BTSC Staff Nurse 31 July-2025
Mental Health Nursing
Easy
Which of the following is a cardinal physical symptom of anxiety disorder?
Appeared in: BTSC Staff Nurse 31 July-2025
Explanation
- Tachycardia, an elevated heart rate (typically above 100 beats per minute), is a common physical manifestation of the body's 'fight or flight' response, which is hyperactivated in anxiety disorders.
- The autonomic nervous system, specifically the sympathetic branch, releases adrenaline (epinephrine), causing the heart to beat faster to increase oxygen supply to muscles in preparation for perceived danger.
- Unlike the other options, which are psychological (perceptual or thought-process-related), tachycardia is a directly measurable physiological change, making it a cardinal physical sign of anxiety.
Why Other Options Were Wrong
- Option A: Hallucinations are false sensory perceptions without any real external stimulus. They are a hallmark symptom of psychotic disorders, such as schizophrenia, not anxiety disorders.
- Option C: Pressured speech is characterized by rapid, forceful, and difficult-to-interrupt speech. It is a classic symptom of a manic or hypomanic episode in bipolar disorder.
- Option D: Flight of ideas describes a pattern of rapid, abrupt, and often disconnected shifts in thought and speech topics. This is a classic thought-process abnormality found in mania.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Identifying the physical symptoms of anxiety disorders helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Nurses must be able to differentiate the physical symptoms of anxiety from other serious medical conditions, such as a myocardial infarction, as the symptoms can overlap. A thorough assessment including vital signs and patient history is crucial.
- Recognizing tachycardia as a sign of escalating anxiety allows the nurse to intervene early with de-escalation techniques, therapeutic communication, and breathing exercises to prevent a full-blown panic attack.
- What if? If a patient with known anxiety presents with tachycardia and chest pain but also has a history of cardiac disease, the nurse's priority must be to rule out a cardiac event first. An immediate ECG and close monitoring would be required before attributing the symptoms solely to anxiety.
How to Approach the Question
- First, break down the question to its core components: 'cardinal' (meaning primary or key), 'physical symptom', and 'anxiety disorder'.
- Next, clearly differentiate between a 'physical' symptom (a physiological change in the body, like a racing heart) and a 'psychological' symptom (related to thoughts, perceptions, or mood).
- Evaluate each option against this physical vs. psychological framework. Tachycardia is physical. Hallucinations, pressured speech, and flight of ideas are psychological (perceptual or thought-related).
- Finally, confirm the association with the correct disorder. Tachycardia is a well-known symptom of anxiety. The other options are classic symptoms of psychosis or mania.
- This two-step process of elimination—first by symptom type (physical) and then by disorder (anxiety)—confidently leads to the correct answer.
Concept Tested & Keywords
- Concept Tested: Identifying the physical symptoms of anxiety disorders.
- Stem keywords: cardinal physical symptom, anxiety disorder
- Lead-in keywords: Which
- Negative lead-in flag: false
Question ID
QiA7KiZVOz4lYWaefYNA7k
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1284-1286
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 3864-3866, 3794-3796
Practise the full BTSC Staff Nurse 31 July-2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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