AIIMS Rishikesh & Jodhpur NO - 2017
Mental Health Nursing
Medium
Which symptom is typically not a primary manifestation in a patient with anxiety?
Appeared in: AIIMS Rishikesh & Jodhpur NO - 2017
Explanation
- Abdominal pain is considered a somatic (physical) symptom of anxiety, not a primary psychological or behavioral manifestation.
- Primary manifestations of anxiety are the core features of the disorder, such as excessive worry and restlessness, which are central to its diagnosis.
- Somatic symptoms like abdominal pain, palpitations, or sweating are secondary effects caused by the activation of the autonomic nervous system in response to psychological distress.
- While patients with anxiety frequently report gastrointestinal issues, these are viewed as physical consequences rather than the core problem itself.
Why Other Options Were Wrong
- Option B: Nervous behavior, which includes motor tension, fidgeting, and an inability to relax, is a classic and primary behavioral manifestation of anxiety.
- Option C: Worry, specifically excessive and uncontrollable worry about various events or activities, is the central cognitive feature of Generalized Anxiety Disorder (GAD) and a primary symptom of anxiety.
- Option D: Restlessness, or feeling 'keyed up' or 'on edge,' is a key psychomotor symptom and one of the specific diagnostic criteria for GAD listed in the DSM-5. It is a primary manifestation.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Primary vs. Somatic Manifestations of Anxiety to guide bedside assessment, documentation, and the next nursing action.
- Nurses must conduct a holistic assessment, recognizing that patients with anxiety may present with physical complaints like abdominal pain. It's crucial to assess for underlying psychological distress instead of solely focusing on the somatic symptom.
- Understanding this distinction prevents misdiagnosis. A patient's recurring abdominal pain might be investigated for gastrointestinal disorders, but if anxiety is the root cause, treatment must target the anxiety itself.
- What if? If a patient presents with chest pain and palpitations, the nurse's first priority is to rule out a cardiac emergency (like a myocardial infarction), even if anxiety is suspected. Once life-threatening conditions are excluded, an anxiety assessment is appropriate.
How to Approach the Question
- First, identify the keywords in the question: 'not a primary manifestation' and 'anxiety'. The word 'not' indicates this is a negative question, meaning you must find the option that does not fit.
- Next, define 'primary manifestation' in the context of anxiety. Primary symptoms are the core psychological and behavioral features that define the disorder.
- Analyze each option: 'Worry', 'Nervous behavior', and 'Restlessness' are all well-known core symptoms of anxiety.
- Evaluate the remaining option, 'Pain abdomen'. This is a physical or somatic symptom. While it can be caused by anxiety, it is a physical consequence, not a primary psychological feature.
- Conclude that abdominal pain is the outlier and therefore the correct answer to the 'not' question.
Concept Tested & Keywords
- Concept Tested: Primary vs. Somatic Manifestations of Anxiety
- Stem keywords: symptom, anxiety, primary manifestation
- Lead-in keywords: not
- Negative lead-in flag: Question asks for the symptom that is NOT a primary manifestation.
Question ID
QHf9hPOYA2ZuXjVEEr4xy4
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) p. 1284-1286
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 290-292
Practise the full AIIMS Rishikesh & Jodhpur NO - 2017
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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