Presumptive signs & symptoms are all, except?

HPSSC - 2015

Obstetrics & Gynaecology

Easy

Appeared in: HPSSC - 2015

Explanation

Hegar's sign is classified as a probable sign of pregnancy, not a presumptive one.
It is an objective sign characterized by the softening of the lower uterine segment (isthmus), which is detected by a healthcare provider during a bimanual examination around 6 to 8 weeks of gestation.
Presumptive signs are subjective changes experienced and reported by the woman. Since Hegar's sign is an objective finding by an examiner, it is the correct exception in a list of presumptive signs.

Option B: Morning sickness (nausea and vomiting) is a classic presumptive sign of pregnancy. It is a subjective symptom reported by the woman, typically occurring in the first trimester.
Option C: Breast changes, such as tenderness, enlargement, tingling, and darkening of the areola, are subjective symptoms experienced by the woman early in pregnancy. This makes them presumptive signs.
Option D: Quickening is the mother's first perception of fetal movement, typically felt between 16 and 20 weeks. As it is a subjective sensation, it is classified as a presumptive sign.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of signs of pregnancy (Presumptive, Probable, Positive) as background academic context rather than a clinical decision trigger.
Nurses must accurately differentiate between presumptive, probable, and positive signs of pregnancy to provide correct patient education and avoid giving false assurances.
It is crucial to explain to patients that while presumptive and probable signs strongly suggest pregnancy, they can also be caused by other physiological or pathological conditions. Only positive signs provide definitive confirmation.
What if? If the question asked for a positive sign of pregnancy, a correct answer would be 'fetal heart sounds heard by Doppler' or 'visualization of the fetus on ultrasound,' as these are the only signs that offer conclusive proof.

How to Approach the Question

First, identify the keyword "except." This indicates that you must find the option that does not belong to the category specified in the question stem.
The question asks about "Presumptive signs & symptoms." Recall the three classifications of pregnancy signs: presumptive, probable, and positive.
Define each category: Presumptive signs are subjective (felt by the woman), probable signs are objective (detected by an examiner), and positive signs are conclusive proof.
Evaluate each option based on these definitions.
Morning sickness, breast changes, and quickening are all subjective experiences reported by the woman.
Hegar's sign is an objective finding assessed by a clinician during a physical exam.

Concept Tested & Keywords

Concept Tested: Classification of signs of pregnancy (Presumptive, Probable, Positive)
Stem keywords: Presumptive signs, symptoms, pregnancy
Lead-in keywords: except
Negative lead-in flag: The question asks for the exception among the given options.

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