Mental Status Exam for COPD Patient

This article presents the mental status exam of a 68-year-old male COPD patient. It includes his medical history, physical examination, current medications, family and social history, and MMSE interpretation. The MMSE score interpretation is also provided in the article.

Running head: MENTAL STATUS EXAM
MENTAL STATUS EXAM
Name of the Student:
Name of the University:
Author Note:

1MENTAL STATUS EXAM
The patient Mr. J, was a 68 year old Caucasian male who was presented to the
emergency department at the hospital as he was suffering from COPD. His past medical
histories show that the FEV1 was 38% almost six weeks ago. He recent CXR showed that he
had a flattened diaphragm along with an AP diameter. At the age of 34 he had appendectomy.
His nose and right arm had been broken as a child.
The physical examination showed that the sounds of breathing had decreased
markedly bilaterally in addition to there were crackles in the right lower lobe. There was also
presence of wheezes in the upper left lobe. The assessment showed visible use of the
accessory muscles. The vitals of the patient were as follows: O2 Saturation 93% room air,
95% O2 on 2lpm. Respiratory rate 24 and shallow, HR 94, BP 150/88.
The current medications which he was taking included Prednisone 10mg q day /
DuoNeb q 4 hrs. / Ibuprofen 400mg BID / Tums prn. The respiratory history of the patient
included that he had asthma as a child. He also had been exposed to the cooking fumes and to
the second hand smoke from cigarettes. The patient also noticed that he was having
difficulties recently like increased cough and felt chest tightening while visiting the art studio
of his wife.
The family history of the patient involved his father having emphysema because of which he
died at the age of 69. Whereas his mother died at the age of 62 while suffering from breast
cancer.
The patient Mr. J had been presented to the Phase II Pulmonary Rehab intake
interview where he appeared to quite dishevel. He was wearing pajama pants along with a
sweatshirt paired with bedroom slippers. His wife accompanied him along with his daughter
who appeared to be quite well dressed. The patient states that the rehab interview will be of
no help to him and that he was just doing this because of his wife and daughter. His wife

2MENTAL STATUS EXAM
reported that the patient had walked outside a little with their grandchildren last Sunday and
got so short of breath, when he almost collapsed.
The social life of the patient included that he was living with his wife who has been
with him for 43 years, who was an artist. They had two children who live about 30 miles
within Mr.J’s house. The patient was a building contractor and he had retired three years ago.
While he was working he was making well and living a good life. He could sent all his
children to college. He mentioned that he was very strong back then however now he has
turned very tired and is tied to his nebulizer. Right now all he does is he sits idle in his chair
while watching television.
Maximum Score Patient’s Score Questions
5 3 “What is the year? Season? Date? Day of the
week? Month?”
5 2 “Where are we now: State? County? Town/city?
Hospital? Floor?”
3 2 The examiner names three unrelated objects clearly
and slowly, then asks the patient to name all three
of them. The patient’s response is used for scoring.
The examiner repeats them until patient learns all
of them, if possible. Number of trials:
___________
5 3 “I would like you to count backward from 100 by
sevens.” (93, 86, 79, 72, 65, …) Stop after five
answers. Alternative: “Spell WORLD backwards.”
(D-L-R-O-W)
3 2 “Earlier I told you the names of three things. Can

3MENTAL STATUS EXAM
you tell me what those were?”
2 2 Show the patient two simple objects, such as a
wristwatch and a pencil, and ask the patient to
name them.
1 1 “Repeat the phrase: ‘No ifs, ands, or buts.’”
3 2 “Take the paper in your right hand, fold it in half,
and put it on the floor.” (The examiner gives the
patient a piece of blank paper.)
1 1 “Please read this and do what it says.” (Written
instruction is “Close your eyes.”)
1 1 “Make up and write a sentence about anything.”
(This sentence must contain a noun and a verb.)
1 0 “Please copy this picture.” (The examiner gives the
patient a blank piece of paper and asks him/her to
draw the symbol below. All 10 angles must be
present and two must intersect.)
30 19 TOTAL
Interpretation of the MMSE
Method Score Interpretation
Single Cutoff <24 Abnormal
Range <21
>25
Increased odds of dementia
Decreased odds of dementia

4MENTAL STATUS EXAM
Education 21
<23
<24
Abnormal for 8th grade education
Abnormal for high school education
Abnormal for college education
Severity 24-30
12-23
0-17
No cognitive impairment
Mild cognitive impairment
Severe cognitive impairment
References

5MENTAL STATUS EXAM
Folstein, M. F., Robins, L. N., & Helzer, J. E. (1983). The mini-mental state
examination. Archives of general psychiatry, 40(7), 812-812.
Rovner, B. W., & Folstein, M. F. (1987). Mini-mental state exam in clinical
practice. Hospital practice (Office ed.), 22(1A), 99-103.