RELIAS LEARNING NURSING UPDATED
SCRIPT 2026 PRACTICE SOLUTIONS
GRADED A+
● Early nursing interventions in a Stage 1 hemorrhage include:
Select an answer.
• Administering uterotonics, drawing labs, and moving to the OR
• Massaging the fundus, ambulating the patient, and quantifying blood
loss
• Massaging the fundus, emptying the bladder, and quantifying blood
loss
O Evaluating vital signs, assessing for cervical lacerations, and
administering IV fluids. Answer: • Massaging the fundus, emptying the
bladder, and quantifying blood loss
● Ms. Diaz expels a grapefruit-sized clot. The nurse massages Ms. Diaz
fundus and informs the physician that the patient has entered Stage 2 of
hemorrhage. The physician states, "Let's just watch her over the next
hour."
What should the prudent nurse do?
Select an answer.
• State that for a Stage 2 hemorrhage, the protocol recommends that the
provider evaluates the patient and orders a uterotonic.
,O Follow the physician's order, as it is the physician's call, not the
nurse's.
• Tell the patient that the doctor does not seem to think her bleeding is
concerning.
• Ask the senior nurse what to do, and follow that advice.. Answer: •
State that for a Stage 2 hemorrhage, the protocol recommends that the
provider evaluates the patient and orders a uterotonic.
● A hemorrhage risk assessment is completed:
SATA
1. Upon admission
2. Throughout labor, as risk factors develop
3. Prior to birth
4. Hourly in labor. Answer: 1. Upon admission
2. Throughout labor, as risk factors develop
3. Prior to birth
● Question 15 of 63
The nurse reports that the quantitative blood loss (QBL) from the under-
buttocks drape after the vaginal birth is 745 mL after dry weights and
pre-placental fluids have been subtracted. Prior to the provider leaving
the room, the obstetric team decides to re-evaluate bleeding, fundal
,height, and vital signs. The decision for heightened surveillance is made
because:
Select an answer.
a. The team mistakenly diagnoses a hemorrhage despite the fact that
QBL is <1000 mL.
b. Cumulative QBL is not accurate enough to diagnose obstetric
hemorrhage.
c. The team correctly identifies 745 mL as an abnormal amount of blood
loss for a vaginal birth, warranting close monitoring.
d. Some providers are more cautious than others, and management
depends on the individual provider.. Answer: c. The team correctly
identifies 745 mL as an abnormal amount of blood loss for a vaginal
birth, warranting close monitoring.
Though the standard definition of a hemorrhage is blood loss >1000 mL,
blood loss
>500 mL is abnormal in a vaginal birth and warrants close monitoring.
This is considered a Stage 1 hemorrhage on AWHONN's hemorrhage
staging system.
Initial interventions to manage hemorrhage are appropriate after 500 mL
blood loss in a vaginal birth (Association of Women's Health, Obstetric
and Neonatal Nurses 2021a). QBL should be the main trigger to help
guide management of a hemorrhage. Standardized protocols help limit
variances due to different providers.
, ● A cumulative quantitative blood loss after a vaginal birth that is 600
mL is considered what stage of hemorrhage?
Select an answer.
• Severe hemorrhage
• Stage 1 hemorrhage
• Stage 3 hemorrhage
• Is not staged because it is <1000 mL. Answer: • Stage 1 hemorrhage
● Which of the following nursing interventions should be performed in
collaboration with other interventions during a Stage 1 obstetric
hemorrhage?
Select all that apply.
1 Keep the patient warm using warmed fluids and warmer devices.
2 Directy quantify blood loss (OBL) and communicate cumulative QBL.
3 Aggressively replace blood loss with an equal amount of crystalloid
fluids.
4 Avoid the use of a bladder catheter to limit the risk of infection..
Answer: 1 Keep the patient warm using warmed fluids and warmer
devices.
2 Directy quantify blood loss (OBL) and communicate cumulative QBL.
SCRIPT 2026 PRACTICE SOLUTIONS
GRADED A+
● Early nursing interventions in a Stage 1 hemorrhage include:
Select an answer.
• Administering uterotonics, drawing labs, and moving to the OR
• Massaging the fundus, ambulating the patient, and quantifying blood
loss
• Massaging the fundus, emptying the bladder, and quantifying blood
loss
O Evaluating vital signs, assessing for cervical lacerations, and
administering IV fluids. Answer: • Massaging the fundus, emptying the
bladder, and quantifying blood loss
● Ms. Diaz expels a grapefruit-sized clot. The nurse massages Ms. Diaz
fundus and informs the physician that the patient has entered Stage 2 of
hemorrhage. The physician states, "Let's just watch her over the next
hour."
What should the prudent nurse do?
Select an answer.
• State that for a Stage 2 hemorrhage, the protocol recommends that the
provider evaluates the patient and orders a uterotonic.
,O Follow the physician's order, as it is the physician's call, not the
nurse's.
• Tell the patient that the doctor does not seem to think her bleeding is
concerning.
• Ask the senior nurse what to do, and follow that advice.. Answer: •
State that for a Stage 2 hemorrhage, the protocol recommends that the
provider evaluates the patient and orders a uterotonic.
● A hemorrhage risk assessment is completed:
SATA
1. Upon admission
2. Throughout labor, as risk factors develop
3. Prior to birth
4. Hourly in labor. Answer: 1. Upon admission
2. Throughout labor, as risk factors develop
3. Prior to birth
● Question 15 of 63
The nurse reports that the quantitative blood loss (QBL) from the under-
buttocks drape after the vaginal birth is 745 mL after dry weights and
pre-placental fluids have been subtracted. Prior to the provider leaving
the room, the obstetric team decides to re-evaluate bleeding, fundal
,height, and vital signs. The decision for heightened surveillance is made
because:
Select an answer.
a. The team mistakenly diagnoses a hemorrhage despite the fact that
QBL is <1000 mL.
b. Cumulative QBL is not accurate enough to diagnose obstetric
hemorrhage.
c. The team correctly identifies 745 mL as an abnormal amount of blood
loss for a vaginal birth, warranting close monitoring.
d. Some providers are more cautious than others, and management
depends on the individual provider.. Answer: c. The team correctly
identifies 745 mL as an abnormal amount of blood loss for a vaginal
birth, warranting close monitoring.
Though the standard definition of a hemorrhage is blood loss >1000 mL,
blood loss
>500 mL is abnormal in a vaginal birth and warrants close monitoring.
This is considered a Stage 1 hemorrhage on AWHONN's hemorrhage
staging system.
Initial interventions to manage hemorrhage are appropriate after 500 mL
blood loss in a vaginal birth (Association of Women's Health, Obstetric
and Neonatal Nurses 2021a). QBL should be the main trigger to help
guide management of a hemorrhage. Standardized protocols help limit
variances due to different providers.
, ● A cumulative quantitative blood loss after a vaginal birth that is 600
mL is considered what stage of hemorrhage?
Select an answer.
• Severe hemorrhage
• Stage 1 hemorrhage
• Stage 3 hemorrhage
• Is not staged because it is <1000 mL. Answer: • Stage 1 hemorrhage
● Which of the following nursing interventions should be performed in
collaboration with other interventions during a Stage 1 obstetric
hemorrhage?
Select all that apply.
1 Keep the patient warm using warmed fluids and warmer devices.
2 Directy quantify blood loss (OBL) and communicate cumulative QBL.
3 Aggressively replace blood loss with an equal amount of crystalloid
fluids.
4 Avoid the use of a bladder catheter to limit the risk of infection..
Answer: 1 Keep the patient warm using warmed fluids and warmer
devices.
2 Directy quantify blood loss (OBL) and communicate cumulative QBL.
