Which language abilities are tested in the MSE and how are impairments categorized?

• A. Fluency, naming, repetition, and comprehension
• B. Fluency and naming only
• C. Repetition only
• D. Comprehension only

Answer: (A)

The language portion of the mental status exam checks four linked abilities: fluency of speech (how smoothly and spontaneously someone talks), naming (identifying objects or pictures), repetition (able to repeat phrases or sentences), and comprehension (understanding spoken language). These areas are assessed together because they cover both expressive and receptive language and reveal where the breakdown is.

Impairments are categorized by the pattern across these domains, typically using whether production is fluent or nonfluent and whether comprehension is preserved. For example, nonfluent speech with relatively good comprehension suggests nonfluent (Broca) aphasia; fluent speech with poor comprehension suggests receptive (Wernicke) aphasia; fluent speech with impaired repetition points to conduction aphasia; and severe deficits in multiple domains indicate global aphasia.