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    HEALTH ASSESSMENT PROCTORED EXAM
    Select All That Apply

    The nurse is assessing the abdomen of a woman who is eight months pregnant. Which characteristic is the nurse likely to observe? Select all that apply.

    Explanation & Rationale

    A. Fetal movement: By the eighth month of gestation, the fetus has developed sufficient muscular coordination and size for its activity to be visible through the maternal abdominal wall. These movements indicate fetal well-being and are a hallmark of late-stage pregnancy assessment. The nurse can often palpate or observe these shifts during the physical examination. B. Linea nigra: This is a hyperpigmented linear streak extending from the symphysis pubis to the top of the fundus, caused by increased melanocyte-stimulating hormone. It is a common physiological integumentary change that occurs during the second and third trimesters. It typically resolves postpartum but is a prominent feature in late pregnancy. C. Striae: Also known as striae gravidarum or stretch marks, these are linear jagged scars resulting from the rapid expansion of the abdomen and hormonal changes. They appear as pink, silver, or purple indents in the skin where dermal collagen has stretched. They are highly prevalent in the third trimester as the uterus reaches maximum distension. D. Vernix caseosa: This is a thick, white, sebaceous substance that coats the skin of the fetus in utero to provide protection and lubrication. While it is present on the fetus, it is not an observable characteristic of the maternal abdomen during an external assessment. It only becomes visible to the nurse upon delivery of the neonate. E. Scaphoid profile: A scaphoid abdomen is characterized by a concave or sunken appearance where the anterior wall is recessed. This is anatomically impossible in the eighth month of pregnancy due to the large, gravid uterus displacing the abdominal contents forward. A pregnant abdomen at this stage is protuberant or globular.

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