Mental Health NCLEX Clinical Study Booklet · 12 cards
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Anxiety Disorders. Anxiety What is Anxiety Disorders?
Excessive worry or fear out of proportion to the situation. Includes GAD, panic disorder, and phobias. What are the Causes / Risk Factors?
Genetic predisposition Neurotransmitter imbalance (GABA, serotonin) Stress, trauma Medical conditions What are the Symptoms?
Restlessness, apprehension Palpitations, sweating, trembling Difficulty concentrating Panic attacks (sudden intense fear) Avoidance behavior How is it Diagnosed?
Clinical assessment Rule out medical causes What is the Treatment?
SSRIs / SNRIs (first-line), buspirone Benzodiazepines (short-term only) CBT, relaxation techniques Calm, low-stimulation environment NCLEX Tip For severe anxiety or panic: stay with the client, use short simple sentences, reduce stimuli, and never leave them alone.
Major Depressive Disorder. Mood What is Major Depressive Disorder?
Persistent depressed mood and loss of interest for ≥2 weeks. Impairs function and raises suicide risk. What are the Causes / Risk Factors?
Neurotransmitter imbalance (serotonin, norepinephrine) Genetics Loss, chronic illness, stress What are the Symptoms?
Depressed mood, anhedonia Sleep & appetite changes Fatigue, worthlessness / guilt Poor concentration Suicidal ideation How is it Diagnosed?
Clinical (DSM criteria) Depression screening (PHQ-9) What is the Treatment?
SSRIs (first-line; onset 2–6 weeks) SNRIs, TCAs, MAOIs; ECT (severe/refractory) Assess suicide risk (especially as mood lifts) Structured activity; therapy NCLEX Tip SSRIs take 2–6 weeks to work. Suicide risk rises as energy returns before mood fully improves — monitor closely early in treatment.
Bipolar Disorder. Mood What is Bipolar Disorder?
Alternating episodes of mania and depression. Bipolar I (full mania) vs II (hypomania). What are the Causes / Risk Factors?
Genetics (strong) Neurotransmitter dysregulation Stress triggers What are the Symptoms?
Mania: grandiosity, ↓need for sleep, pressured speech, flight of ideas Impulsivity, risk-taking, poor judgment Depression: as in MDD How is it Diagnosed?
Clinical (DSM criteria) Mood history What is the Treatment?
Mood stabilizers: lithium (0.6–1.2), valproate, carbamazepine Antipsychotics; manage sleep Mania: high-calorie finger foods, low stimulation, safety Monitor lithium level & toxicity NCLEX Tip During mania, provide high-calorie finger foods and a low-stimulation environment. Monitor lithium levels (therapeutic 0.6–1.2 mEq/L).
Schizophrenia. Psychotic What is Schizophrenia?
Chronic psychotic disorder with disturbed thought and perception. Positive and negative symptoms. What are the Causes / Risk Factors?
Genetics Dopamine dysregulation Neurodevelopmental / environmental factors What are the Symptoms?
POSITIVE: hallucinations, delusions, disorganized speech NEGATIVE: flat affect, avolition, social withdrawal Impaired cognition Command hallucinations (safety risk) How is it Diagnosed?
Clinical (DSM criteria, ≥6 months) Rule out substances / medical What is the Treatment?
Antipsychotics (typical & atypical) Clozapine: monitor WBC (agranulocytosis) Present reality without arguing; assess for command hallucinations Build trust; consistent care NCLEX Tip For hallucinations, present reality calmly and assess for command hallucinations (a safety risk). Watch antipsychotics for EPS and NMS.
Obsessive-Compulsive Disorder. Anxiety What is Obsessive-Compulsive Disorder?
Recurrent obsessions (thoughts) and compulsions (behaviors). Rituals temporarily reduce anxiety. What are the Causes / Risk Factors?
Genetics Serotonin dysfunction Stress What are the Symptoms?
Intrusive, unwanted thoughts (obsessions) Repetitive behaviors / rituals (compulsions) Distress if the ritual is prevented Time-consuming; impairs function What is the Treatment?
SSRIs (often higher doses) CBT with exposure & response prevention Allow time for rituals initially; set limits gradually Do NOT abruptly stop rituals (↑anxiety) NCLEX Tip Don't abruptly interrupt a client's rituals — it increases anxiety. Allow time for them initially, then set gradual limits with CBT.
PTSD. Anxiety What is PTSD?
Trauma- and stressor-related disorder after a traumatic event. Re-experiencing, avoidance, hyperarousal. What are the Causes / Risk Factors?
Exposure to trauma (combat, assault, disaster) Prior trauma, lack of support What are the Symptoms?
Flashbacks, nightmares, intrusive memories Avoidance of reminders Hyperarousal, hypervigilance, exaggerated startle Emotional numbing, guilt How is it Diagnosed?
Clinical (symptoms >1 month) What is the Treatment?
Trauma-focused CBT, EMDR SSRIs / SNRIs; prazosin (nightmares) Establish safety & trust Grounding techniques; avoid re-traumatization NCLEX Tip PTSD: establish safety and trust first. Prazosin can help nightmares; trauma-focused therapy (CBT, EMDR) is first-line.
Anorexia Nervosa. Eating What is Anorexia Nervosa?
Restriction of intake → significantly low body weight. Intense fear of weight gain; distorted body image. What are the Causes / Risk Factors?
Genetic, psychological Control issues, perfectionism Sociocultural pressures What are the Symptoms?
Extreme weight loss, emaciation Amenorrhea, lanugo, cold intolerance Bradycardia, hypotension, dysrhythmias Electrolyte imbalance Distorted body image; denial of hunger How is it Diagnosed?
BMI, weight history Electrolytes, ECG What is the Treatment?
Nutritional rehabilitation (watch REFEEDING syndrome — monitor phosphorus) Supervise meals & bathroom (1 hr after) Cardiac monitoring (priority) Therapy; address body image NCLEX Tip The priority in anorexia is cardiac status (dysrhythmias from electrolyte loss). Watch for refeeding syndrome — monitor phosphorus.
Bulimia Nervosa. Eating What is Bulimia Nervosa?
Binge eating followed by compensatory behaviors (purging). Usually normal body weight. What are the Causes / Risk Factors?
Genetic, psychological Impulsivity, low self-esteem What are the Symptoms?
Binge-purge cycles Hypokalemia (dangerous) Dental erosion; Russell's sign (knuckle calluses) Parotid swelling Esophageal irritation How is it Diagnosed?
Clinical Electrolytes (↓K) What is the Treatment?
Correct electrolytes (hypokalemia) SSRIs; CBT Monitor for purging; meal support Address self-esteem / triggers NCLEX Tip Bulimia's biggest danger is hypokalemia from purging (fatal dysrhythmias). Note dental erosion and Russell's sign.
Substance Use & Alcohol Withdrawal. Substance What is Substance Use & Alcohol Withdrawal?
Problematic substance use with dependence and withdrawal. Alcohol withdrawal can be life-threatening. What are the Causes / Risk Factors?
Genetic, environmental Chronic use → tolerance & dependence What are the Symptoms?
Alcohol withdrawal: tremors, anxiety, ↑VS (6–24h) Delirium tremens (48–72h): confusion, hallucinations, seizures, autonomic instability Opioid withdrawal: yawning, cramps, diarrhea (uncomfortable, rarely lethal) How is it Diagnosed?
History, CIWA scale Tox screen What is the Treatment?
Alcohol: benzodiazepines (taper), thiamine (prevent Wernicke's) Seizure & safety precautions Opioid: methadone / buprenorphine; naloxone for overdose Support; rehab referral NCLEX Tip Alcohol withdrawal (especially delirium tremens at 48–72h) is life-threatening — treat with benzodiazepines and give thiamine to prevent Wernicke's.
Suicide Risk. Crisis What is Suicide Risk?
Risk of intentional self-harm or death. A psychiatric emergency. What are the Causes / Risk Factors?
Depression, hopelessness Prior attempts, substance use Loss, chronic illness, isolation What are the Symptoms?
Verbal / behavioral cues (giving away possessions) Sudden calm after depression (may have a plan) Specific plan and means (highest risk) Withdrawal, hopelessness How is it Diagnosed?
Direct questioning (safe — does NOT plant the idea) Risk assessment (plan, means, intent) What is the Treatment?
1:1 constant observation; remove hazards Safety / no-harm plan Ensure immediate safety (priority over talking/meds) Document; involve support NCLEX Tip Ask directly about suicide — it does not plant the idea. A specific plan and means = highest risk. Safety (constant observation, remove means) is the priority.
Therapeutic Communication. Communication Therapeutic Techniques
Open-ended questions; reflecting & restating Silence; offering self; active listening Focus on feelings, not just facts Non-Therapeutic (avoid)
Giving advice; false reassurance ('everything will be fine') Asking 'why'; changing the subject Minimizing feelings; being defensive Key Principle
Keep the client talking; be non-judgmental Address feelings first Choose the open-ended, feeling-focused response NCLEX Tip On the NCLEX, choose the response that reflects feelings and is open-ended. Avoid advice, false reassurance, and 'why' questions.
Personality Disorders. Personality What is Personality Disorders?
Enduring maladaptive patterns of behavior and inner experience. Clusters A (odd), B (dramatic), C (anxious). What are the Causes / Risk Factors?
Genetic + environmental Early trauma / attachment issues What are the Symptoms?
Borderline: unstable relationships/mood, impulsivity, self-harm, splitting, fear of abandonment Antisocial: disregard for others, manipulation Narcissistic: grandiosity How is it Diagnosed?
Clinical (long-standing patterns) What is the Treatment?
Set clear, consistent limits & boundaries Dialectical behavior therapy (DBT) for borderline Consistent team approach (avoid splitting) Safety (self-harm risk) NCLEX Tip With borderline personality disorder, set consistent limits and keep a unified team approach to prevent splitting. Monitor for self-harm.
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