Critical neurological and psychiatric practice diagnostic tool

Mental Status Examination (MSE) is a critical neurological and psychiatric practice diagnostic tool.

case study

Mr Fred Robinson is a 24-year-old man from Derby (2392 km from Perth) in the Kimberley Region of Western Australia. He has a supportive family consisting of his father, mother, three brothers, and friends. Fred is usually presented well. when found, he is dishevelled, unwashed, wearing one shoe, a woollen jumper, beany, and boardshorts.

The police escorted him to the local public hospital after he was observed muttering to himself and pacing near the railing of a bridge next to the railway yard. They found a bag of ripped clothing and papers, a bible, a wallet, and an unlabeled medicine bottle containing numerous coloured tablets near him.

Initially, Fred was uncooperative when questioned by the police, and he accused them of trying to take thoughts from his head. He subsequently became aggressive and displayed violent behaviour by attempting to punch a police officer and shouting at the others. He was restless, overactive, singing loudly, and it was difficult to calm him.

Following scrutiny of his bag, the hospital staff contacted Fred’s parents and informed them of his whereabouts. They reported that Fred had been missing for five days, and they feared for his safety as he recently revealed to them that he had been hearing voices telling him to jump from the bridge that was located near the town.

Following examination by a doctor at the hospital, he was sedated and restrained and referred via the Royal Flying Doctor Service, with a nurse and police escort for admission to a medium-security ward at an ‘approved hospital’ in Perth.

Based on the above case scenario, address the following questions:

An introductory paragraph Presents a brief overview of the main presenting issues outlined in the case scenario. Briefly describe what the psycho-social issues pertaining to this client are that need to be taken into account by the nurses to ensure that Fred receives the most therapeutic care and outcome. In your answer, you need to consider issues of safety, the consumer (Fred) focus, and self-efficacy.


MSE: Gather the available information (evidence) from the case scenario, and document the client’s Mental State Examination in the form of progress notes (medical record) under the appropriate MSE headings (Present your information in the MSE format using the provided sequencing).

Explain why the MSE is important in capturing a ‘picture’ of the patient at the time of the assessment. Provide a provisional diagnose(s) that could be made (based on the MSE) as to Fred’s possible presenting condition (s) in the way of a critical discussion.

Risk Assessment: Based on your MSE of Fred’s presentation (in Derby) in the above case scenario, clearly list and briefly describe THREE potential risks (in order of priority) that Fred is likely to pose over the next 24 hours when admitted to the ‘authorized hospital’ in Perth.

Describe Fred’s management plan based on your identified (3) risks within the 24 hours in the approved hospital in Perth.

Conclusion: Effectively and comprehensively summarises main points within the report – highlighting key areas.

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