MMSE - Mini-Mental State Examination Following a 3-Stage Command Questions and Answers — Questions and Answers
Question 1: An examiner administers the 3-stage command to a patient. The patient takes the paper in their LEFT hand, folds it in half correctly, and places it on the floor. How many points should be awarded?
- 0 points
- 1 point
- 2 points (Correct answer)
- 3 points
Correct answer: 2 points
One point is awarded for each correctly performed part of the command. The patient correctly 'folded it in half' (1 point) and 'put it on the floor' (1 point). However, the first part, 'take the paper in your right hand,' was performed incorrectly because the left hand was used. Therefore, the total score is 2.
Question 2: Which of the following describes the correct procedure for an examiner administering the 3-stage command?
- Demonstrate the actions while giving the command.
- Give the entire command once, without repeating or providing non-verbal cues. (Correct answer)
- Break the command into three separate instructions, waiting for compliance after each.
- Repeat the command until the patient indicates they understand.
Correct answer: Give the entire command once, without repeating or providing non-verbal cues.
The standard protocol for the 3-stage command requires the examiner to state the complete instruction only once. This is to assess the patient's ability to comprehend, retain, and execute a multi-step instruction without assistance or prompting. Repeating, demonstrating, or breaking up the command invalidates the assessment of this specific cognitive function.
Question 3: A patient is given the 3-stage command. They take the paper in their right hand, but then immediately hand it back to the examiner. What score should be recorded?
- 0 points
- 1 point (Correct answer)
- 2 points
- 3 points
Correct answer: 1 point
The patient successfully completed only the first part of the three-part command: 'Take the paper in your right hand.' They did not proceed to fold the paper or put it on the floor. Therefore, they earn exactly one point for the single completed action.
Question 4: The 3-stage command task primarily assesses which of the following cognitive functions?
- Long-term memory and abstract reasoning
- Visuospatial construction and orientation
- Attention and calculation
- Language comprehension and praxis (Correct answer)
Correct answer: Language comprehension and praxis
This task requires the patient to first understand the verbal instructions (language comprehension) and then plan and execute the sequence of physical actions (praxis). It is a measure of the ability to translate auditory information into a correct motor response.
Question 5: What is the maximum score a patient can achieve on the 'Following a 3-Stage Command' section of the MMSE?
- 3 points (Correct answer)
- 1 point
- 5 points
- 2 points
Correct answer: 3 points
The command consists of three distinct actions. A point is awarded for each action the patient correctly performs, leading to a maximum possible score of 3.
Question 6: An examiner administers the 3-stage command by saying, "First, take this paper in your right hand." After the patient complies, the examiner says, "Good, now fold it in half." This method of administration would be considered:
- Correct, as it ensures the patient understands each step.
- Incorrect, because it invalidates the assessment of following a multi-step instruction. (Correct answer)
- Correct, but only if the patient has a known hearing impairment.
- Incorrect, because the examiner should not provide positive feedback like "Good."
Correct answer: Incorrect, because it invalidates the assessment of following a multi-step instruction.
The core purpose of this task is to assess if the patient can hear, remember, and execute a sequence of three actions given at once. By breaking the command into individual steps, the examiner is no longer testing this ability. The standard procedure requires giving the full command a single time.
MMSE - Mini-Mental State Examination Following a 3-Stage Command Questions and Answers
An examiner administers the 3-stage command to a patient.
The patient takes the paper in their LEFT hand, folds it in half correctly, and places it on the floor.
How many points should be awarded?