AIIMS Rishikesh & Jodhpur NO - 2017
Psychiatric 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 a somatic (physical) symptom, not a primary psychological or behavioral feature of anxiety.
- Somatic symptoms like abdominal pain, nausea, or diarrhea are secondary to the activation of the autonomic nervous system (the 'fight-or-flight' response) caused by anxiety.
- Core diagnostic criteria for anxiety disorders emphasize the psychological and behavioral components, such as excessive worry and restlessness.
Why Other Options Were Wrong
- Option B: Nervous behavior is a classic and primary behavioral manifestation of anxiety, reflecting internal motor tension and agitation.
- Option C: Worry, specifically excessive and uncontrollable worry, is the central cognitive feature of Generalized Anxiety Disorder (GAD) and a primary manifestation of anxiety.
- Option D: Restlessness, or feeling 'keyed up or on edge,' is a key psychomotor symptom and a specific diagnostic criterion for GAD, making it 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 often present with physical complaints first. Ruling out organic causes for somatic symptoms like abdominal pain is a crucial first step.
- Understanding the link between anxiety and functional gastrointestinal disorders (like Irritable Bowel Syndrome) is vital for patient education and management.
- What if? If a patient presents with chest pain and palpitations instead of abdominal pain, the immediate nursing priority is to rule out a cardiac event (like a myocardial infarction) even if anxiety is suspected, as the symptoms significantly overlap.
How to Approach the Question
- First, identify the core concept being tested, which is the nature of anxiety symptoms.
- Recognize the negative keyword 'not'. This signals that you must find the option that is an exception or does not belong with the others.
- Categorize each option as either a psychological/behavioral symptom or a physical/somatic symptom.
- Worry is cognitive/psychological. Nervous behavior is behavioral. Restlessness is psychomotor/behavioral.
- Pain abdomen is a physical/somatic symptom.
- Conclude that the primary manifestations of a mental health disorder are its core psychological and behavioral features. The physical symptom (pain abdomen) is the outlier and therefore the correct answer.
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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