The Mini-Mental State Exam

Patient: Gallardo, N.P.

Examiner: Alas, Allado, Cervantes

Question/Situation
Orientation

Response

1. What is the (year) (season) (date)

- The client responded by saying July 1990. She cannot

(day) (month)?

determine the exact date and the season.

2. Where are we (state) (country) (town)

- She responded by saying 10 Aries St., Talomo, Davao

(hospital) (floor)?

City

Maximum

Score

Registration
3. Name 3 objects: 1 second to say

- The examiner names three objects in Filipino namely

each. Then ask the patient all 3 after you

"libro, mesa, silya". Then the client repeats by saying

have said them. Give 1 point for each

libro, mesa, silya.

correct answer.
Then repeat them until he/she learns all
Count trials and record.
Trials ___________
Date: July 10, 2016

Question/Situation
Attention and Calculation
4. Serial 7s. 1 point for each correct

Response

- She responded intermittently the letters D, L, R, O, W.

Maximum

Score

answer. Stop after 5 answers.

Alternatively spell world backward.
Recall
5. Ask for the 3 objects repeated above.
Give 1 point for each correct answer.
Language

3
- When asked to name the previously mentioned objects,
the client states it in English but jumbled in order. She
said book, chair, and table.

6. Name a pencil and watch.

7. Repeat the following No ifs, ands, or
buts

Question/Situation
Follow a 3-stage command:

2
She named Mongol and Seiko.

- She repeated the words in exact order: No ifs, ands, or

buts.

Response

2
1

Maximum

Score

8. Take a paper in your hand, fold it in

half, and put it on the floor.
9. Read and obey the following: CLOSE
YOUR EYES

- The client takes a paper given to her, folds it in half and

put it on the floor as instructed.

- She closes her eyes.

10. Write a sentence.

11. Copy the design shown.

1
1

ASSESS level of consciousness along a

continuum ____________
Alert Drowsy Stupor Coma
-

The client was alert the whole time along the

examination.

30
Total
26

Note : The maximum score is 30. A score of 23 or lower is indicative of cognitive impairment.