A patient experiences apprehensive expectations for three months about several events with symptoms of restlessness, fatigue, mind going blank, along with sleep disturbances. Which anxiety disorder is related to these symptoms?

Appeared in: BTSC Staff Nurse 1 August-2025

Explanation

The patient's presentation includes excessive, ongoing worry about multiple life areas, which is the core feature of Generalized Anxiety Disorder (GAD).
The associated symptoms of restlessness, fatigue, difficulty concentrating ('mind going blank'), and sleep disturbances are classic diagnostic criteria for GAD.
While the official diagnostic timeframe for GAD is at least 6 months, the symptom profile presented is the most consistent with GAD compared to the other options.
The worry is described as general ('about several events') rather than being focused on a specific trigger like social situations or a past trauma.

Why Other Options Were Wrong

Option A: Acute Stress Disorder is incorrect because its symptoms must occur within one month of a traumatic event and last from 3 days to 1 month. The patient's symptoms have persisted for three months.
Option B: Social phobia (Social Anxiety Disorder) is characterized by an intense fear of being judged or scrutinized in social or performance situations. The patient's worry is broad and about 'several events,' not specifically social contexts.
Option D: Panic anxiety disorder is defined by recurrent, unexpected panic attacks—abrupt surges of intense fear that peak within minutes. The patient's symptoms are chronic and persistent, not episodic and acute.

Related Visual

Clinical Relevance

Nursing practice connection: Use the key finding related to Differentiating common anxiety disorders based on clinical presentation and duration to guide bedside assessment, documentation, and the next nursing action.
Nurses play a vital role in screening for GAD in primary care settings, as patients often present with physical complaints like fatigue or sleep problems before identifying anxiety as the root cause.
GAD has a high rate of comorbidity with other mental health conditions, particularly major depressive disorder. A thorough assessment is crucial.
Patient education is a key nursing intervention, involving teaching about the nature of GAD, stress management techniques (like mindfulness and relaxation exercises), and the importance of adhering to treatment plans, which may include therapy and/or medication.

How to Approach the Question

First, break down the clinical scenario in the question stem. Identify the key symptoms: apprehensive expectations (worry), restlessness, fatigue, mind going blank, and sleep disturbances.
Note the duration of the symptoms, which is 'three months'. This is a critical clue for differentiating time-based disorders.
Evaluate each option against the patient's presentation.
Eliminate 'Acute stress disorder' because the duration (3 months) exceeds its maximum of 1 month.
Eliminate 'Social phobia' because the worry is about 'several events,' not specifically social situations.
Eliminate 'Panic anxiety disorder' because the description is of chronic, persistent worry, not sudden, intense panic attacks.

Concept Tested & Keywords

Concept Tested: Differentiating common anxiety disorders based on clinical presentation and duration.
Stem keywords: apprehensive expectations, three months, restlessness, fatigue, mind going blank, sleep disturbances
Lead-in keywords: Which anxiety disorder
Clinical cues: Duration of 3 months helps differentiate from acute disorders.
Clinical cues: Worry about 'several events' points away from specific phobias.

Question ID

QzSDy2DB8Lp0megX4A0XYP

Reference Book

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 1296-1298, 1298-1300

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 5733-5735

Practise the full BTSC Staff Nurse 1 August-2025

Attempt every question from this paper in a timed mock, then review the full solution for each one.

Attempt this paper Attempt in the NPrep app