RELIAS NURSING CARE OF THE PATIENT EXAM
SCRIPT 2026 SOLVED QUESTIONS 100%
CORRECT
◉ ACOG definition (2017). Answer: ≥1000 mL blood loss + signs of
hypovolemia within 24 hours postpartum
◉ Early PPH. Answer: Occurs within 24 hours (most common in first
1-2 hours)
◉ Late PPH. Answer: Occurs after 24 hours
◉ Major Causes of PPH. Answer: 3 T's: Tone, Tissue, Trauma
◉ Tone (Uterine atony). Answer: 70-80% of cases of PPH
◉ Tissue. Answer: Retained placenta/placental fragments
◉ Trauma. Answer: Cervical, vaginal, perineal tears/lacerations
◉ Uterine Atony. Answer: Uterus fails to contract effectively
, ◉ Risk Factors for Uterine Atony. Answer: Overdistention, grand
multiparity, history of PPH, fast or long labor, oxytocin or
magnesium sulfate use, uterine infection, cesarean, retained
placenta
◉ Signs of Uterine Atony. Answer: Boggy fundus, fundus high above
umbilicus, excessive lochia (>1 pad/15 min), large clots, fundus
firms with massage but becomes boggy again
◉ Nursing Interventions for Uterine Atony. Answer: Frequent fundal
assessments, keep bladder empty, fundal massage, expel clots after
contraction, monitor vitals, maintain large-bore IV access, notify
provider / follow PPH protocol
◉ Oxytocin (Pitocin). Answer: IV/IM, dilute IV, titrate; painful
sustained contraction
◉ Methylergonovine (Methergine). Answer: IM/PO, check BP;
contraindicated in hypertension
◉ Carboprost (Hemabate). Answer: IM / directly uterine, side
effects: N/V/D, painful contractions
◉ Misoprostol (Cytotec). Answer: Rectal / oral, side effects: N/V/D,
painful contractions
SCRIPT 2026 SOLVED QUESTIONS 100%
CORRECT
◉ ACOG definition (2017). Answer: ≥1000 mL blood loss + signs of
hypovolemia within 24 hours postpartum
◉ Early PPH. Answer: Occurs within 24 hours (most common in first
1-2 hours)
◉ Late PPH. Answer: Occurs after 24 hours
◉ Major Causes of PPH. Answer: 3 T's: Tone, Tissue, Trauma
◉ Tone (Uterine atony). Answer: 70-80% of cases of PPH
◉ Tissue. Answer: Retained placenta/placental fragments
◉ Trauma. Answer: Cervical, vaginal, perineal tears/lacerations
◉ Uterine Atony. Answer: Uterus fails to contract effectively
, ◉ Risk Factors for Uterine Atony. Answer: Overdistention, grand
multiparity, history of PPH, fast or long labor, oxytocin or
magnesium sulfate use, uterine infection, cesarean, retained
placenta
◉ Signs of Uterine Atony. Answer: Boggy fundus, fundus high above
umbilicus, excessive lochia (>1 pad/15 min), large clots, fundus
firms with massage but becomes boggy again
◉ Nursing Interventions for Uterine Atony. Answer: Frequent fundal
assessments, keep bladder empty, fundal massage, expel clots after
contraction, monitor vitals, maintain large-bore IV access, notify
provider / follow PPH protocol
◉ Oxytocin (Pitocin). Answer: IV/IM, dilute IV, titrate; painful
sustained contraction
◉ Methylergonovine (Methergine). Answer: IM/PO, check BP;
contraindicated in hypertension
◉ Carboprost (Hemabate). Answer: IM / directly uterine, side
effects: N/V/D, painful contractions
◉ Misoprostol (Cytotec). Answer: Rectal / oral, side effects: N/V/D,
painful contractions
