NCLEX Review Guide: Mental Health & Neurodevelopmental Disorders

Therapeutic Communication

• Active listening involves maintaining eye contact, using open-ended questions, and reflecting client feelings to build trust and rapport.
• Therapeutic silence allows clients time to process emotions and thoughts, demonstrating patience and acceptance.
• Avoid giving advice, making judgments, or offering false reassurance as these block therapeutic communication.

Depression & Anxiety Disorders

• Major depressive disorder requires at least 5 symptoms for 2+ weeks including depressed mood, anhedonia, weight changes, sleep disturbances, and fatigue.
• Suicide risk assessment is priority - ask directly about suicidal ideation, plan, and means using SAD PERSONS scale.
• Generalized anxiety disorder involves excessive worry about multiple life events for 6+ months with physical symptoms like restlessness and muscle tension.

Autism Spectrum Disorder (ASD)

• ASD is characterized by persistent deficits in social communication and restricted, repetitive behaviors appearing in early development.
• Nursing interventions include maintaining consistent routines, using clear simple language, and providing sensory-friendly environments.
• Sensory overload can trigger behavioral responses - monitor for signs and provide calm, quiet spaces.

ADHD (Attention-Deficit/Hyperactivity Disorder)

• ADHD presents with inattention, hyperactivity, and impulsivity symptoms that impair functioning in multiple settings.
• Medication management includes stimulants (methylphenidate, amphetamines) and non-stimulants (atomoxetine).
• Monitor for side effects: decreased appetite, sleep disturbances, and growth suppression in children.

1. Practice therapeutic communication techniques daily
2. Memorize normal vs. abnormal developmental milestones
3. Understand medication classes and major side effects
4. Focus on safety as the priority nursing intervention