Which statement best describes the 'Question Order' guideline for administering BIMS?

• A. Randomizing the order of BIMS questions.
• B. Asking BIMS items in a specified sequence.
• C. Skipping questions with no patient response.
• D. Recording answers before questioning.

Answer: (B)

Consistent administration relies on asking BIMS items in a fixed, specified sequence. This order is built into the tool so responses are comparable and scoring is applied uniformly across patients and examiners. When the items are presented in a set order, you minimize order effects and keep the assessment’s reliability intact. Randomizing the sequence would introduce variability that isn’t due to the patient’s cognitive status, undermining comparability. Skipping questions or recording answers before questioning would lead to incomplete data and disrupt the proper workflow of the assessment. So the best practice is to administer the items in the designated order.