Quality Indicator Section C: Cognitive PatternsOnline version
Test your knowledge on the Brief Interview of Mental Status with this fun quiz game!
1
The nurse is completing an admission assessment on Steve who had a stroke. During the admission assessment, Steve has been responding verbally to the nurse and has been able to be understood. What cognitive assessment should the nurse complete first with Steve?
2
The interviewer says, “The words are sock, blue, and bed. Now please tell me the three
words.” The patient replies, “Shoe, bed, black.” The interviewer repeats the three words plus
the category cues, saying, “Let me say the three words again. They are sock, something to
wear; blue, a color; and bed, a piece of furniture. Now tell me the three words.” The patient
says, “Oh yes, that’s right, sock, blue, bed.” What was Steve's score for repetition of three words?
3
The date of interview is April 4, 2025. Steve, responding to the statement, “Please tell
me what year it is right now,” states that it is 2025. What would you score Steve in "able to report correct year"?
4
The date of interview is April 4, 2025. The nurse asks Steve, "What month are we in right now?" and Steve responds with "May". What would you score Steve in "able to report correct month"?
5
The date of interview is Friday, April 4, 2025. The nurse asks, "What day of the week is today?" Steve responds with "Tuesday, isn't it?" What would you score Steve in "able to report correct day of the week"?
6
The nurse states, "Let's go back to an earlier question. What were those three words I asked you to repeat?" Steve responds, "Oh boy, uh, I think it was black, shoe, and bed". The nurse states, "One word is something you wear, one is a color, and the last word was a piece of furniture." Steven becomes agitated and states, "Yes, that's what I said, black shoe, and bed." What would you score Steve in his ability to recall "sock"?
7
The nurse states, "Let's go back to an earlier question. What were those three words I asked you to repeat?" Steve responds, "Oh boy, uh, I think it was black, shoe, and bed". The nurse states, "One word is something you wear, one is a color, and the last word was a piece of furniture." Steven becomes agitated and states, "Yes, that's what I said, black shoe, and bed." What would you score Steve in his ability to recall "blue"?
Choose one or more answers
8
The nurse states, "Let's go back to an earlier question. What were those three words I asked you to repeat?" Steve responds, "Oh boy, uh, I think it was black, shoe, and bed". The nurse states, "One word is something you wear, one is a color, and the last word was a pieve of furniture." Steven becomes agitated and states, "Yes, that's what I said, black shoe, and bed." What would you score Steve in his ability to recall "bed"?
9
Steve completed the BIMS with the nurse and scored a 7 out of 15 indicating a severe impairment. Should the Staff Assessent for Mental Status be conducted?
10
The nurse is now completing the Signs and Symptoms of Delirium (from CAM). Steve's significant other is present and states to the nurse, "This isn't like Steve." Is there evidence of an acute change in mental status from the patient’s baseline?
11
Throughout the BIMS, the nurse cued Steve a few times to pay attention and they had to repeat a few of the questions. Steve's significant other stated, "He had trouble answering the doctor's questions earlier." The nurse also confirmed that the therapists had difficulty keeping Steve on task during their evaluations. "Did the patient have difficulty focusing attention, for example being easily distractible or having difficulty keeping track of what was being said?"
12
Even though Steve was agitated towards the end of the interview, he did not demonstrate any disorganized thinking and stayed on task when cued. "Was the patient’s thinking disorganized or incoherent (rambling or irrelevant conversation, unclear or illogical flow of ideas, or unpredictable switching from subject to subject)?"
13
Steve was alert and maintained wakefulness throughout the interview. Later the OT came out of the room and said Steve was falling asleep when the OT was trying to complete their evaluation. "Did the patient have altered level of consciousness as indicated by any of the following criteria? vigilant - startled easily, lethargic - repeatedly dozed off when being asked questions, but responded to voice or touch, stuporous - very difficult to arouse and stay aroused, comatose - could not be aroused"
Feedback
The BIMS should be attempted with everyone, exceptions include if the patient is
rarely/never understood; cannot respond verbally, in writing, or using another method; or
an interpreter is needed but not available.
The patient repeated one of the three items on the first attempt. Patients are
scored based on the first attempt.
If the BIMS was completed and scored between 00 and 15, skip this assessment.
If patient has an alteration in mental status observed in the assessment period or in the cognitive assessment (e.g., BIMS) that represents an acute change from baseline.
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