For this assignment, list the parts of a comprehensive mental status examination (MSE) for mental health patients. Give examples of each and describe the significance to the advanced practice nurse.
Sample solution
Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell.
In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.
God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.
Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.
To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.
References
Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.
Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.
Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.
Sample Answer
Sample Answer
Comprehensive Mental Status Examination (MSE) for Mental Health Patients
The Mental Status Examination (MSE) is an essential tool used by mental health professionals to assess a patient’s current mental state. It provides a structured framework for gathering pertinent information about a patient’s cognitive, emotional, and behavioral functioning. For advanced practice nurses (APNs), conducting a thorough MSE is crucial for diagnosing mental health conditions, developing treatment plans, and monitoring patient progress. Below are the key components of a comprehensive MSE, along with examples and their significance to advanced practice nursing.
1. Appearance
Example:
– A patient may present as disheveled with unkempt hair, wearing inappropriate clothing for the weather (e.g., a heavy coat in warm weather).
Significance:
– The appearance can provide insight into the patient’s self-care and level of functioning. Changes in appearance may indicate worsening mental health or engagement levels, guiding the APN in assessing the severity of the patient’s condition and potential need for intervention.
2. Behavior
Example:
– A patient may exhibit restlessness, pacing back and forth, or may appear withdrawn and avoid eye contact during the assessment.
Significance:
– Observing behavior helps in understanding the patient’s level of agitation, anxiety, or depression. It also informs the APN about how the patient may interact with others in different settings, aiding in formulating a treatment plan tailored to their behavioral patterns.
3. Speech
Example:
– The patient might speak rapidly and incoherently (pressured speech) when experiencing mania or may speak softly and slowly (poverty of speech) when depressed.
Significance:
– Speech patterns can indicate cognitive processes and emotional states. For instance, rapid speech may suggest mania or anxiety, while slowed speech could reflect depression or cognitive impairment. This information is vital for determining appropriate therapeutic interventions.
4. Mood and Affect
Example:
– A patient reports feeling “numb” or “empty,” while their affect is flat, showing little emotional expression. Conversely, they might report extreme happiness while displaying inappropriate laughter during serious topics.
Significance:
– Mood reflects the patient’s self-reported emotional state, while affect refers to observed emotional expression. Discrepancies between mood and affect can provide critical insights into underlying mental health conditions, such as mood disorders or personality disorders, which are essential for diagnosis and treatment.
5. Thought Process
Example:
– A patient might demonstrate tangential thinking or flight of ideas during the interview, jumping from one topic to another without logical connections.
Significance:
– The evaluation of thought process helps determine the organization and coherence of a patient’s thoughts. Disorganized thinking can indicate psychosis or severe anxiety disorders, necessitating specific therapeutic approaches and interventions.
6. Thought Content
Example:
– A patient may express delusional beliefs (e.g., believing they are being persecuted) or have obsessive thoughts about cleanliness that interfere with daily functioning.
Significance:
– Assessing thought content allows the APN to identify any harmful or distorted beliefs that could impact the patient’s behavior and safety. This is essential for risk assessment and developing effective treatment strategies.
7. Perception
Example:
– The patient reports hearing voices that are not present (auditory hallucinations) or seeing things that do not exist (visual hallucinations).
Significance:
– Evaluating perception helps identify hallucinations or other perceptual disturbances. Understanding a patient’s perceptual experiences is crucial for appropriate diagnosis and the formulation of a treatment plan, especially when considering medication management.
8. Cognition
Example:
– The patient might be assessed for orientation by asking questions like “What is your name? Where are you? What day is it?” A patient who cannot answer these questions appropriately may have cognitive impairments.
Significance:
– Cognitive assessment checks memory, attention, and orientation. Identifying cognitive deficits can inform the advanced practice nurse about the need for cognitive rehabilitation strategies and support systems to enhance the patient’s quality of life.
9. Insight and Judgment
Example:
– A patient might show poor insight by not recognizing that their behavior is problematic (e.g., denying substance abuse issues) or demonstrate good judgment by making realistic plans for future treatment.
Significance:
– Insight refers to the patient’s awareness of their condition, while judgment evaluates decision-making abilities. Understanding a patient’s level of insight and judgment is crucial for tailoring interventions and fostering collaboration in treatment planning.
Conclusion
The Mental Status Examination (MSE) is a critical component of psychiatric assessment that provides a comprehensive overview of a patient’s mental state. For advanced practice nurses, mastering the MSE allows for accurate diagnosis, effective treatment planning, and monitoring of progression within mental health care. By systematically evaluating each component, APNs can ensure holistic approaches to patient care that address both immediate needs and long-term mental health goals.
