A woman brought her husband saying she wants the ‘thing’ on his forehead removed. The
husband is refusing tx saying it improves his thinking. What is the next most appropriate next
step?
a. Assess his mental capacity to refuse tx
b. Remove lesion
c. Refer to ED
d. Mini-mental state exam
e. Refuse surgery and send pt back
answer: D , no indication that he needs treatment, so let's find out if he's sane or just eccentric!
The mental state examination is a structured way
of observing and describing a patient’s current state of mind, under
the domains of appearance, attitude, behavior, mood and affect, speech,
thought process, thought content, perception, cognition and insight.
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