Following a 3-Stage Command Flashcards
7 cards from real MMSE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Following a 3-Stage Command flashcards as text
If a patient has a right-hand motor deficit (e.g., stroke), how should the examiner handle the instruction to 'take the paper in your right hand'?
Answer: Allow the patient to use the left hand and give full credit if other stages are completed
Clinical best practice allows accommodation for physical disabilities; the spirit of the task is command comprehension, and credit is given if the patient understands and executes the remaining steps.
Which of the following patients would MOST likely score 3/3 on the 3-stage command despite significant cognitive impairment?
Answer: A patient with mild depression and intact language
Mild depression with intact language and working memory would preserve command-following ability, while the other conditions directly impair the required cognitive mechanisms.
In the context of MMSE scoring norms, a score of 1/3 on the 3-stage command is most consistent with what stage of cognitive impairment?
Answer: Moderate dementia
Completing only one of three stages typically indicates moderate impairment of working memory and executive function, consistent with moderate dementia.
The 3-stage command was introduced in the MMSE to assess which aspect of language that simple naming tasks cannot evaluate?
Answer: Comprehension of complex sequential verbal instructions
Naming tasks assess word retrieval, while the 3-stage command specifically evaluates whether patients can comprehend and act upon multi-step verbal instructions.
A caregiver reports that the patient follows simple 1-step instructions at home but struggles with preparing meals. Which MMSE finding would best correlate with this observation?
Answer: Score of 0-1/3 on the 3-stage command
Failing multi-step commands on the MMSE correlates with inability to sequence complex daily activities like meal preparation, which require multi-step planning and execution.
Which of the following is a key difference between the MMSE 3-stage command and an ideomotor apraxia evaluation?
Answer: The MMSE evaluates comprehension of a real-world action sequence, while apraxia testing focuses on pantomiming tool use on command
Apraxia evaluation specifically tests learned skilled motor programs (e.g., pantomiming using a hammer), whereas the MMSE 3-stage command tests sequential instruction comprehension using everyday actions.
A patient asks the examiner to repeat the 3-stage command immediately after it is given, before beginning the task. What should the examiner do?
Answer: Decline to repeat and instruct the patient to begin with what they remember
Standard MMSE protocol does not permit repetition of the command; the patient must proceed with what was heard to validly assess working memory and comprehension.