PGIMS Rohtak NO - 2017
Mental Health Nursing
Medium
The following are symptoms of anxiety except?
Appeared in: PGIMS Rohtak NO - 2017
Explanation
- Bradycardia is defined as a slow heart rate, typically under 60 beats per minute.
- Anxiety activates the sympathetic nervous system, initiating the 'fight-or-flight' response.
- This response causes the release of adrenaline, which increases the heart rate (tachycardia) to pump more oxygenated blood to the muscles.
- Therefore, a slow heart rate (bradycardia) is inconsistent with the physiological state of anxiety.
Why Other Options Were Wrong
- Option A: Palpitations, the sensation of a rapid or forceful heartbeat, are a hallmark symptom of anxiety and panic attacks due to the surge of adrenaline.
- Option B: The 'fight-or-flight' response diverts blood away from the digestive system, which can cause various forms of gastric discomfort, including nausea, stomach cramps, or diarrhea.
- Option D: Anxiety can cause muscle tension, including in the bladder, and heighten sensory awareness, leading to an increased urge and frequency of urination.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Physiological manifestations of anxiety as background academic context rather than a clinical decision trigger.
- Nurses must be able to distinguish the symptoms of an anxiety attack from other life-threatening conditions, such as a myocardial infarction, as both can present with chest pain and palpitations.
- A thorough assessment, including vital signs, is critical. While tachycardia is expected with anxiety, an unexpected finding like bradycardia would prompt the nurse to investigate other causes, such as medication side effects or a cardiac conduction issue.
- What if? If an anxious patient is taking a beta-blocker medication (e.g., propranolol), their heart rate may not become tachycardic. The nurse must rely on other signs and the patient's subjective report to assess their level of anxiety, as the medication can mask this key vital sign.
How to Approach the Question
- First, identify the keyword 'except' in the question stem. This indicates you are looking for the option that is NOT a symptom of anxiety.
- Recall the basic pathophysiology of anxiety: it is an activation of the sympathetic nervous system (the 'fight-or-flight' response).
- Think about what the 'fight-or-flight' response does to the body: it prepares it for action. This means the heart speeds up, breathing increases, and blood is shunted to muscles.
- Evaluate each option against this physiological response.
- Palpitations (fast/strong heartbeat), gastric upset, and urinary frequency are all known consequences of sympathetic activation.
- Bradycardia (slow heartbeat) is the opposite of what happens to the heart during a 'fight-or-flight' response. Therefore, it is the correct exception.
Concept Tested & Keywords
- Concept Tested: Physiological manifestations of anxiety
- Stem keywords: symptoms, anxiety
- Lead-in keywords: except
- Negative lead-in flag: Question asks for the exception
Question ID
Qm4J-0uxfDQ4jU0t5TX6Uk
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 3864-3866
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 1284-1286, 1287-1289
Practise the full PGIMS Rohtak NO - 2017
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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