MMSE Attention and Calculation 2 — Questions and Answers
Question 1: A patient is asked to count backward from 100 by 7s. After '93', they say '87'. How many errors have they made?
- One error (correct answer was 86) (Correct answer)
- No errors
- Two errors
- Three errors
Correct answer: One error (correct answer was 86)
100 minus 7 is 93, and 93 minus 7 is 86, so saying 87 constitutes one serial subtraction error.
Question 2: Which alternative task is commonly substituted for serial 7s when a patient has limited education?
- Spell 'WORLD' backward (Correct answer)
- Repeat three words
- Name the current president
- Draw a clock face
Correct answer: Spell 'WORLD' backward
Spelling 'WORLD' backward is the standard MMSE alternative to serial 7s for individuals with limited formal education.
Question 3: On the MMSE, how many points are allocated to the Attention and Calculation section?
- 5 (Correct answer)
- 3
- 7
- 10
Correct answer: 5
The Attention and Calculation section of the MMSE is worth a maximum of 5 points.
Question 4: A patient correctly completes three of the five serial 7 subtractions. What score do they receive for this section?
- 3 out of 5 (Correct answer)
- 2 out of 5
- 5 out of 5
- 0 out of 5
Correct answer: 3 out of 5
Each correctly executed serial subtraction step earns 1 point, so three correct steps yield a score of 3.
Question 5: Why is the serial 7s task considered a measure of attention rather than pure arithmetic ability?
- It requires sustained concentration and working memory while calculating (Correct answer)
- It only tests long-term memory recall
- It measures language comprehension skills
- It evaluates visual-spatial processing
Correct answer: It requires sustained concentration and working memory while calculating
Serial 7s demands holding a running total in working memory while performing repeated subtraction, making sustained attention essential.
Question 6: If a patient makes an error at step 2 of serial 7s (e.g., says 84 instead of 86) but then correctly subtracts 7 from their wrong answer to get 77, how is step 3 scored?
- Correct, because the subtraction of 7 was performed accurately (Correct answer)
- Incorrect, because 77 is not the right answer from 93
- Not scored at all
- Incorrect because they already made an error
Correct answer: Correct, because the subtraction of 7 was performed accurately
The MMSE scores each serial 7 step based on whether the patient correctly subtracted 7 from their previous answer, not whether the running total is accurate.
Question 7: Which cognitive domain is being assessed when the examiner asks a patient to spell 'WORLD' backward?
- Attention and working memory (Correct answer)
- Orientation to time
- Language and naming
- Visuospatial construction
Correct answer: Attention and working memory
Spelling 'WORLD' backward assesses attention and working memory, the same domain targeted by serial 7s.
MMSE Attention and Calculation 2
A patient is asked to count backward from 100 by 7s.
After '93', they say '87'.
How many errors have they made?