardation suggests
depression.
2. Gait abnormalities may indicate neurologic conditions or medication side effects.
9. What aspects of speech are assessed in the MSE?
Correct Answer: Rate (slow, fast, pressured); rhythm; latency (how fast they respond); volume (high,
low); content (thoughtful, articulate, rambling, vague).
1. Pressured speech is characteristic of mania/hypomania.
2. Latency (prolonged pauses) may occur in depression or cognitive impairment.
10. What is the difference between mood and affect in the MSE?
Correct Answer: Mood is the patient's report of how they feel (subjective). Affect is your impression of
their emotional state (objective observation).
1. Mood: what the patient says ("I feel depressed"). Affect: what you observe (facial expression,
tone).
2. Incongruent affect (laughing while discussing sad topics) is clinically significant.
Status Exam | Q&A | Grade A | 100% Correct (Verified Answers) –
Chamberlain University
Subject: Psychiatric-Mental Health Nurse Practitioner (PMHNP) – Cognitive Assessment, Attention
Testing, Mini-Cog, Mental Status Exam (MSE) Components, Documentation
Source: NR 548 Exam 3 / Chamberlain University / Clinical Assessment Guidelines (2026/2027 Update)
Format: Q&A Guide with Clinical Rationales | Grade A Guaranteed
1. What is the digit span test?
Correct Answer: An attention test in which a series of numbers is read to subjects and they are asked to
repeat forward and backwards. No studies show good results on this test.
1. Digit span assesses attention and working memory.
2. Forward digit span measures attention; backward digit span measures working memory.
However, this test has limited research support for validity.
2. What is the SSST (Serial Sevens Subtraction Test)?
Correct Answer: An attention test in which the patient is asked to count backwards from 100 by 7 until
told to stop. No studies show good results on this test.
1. Serial sevens measures attention and concentration.
2. It can be challenging for patients with lower education levels. Alternative: "world" spelled
backwards.
3. What is the months backward test (MBT)?
Correct Answer: An attention test in which the patient is asked to recite the months of the year
backwards. Should be able to complete in about 20 seconds. If not, strongly suggests cognitive
impairment. This test has shown to be fairly sensitive.
1. MBT is a sensitive screening tool for cognitive impairment.
2. Unlike serial sevens, it is not influenced by mathematical ability or education level.
4. What is the best way to assess attention and concentration in a patient?
Correct Answer: Simply talk to the patient. Observe whether they are able to concentrate on the
question and maintain a train of thought while answering. If so, their attention is intact.
1. Clinical observation during natural conversation is often the most valid attention assessment.
2. Formal tests supplement but do not replace clinical observation.
, 5. How is the Mini-Cog examination conducted?
Correct Answer: First, ask the patient to memorize 3 simple words. Second, ask them to draw a clock
showing the time 11:10. Once the clock is drawn, ask them to say back the 3 words.
1. The Mini-Cog takes only 3-5 minutes to administer.
2. Clock drawing assesses executive function and visuospatial skills; word recall assesses
memory.
6. How is the Mini-Cog scored?
Correct Answer: A total score of 0, 1, or 2 indicates higher likelihood of clinically important cognitive
impairment. A total score of 3, 4, or 5 indicates lower likelihood of dementia but does not rule out some
degree of cognitive impairment.
1. Score = 3-item recall (0-3) + clock drawing (0-2).
A score of 3-5 is reassuring for dementia but does not exclude mild cognitive impairment.
7. What are the elements of the Mental Status Exam (MSE)?
Correct Answer: Appearance, Behavior, Speech, Affect, Thought Process, Thought Content, Cognitive
Examination (includes insight and judgment).
1. The MSE is the psychiatric equivalent of the physical exam.
2. Each domain contributes essential diagnostic information.
8. What is assessed under Behavior in the MSE?
Correct Answer: How the client presents themselves during the examination. Assess eye contact,
psychomotor activity (increased or decreased), movements, mannerisms, stereotypies, posturing, gait,
and how the client responds to the exam (responses appropriate? sit still?).
1. Psychomotor agitation suggests mania or anxiety; psychomotor retardation suggests
depression.
2. Gait abnormalities may indicate neurologic conditions or medication side effects.
9. What aspects of speech are assessed in the MSE?
Correct Answer: Rate (slow, fast, pressured); rhythm; latency (how fast they respond); volume (high,
low); content (thoughtful, articulate, rambling, vague).
1. Pressured speech is characteristic of mania/hypomania.
2. Latency (prolonged pauses) may occur in depression or cognitive impairment.
10. What is the difference between mood and affect in the MSE?
Correct Answer: Mood is the patient's report of how they feel (subjective). Affect is your impression of
their emotional state (objective observation).
1. Mood: what the patient says ("I feel depressed"). Affect: what you observe (facial expression,
tone).
2. Incongruent affect (laughing while discussing sad topics) is clinically significant.
