Excessive worrying, muscle tension, headaches, sweating, tiredness, trembling and nausea may be symptoms of :

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2023

Mental Health Nursing

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2023

Explanation

The correct option is Generalised anxiety disorder because the question describes a combination of psychological, motor, and autonomic symptoms that are characteristic of this condition.
The core feature described is 'excessive worrying,' which is the central psychological symptom of GAD.
The physical symptoms listed, such as muscle tension, headaches, trembling (motor tension), and sweating, nausea, tiredness (autonomic hyperactivity), are classic manifestations of GAD as per diagnostic criteria.
Unlike other anxiety disorders, the anxiety in GAD is generalized, persistent, and not restricted to specific situations or triggers, which aligns with the broad range of symptoms given.

Option A: OCD is incorrect because its primary features are obsessions (intrusive, unwanted thoughts) and compulsions (repetitive behaviors), which are not mentioned in the symptom list.
Option B: Phobia is incorrect because it involves an intense, irrational fear of a specific object or situation. The symptoms described are persistent and generalized, not linked to a specific trigger.
Option C: Hysteria is an outdated term, now more accurately described as Conversion Disorder. It involves the development of neurological symptoms (like paralysis, blindness, or non-epileptic seizures) in response to stress, which is a different presentation from the generalized anxiety symptoms listed.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical features of Generalized Anxiety Disorder (GAD) as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in identifying the signs of anxiety disorders during patient assessments. Recognizing the specific cluster of symptoms for GAD helps in early referral and management.
It is important for nurses to differentiate between anxiety types to provide appropriate patient education. A patient with GAD needs strategies for managing chronic worry, whereas a patient with a phobia needs strategies for exposure and coping with specific triggers.
What if the patient's worry was focused solely on having a serious illness, despite medical reassurance? This might point towards Illness Anxiety Disorder (formerly hypochondriasis) rather than GAD, requiring a different therapeutic approach.

How to Approach the Question

First, carefully read the list of symptoms provided in the question stem: worrying, muscle tension, headaches, sweating, tiredness, trembling, and nausea.
Categorize the symptoms. Notice the mix of psychological ('excessive worrying'), physical/motor ('muscle tension', 'trembling'), and autonomic ('sweating', 'nausea') symptoms.
Evaluate each option against this symptom cluster.
Eliminate OCD because it requires obsessions or compulsions, which are not mentioned.
Eliminate Phobia because the symptoms are described in a general way, not linked to a specific trigger.
Eliminate Hysteria as it involves specific neurological deficits, not generalized anxiety.

Concept Tested & Keywords

Concept Tested: Clinical features of Generalized Anxiety Disorder (GAD)
Stem keywords: Excessive worrying, muscle tension, headaches, sweating, tiredness, trembling, nausea
Lead-in keywords: symptoms of
Negative lead-in flag: false

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

E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 1 (pp 26-289 of 579) p. 228-230