The following are skin changes in pregnancy EXCEPT:

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2020

Explanation

Eczema (atopic dermatitis) is an inflammatory skin condition, classified as a dermatological pathology or dermatosis.
While pregnancy can influence the course of eczema (sometimes causing flare-ups, other times improvement), it is not considered a normal physiological change that happens because of pregnancy.
The other three options are direct, common physiological consequences of hormonal changes and physical stretching during pregnancy.

Option B: Striae gravidarum, or stretch marks, are very common physiological skin changes resulting from the stretching of the skin and hormonal effects on connective tissue.
Option C: Linea nigra is a dark, vertical line that appears on the abdomen and is a classic example of physiological hyperpigmentation in pregnancy, caused by increased melanocyte-stimulating hormone.
Option D: Chloasma, also known as melasma or the "mask of pregnancy," refers to patches of hyperpigmentation on the face. It is a common physiological change due to hormonal fluctuations.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Differentiating between physiological and pathological skin changes during pregnancy as background academic context rather than a clinical decision trigger.
Nurses must be able to differentiate between normal physiological changes and pathological conditions to provide appropriate patient education and reassurance.
Recognizing a pathological condition like eczema allows the nurse to recommend appropriate consultation with a healthcare provider for management, which may include topical treatments safe for use in pregnancy.
Patient counseling is key. Reassuring a patient that striae, linea nigra, and chloasma are normal and often fade after delivery can alleviate anxiety.

How to Approach the Question

First, carefully read the question and note the keyword "EXCEPT." This means you are looking for the option that does not belong with the others.
Identify the common theme among the options. The question is about skin changes in pregnancy.
Analyze each option: Striae gravidarum, Linea nigra, and Chloasma are all well-known, normal (physiological) skin changes that occur in many pregnancies.
Consider the remaining option, Eczema. Eczema is a skin disease (a pathology), not a normal adaptation to pregnancy.
The option that is the exception is Eczema, as it is a pathological condition, whereas the other three are physiological changes.

Concept Tested & Keywords

Concept Tested: Differentiating between physiological and pathological skin changes during pregnancy.
Stem keywords: skin changes, pregnancy
Lead-in keywords: EXCEPT
Negative lead-in flag: The question asks to identify the option that is an exception.

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E6 Obstetrics Williams p. 40-59

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Attempt every question from this paper in a timed mock, then review the full solution for each one.