Lesson 8 — Neurology and Mental Health Assisting
All procedural steps, PURPOSE rationales, and topic content below are verbatim from MedCerts HLT420A Storyline modules. Quiz items have been normalized to multiple-choice format with verbatim source rationales. Reference textbook: Niedzwiecki & Pepper, Kinn's The Clinical Medical Assistant, 15th ed., Chapter 22 & 23. No outside material added.
- Differentiate central and peripheral nervous system disorders
- Discuss common mental health conditions
- Describe preparation for a neurological examination
- Summarize the neurological examination and the medical assistant's role
Mental Health Screenings
Mental health screenings can be instrumental in assessment of overall health and wellness.
Mental health testing, also known as neurocognitive testing, evaluates cognitive and emotional health. The assessment is determined by the physician. The Mini-Mental State Examination, or M-M-S-E, is one common tool used with patients who have Alzheimer's or dementia. The Folstein test is another name for M-M-S-E. The Montreal Cognitive Assessment is an additional screening instrument for dementia or Alzheimer's.
Under the direction of the physician, the clinical medical assistant may obtain a mental health questionnaire. Patients may answer questions in the exam room or complete a questionnaire upon check-in. The physician uses the answers to help assess the patient's emotional state or mood.
Depression screening is most common and asks questions like: Have you lost interest or pleasure in doing things? Do you feel down or hopeless? Do you have trouble falling or staying asleep? Or: Do you sleep too much? Do you feel listless or lack energy? Or: Do you have trouble concentrating? Patients may be ranked each answer with clarifiers like never, sometimes, most times, or always.
Questions may be broad, such as: How would you rate your overall mental health on a range from poor to excellent? Or they may be specific to sleep, work, or daily activities, such as: In your daily life, do you feel depressed, sad, or anxious? Or: Do these feelings affect your relationships or impact your job? And: Have your dietary or sleep habits changed? Geriatric depression screening tools also consider activities or conditions that affect daily life. For example, a patient experiencing loss of vision, hearing, or taste may lose general interest in tasks requiring these senses. They may be grieving the loss of memory, language, and ability to think. Factors like this impact daily living, interest, and feelings.
The M-A may notice specific behaviors and actions, such as a patient who is: Friendly or withdrawn, Shy or talkative, Hostile or irritable, Relaxed and cooperative. General observations based on physical appearances may be made in relationship to clothing, grooming, and posture. The M-A will document emotional responses such as body movements, eye contact, and facial expressions.
As the M-A becomes more familiar with patients, changes in behavior or mood may be noticed. These observations should be privately shared with the physician before the exam. With this knowledge, the physician will be better prepared to address the patient.
Neurology Assisting
Goal: To assist the provider in performing a neurologic examination of the patient.
- Patient's record
- Patient gown
- Drape
- Otoscope, Ophthalmoscope
- Percussion hammer
- Disposable pinwheel
- Penlight
- Tuning fork
- Cotton ball
- Tongue depressor
- Small vials of warm and cold liquids prepared according to the provider's instructions
- Small vials of sweet and salty liquids prepared according to the provider's instructions
- Small vials containing substances with distinct odors (e.g., instant coffee, cinnamon, vanilla) prepared according to the provider's instructions
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Assemble and prepare the equipment and supplies needed for the neurologic examination, and prepare the room.
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Sanitize your hands and follow Standard Precautions.Purpose
To ensure infection control.
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Greet and identify the patient by name and date of birth, and introduce yourself. Briefly explain the procedure.Purpose
Explanations gain the patient's cooperation and ease apprehension.
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Instruct the patient to disrobe as needed for the examination and to put on an exam gown with the opening in the back.
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During the examination, be prepared to assist the patient in changing positions as necessary.
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Have the necessary examination instruments ready for the provider at the appropriate time during the examination.
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Record all results from the examination as indicated by the provider.Purpose
To facilitate a thorough, accurate neurologic examination.
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A neurologic examination proceeds as follows but can be modified according to the provider's preference: Mental status examination, Proprioception and cerebellar function, Cranial nerve assessment, Sensory nerve function, Reflexes.Purpose
Understand the neurologic exam to assist the provider.
Knowledge-check items
Click an answer to lock it in — you'll see the rationale below. Reset any time to re-attempt. Items originally formatted as true/false, fill-in-blank, or drag-and-drop have been normalized to multiple choice; the source format is noted in the eyebrow.
L08-01 · Mental Health Screenings
"Mental status testing, also known as neurocognitive testing, evaluates both cognitive and emotional health."
Mental health testing, also known as neurocognitive testing, is designed to assess both the cognitive functioning and emotional well-being of the patient.
"Mental health questions are targeted to assess the patient's emotional state and mood."
The mental health questionnaire provides information that helps the physician understand the patient's overall emotional state and current mood.
"Screening questions may be broad, assessing general overall mental health, or they may be specific, considering aspects of the patient's daily life, like work, sleep, diet, and daily activities."
Mental health screening questions range from broad questions about overall mental health to specific questions about particular areas of daily functioning.
"General observations based on physical appearances may be made in relationship to clothing, grooming, and posture."
When observing a patient's physical appearance as part of mental health assessment, the MA should note clothing, grooming habits, and posture, as these can indicate mental health status.
"As the MA becomes more familiar with patients, changes in mood or behavior may be observed. The physician will be more prepared to address the patient if provided this information before the exam."
Sharing observations before the exam allows the physician to be better prepared to address the patient's mental health needs during the examination.
L08-02 · Neurology Assisting
"A neurologic examination proceeds as follows but can be modified according to the provider's preference: Mental status examination, Proprioception and cerebellar function, Cranial nerve assessment, Sensory nerve function, Reflexes."
Proprioception and cerebellar function assessment is one of the standard components of a comprehensive neurologic examination.
"Instruct the patient to disrobe as needed for the examination and to put on an exam gown with the opening in the back."
The exam gown should be positioned with the opening in the back to allow the provider access to the patient's back and posterior surfaces during the neurologic examination.
"Sanitize your hands and follow Standard Precautions. PURPOSE: To ensure infection control."
Hand sanitization is an essential step in maintaining infection control and following Standard Precautions during all patient care procedures, including neurologic examinations.