When carrying out a mental status exam on a non-English speaking ...

[sdfghj]

When carrying out a mental status exam on a non-English speaking patient, it is important to have a(n):
 
  A. Patient's family member, who is bilingual, interpret for the patient
  B. Objective interpreter ask the questions for the patient
  C. Friend of the patient interpret the questions for the patient
  D. Any of the above is acceptable

Question 2

A 43-year-old female was in a bicycling accident and complains of severe pain of the right foot. The patient limps into the emergency room. On physical examination, there is no point tenderness over the medial or lateral ankle malleolus.
 
  There is no foot tenderness except at the base of the fifth metatarsal bone. According to the Ottawa foot rules, should an x-ray of the feet be ordered?
  A. Yes, there is tenderness over the fifth metatarsal
  B. No, there is not tenderness over the navicular bone
  C. Yes, the patient cannot bear weight on the foot
  D. A and C

[matt95]

Answer to Question 1

ANS: B
Ask the family or significant other whether the patient's behavior patterns have changed. If the patient does not speak or write English, have an interpreter available during the examination. It is important to have an objective interpreter ask the patient translated questions. The patient may not be truthful or forthcoming if he/she knows the interpreter. A friend or relative may slant the mental status exam questions or influence the patient regarding the answers. A good screening tool for use in the outpatient setting is the Mini-Mental Status Exam, described in detail in Chapter 20.

Answer to Question 2

ANS: D
Foot Rule: Order film if one of the following is met:
Inability to bear weight for four steps (both immediately and in emergency department)
Bone tenderness at navicular or base of fifth metatarsal
Sensitivity = 100
Specificity = 79