When performing a mental status examination on an older adult client,

QUESTION

When performing a mental status examination on an older adult client, the nurse discovers that the client is illiterate and only has a third-grade education. How should the nurse assess the client’s cognition?

a. Have the client spell the word “world” backwards.
b. Have the client spell the word “world” forwards.
c. Ask the client to perform serial 7s.
d. Instruct the client to state the days of the week backwards.

ANSWER:

ANS: D
The nurse should determine the client’s level of formal education. If the client never learned to spell, it will be impossible to spell “world” backwards. Saying the days of the week backwards is a good alternative. Spelling and use of serial 7s would not be an appropriate alternative with this client’s level of formal education.