RUHS, Jaipur, M.Sc Nursing Entrance Exam-2016
Mental Health Nursing
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A patient not willing to go outside alone with the fear of doing something crazy in public is?
Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2016
Explanation
- Agoraphobia is defined as a marked fear or anxiety about situations from which escape might be difficult or help unavailable.
- Commonly feared situations include being outside the home alone, being in a crowd, using public transportation, or being in open spaces.
- A key cognitive feature is the fear of losing control, having a panic attack, or experiencing embarrassing symptoms (like 'doing something crazy') in public.
- This leads to avoidance of these situations, which can become severely disabling and confine the person to their home.
Why Other Options Were Wrong
- Option B: Social phobia (or social anxiety disorder) involves a primary fear of negative evaluation, scrutiny, or judgment from others in social situations.
- Option C: Claustrophobia is a situational phobia characterized by the fear of enclosed or confined spaces.
- Option D: Hydrophobia is an irrational fear of water. It is not related to social situations or being in public.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Differentiating between types of phobias based on clinical presentation to guide bedside assessment, documentation, and the next nursing action.
- Nurses play a vital role in managing agoraphobia by building a therapeutic alliance, encouraging gradual exposure (as part of cognitive-behavioral therapy), teaching relaxation techniques, and administering prescribed medications like SSRIs.
- Patient education is crucial. The nurse must explain that the physical symptoms of panic are not dangerous and that avoidance behaviors worsen the phobia over time.
- What if the patient was only afraid of public speaking but comfortable in crowds or traveling alone? The diagnosis would more likely be Social Phobia, as the fear is tied to performance and scrutiny, not the inability to escape.
How to Approach the Question
- First, analyze the core fear described in the question stem. The patient fears 'going outside alone' and 'doing something crazy in public'.
- Break down the fear. 'Going outside alone' points to a fear of specific situations. 'Doing something crazy' points to a fear of losing control or having a panic attack.
- Evaluate the options against this core fear.
- Social phobia is about fear of judgment, not loss of control in this context.
- Claustrophobia is about enclosed spaces, which is the opposite of the situation described.
- Hydrophobia is about water and is irrelevant.
Concept Tested & Keywords
- Concept Tested: Differentiating between types of phobias based on clinical presentation.
- Stem keywords: not willing to go outside alone, fear, doing something crazy in public
- Lead-in keywords: is
- Clinical cues: The patient's fear is twofold: being outside alone and losing control in public. This combination is a hallmark of agoraphobia.
- Negative lead-in flag: false
Question ID
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Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 1290-1292, 1289-1291
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 15577-15579
Practise the full RUHS, Jaipur, M.Sc Nursing Entrance Exam-2016
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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