How is judgment assessed in the mental status examination, and what would indicate impairment?

• A. Memory for facts.
• B. Ability to perform complex calculations.
• C. Capacity to make sound, appropriate decisions.
• D. Ability to describe current mood.

Answer: (C)

Judgment in the mental status examination reflects a person’s ability to make sound, appropriate decisions about daily life and safety. It’s explored by presenting real or hypothetical situations and watching whether the person can anticipate consequences, choose reasonable actions, and act in their own best interest. Good judgment means recognizing risks, planning ahead, and avoiding dangerous or clearly inappropriate choices.

Impairment shows up as consistently poor or unsafe decisions, failure to recognize risks, inability to foresee outcomes, or impulsive actions without consideration of consequences. This contrasts with other domains: memory for facts gauges recall, complex calculations test cognitive arithmetic ability, and describing current mood assesses affect—these do not directly measure the ability to weigh options and foresee consequences.