Mental state examination of a withdrawn patient
NMC OSCE practice station

The task

You are a registered nurse on an adult mental health ward. Fergus Doyle, aged 58, was admitted two days ago. Staff report that he stays in his room, eats little and speaks rarely. A healthcare assistant is nearby. Introduce yourself and carry out a mental state examination, covering each area in a logical order. Say aloud what you are observing and asking. Record your findings and summarise your impression, including any immediate concern about risk, on the form provided.

What this station tests

• Follow a consistent order: appearance, speech, mood and affect, thought, perception, cognition, insight and judgement.
• Describe what you see in plain words rather than labels alone.
• Ask directly about suicide; a passive wish to be dead is still a risk to escalate.
• Slow, quiet speech is a finding to record, not a reason to hurry the patient.
• Never promise to keep a risk secret; explain who you will tell and why.

Sources for the clinical content

• NICE NG222: Depression in adults: treatment and management
• NICE NG225: Self-harm: assessment, management and preventing recurrence
• NMC: The Code

An original practice scenario with invented patients. Not an exam question.

Practise next

• Assessment of a young woman with episodes of sudden fear
• De-escalating an agitated patient on a mental health unit
• Urgent assessment of a woman with persistent low mood