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               Optum Pts: St Louis University Mental State Examination (SLUMS) 
  
  
  
  
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               1. What day of the week is it?  
  
  
  
  
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               2. What year is it?  
  
  
  
  
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               3. What state are we in?  
  
  
  
  
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               4. Remember these 5 objects, (I will ask later): apple, pen, tie, house, car 
  
  
  
  
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               5. You have $100 and you go to the store and buy a dozen apples for $3 and a tricycle for $20.  
  
  
  
  
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               5a. How much money did you spend? 
  
  
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               5b. How much money do you have left?  
  
  
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               6. Please name as many animals as you can in one minute.  
  
  
  
  
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               7. What 5 objects did I ask you to remember earlier? (refer to question #4) 
  
  
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               8. I am going to give you a series of numbers and I would like you to give them to me backwards (if I say 42, you say 24) 
  
  
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               Draw clock face. Pt to put in hours & time to 10 min to 11. 
  
  
  
  
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               Draw circle and have pt fill in rest. 
  
  
  
  
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               9a. Hour markers ok?  
  
  
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               9b. Time correct?  
  
  
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               MA/PA - Draw square, triangle, vertical rectangle (make one of the 3 shapes larger than others).  
  
  
  
  
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               10. Put an "x" on the triangle.  
  
  
  
  
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               10a. Which figure is the largest?  
  
  
  
  
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               11. I will tell you a story that I will ask questions about later. 
  
  
  
  
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               Jill was a very successful stockbroker. She made a lot of money on the stock market. She then met Jack, a devastatingly 
  
  
  
  
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               handsome man. She married him and had three children. They lived in Chicago. She then stopped work and stayed at home to bring  
  
  
  
  
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               up her children. When they were teenagers, she went back to work. She and Jack lived happily ever after.  
  
  
  
  
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               11a. What was the female's name?  
  
  
  
  
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               11b. What work did she do?  
  
  
  
  
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               11c. When did she go back to work? 
  
  
  
  
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               11d. What state did she live in? 
  
  
  
  
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               Add up all points for TOTAL SLUMS SCORE 
  
  
  
  
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               TOTAL SLUM POINTS  
  
  
  
  
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               If high school education or above, results:  
  
  
  
  
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               If less than high school education, results:  
  
  
  
  
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               Other: Put in reason for unable to assess.  
  
  
  
  
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