NCLEX Review Guide: Mental Health Nursing

Mental Health vs Mental Illness

• Mental health is a state of well-being where individuals realize their potential, cope with normal life stresses, work productively, and contribute to their community. It exists on a continuum rather than being simply present or absent.
• Mental illness refers to diagnosable conditions that significantly interfere with cognitive, emotional, or social abilities and require professional treatment. These conditions affect thinking, feeling, mood, and behavior patterns.

Anxiety Disorders

• Generalized Anxiety Disorder (GAD) involves excessive worry about multiple life areas for at least 6 months, accompanied by physical symptoms like restlessness and fatigue. Patients often describe feeling "on edge" constantly.
• Panic Disorder features recurrent panic attacks with intense fear, physical symptoms (palpitations, sweating, trembling), and persistent worry about future attacks. Attacks peak within minutes and can feel life-threatening to patients.

Mood Disorders

• Major Depressive Disorder requires at least 5 symptoms for 2+ weeks including depressed mood or anhedonia, plus changes in sleep, appetite, energy, concentration, or thoughts of death. Always assess suicide risk.
• Bipolar Disorder involves alternating episodes of mania/hypomania and depression, with manic episodes lasting at least 1 week and including elevated mood, decreased need for sleep, and impaired judgment.

Therapeutic vs Non-Therapeutic Techniques

1. Establish rapport and trust through consistency and genuineness
2. Use active listening with appropriate eye contact and body language
3. Validate emotions without agreeing with distorted thoughts
4. Set appropriate boundaries while maintaining therapeutic relationship
5. Document interactions objectively focusing on behaviors and quotes

Suicide Risk Assessment

• Always directly ask about suicidal thoughts - asking does not increase risk but provides essential safety information. Use clear, direct language: "Are you thinking about killing yourself?"
• Assess for protective factors (family support, religious beliefs, future goals) and risk factors (previous attempts, substance use, social isolation, access to means).