Which speech process should the nurse document on the daily mental status exam record?

• A. Poverty of speech
• B. Loose associations
• C. Monotone
• D. Tangential

Answer: (A)

In a mental status exam, you look at how a person communicates, focusing on the amount and fluency of speech. Poverty of speech means the person speaks very little or gives brief, minimal responses, showing a noticeable reduction in verbal output. This is a direct speech process observation and often reflects negative symptoms like alogia seen in schizophrenia. It provides a clear, observable measure of how much the person is willing or able to express verbally, which is exactly what the daily MSE record aims to capture for speech.

Monotone relates to voice quality or affective presentation rather than the amount of speech, and the remaining options describe patterns of thought rather than speech production. So documenting poverty of speech best reflects the speech process in the daily mental status exam.