How to do a mental status exam
Other platforms explain it with text and video. In Making Synapses you practice it on the patient.
The mental status exam is a structured description of what you see and hear during the interview. Asking directly about suicide is safe and necessary.
Step by step
Prepare
Quiet private room, introduce yourself, explain and get consent. [1]
Appearance and behavior
Dress, hygiene, eye contact, movements, cooperation. [1]
Speech
Rate, volume, amount and clarity. [2]
Mood and affect
Mood in the patient's own words; affect is what you observe (range, fit with the topic). [2]
Thought process and content
Logical or jumping between topics; delusions, obsessions, and thoughts of harming self or others. [2]
Ask about suicide directly
"Are you having thoughts of killing yourself?" Ask about a plan, means and intent. If at risk, do not leave the patient alone and get help. [1]
Perception
Hearing or seeing things others do not. [2]
Cognition, insight and judgment
Orientation, attention, memory; do they understand the problem and make safe choices? [2]
Common errors
- Avoiding the suicide question.
- Mixing up mood (what the patient says) and affect (what you see).
- Judging instead of describing.
Practice it in Making Synapses
In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
Making Synapses cases that train this skill
- Anaphylaxis in a child
- Intimate partner violence in pregnancy
- Neonatal jaundice
- Intussusception
- Child with diarrhea and dehydration
- Poststreptococcal glomerulonephritis
612 Making Synapses cases train this skill: open the case library
Sources
Facts and steps follow NCCPA PANCE Content Blueprint; NCSBN 2026 NCLEX-RN Test Plan. Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.