You tell a 65 year old patient, "Listen carefully and repeat after me: Apple, Pen, Table." If he repeats these three words immediately after you in the correct sequence, he has normal:

Appeared in: GMCH - 2016

Explanation

Asking a patient to immediately repeat a list of words tests the cognitive function of registration.
Registration is the ability to immediately encode and repeat new information, which is the very first step in the memory process.
The patient's successful and immediate repetition of "Apple, Pen, Table" indicates that this initial stage of memory is functioning normally.
This specific test is a standard component of the Mini-Mental State Examination (MMSE).

Why Other Options Were Wrong

Option A: Judgement is the ability to make considered decisions or come to sensible conclusions. It is not tested by immediate word repetition.
Option B: Orientation refers to a patient's awareness of person, place, and time. This is different from repeating words.
Option C: Recall is the ability to retrieve information after a period of delay (e.g., 3-5 minutes). The question specifies immediate repetition, not delayed memory.

Related Visual

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Cognitive Function Assessment in Nursing in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Assessing registration is a crucial first step in evaluating a patient's memory. An inability to register information makes it impossible to assess recall, as the information was never stored in the first place.
This simple bedside test helps nurses quickly screen for acute changes in mental status, such as delirium, or for signs of chronic cognitive decline like dementia.
What if? If the patient could not repeat the three words even after several tries, the nurse would document an impairment in registration and suspect a condition like delirium or a more advanced dementia, warranting further neurological evaluation.

How to Approach the Question

First, identify the core action being tested in the question stem. Here, the key phrase is "repeats these three words immediately."
Next, analyze the provided options, which are all different cognitive functions.
Define each cognitive function in your mind: Judgement (decision-making), Orientation (time, place, person), Recall (delayed memory), and Registration (immediate repetition).
Match the action from the stem ("immediate repetition") with its correct definition.
Recognize that immediate repetition is the definition of Registration, while remembering the words after a delay would be Recall. This distinction is critical.
Select the option that correctly matches the action described.

Concept Tested & Keywords

Concept Tested: Cognitive Function Assessment in Nursing
Stem keywords: 65 year old patient, repeat after me, Apple, Pen, Table, repeats immediately
Lead-in keywords: normal
Clinical cues: The key action is immediate repetition, which points to the initial step of memory.

Question ID

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Reference Book

E6 Nursing Fundamentals Potter Perry 12e Part 3 p. 124-126

E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 2 (pp 290-564 of 579) p. 199-201

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 13423-13425

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