MATERNITY CASE 5 FATIME SANOGO
DOCUMENTATION ACTUAL TEST PAPER 2026
QUESTIONS ANSWERS SOLUTIONS GRADED
A+
◉ Which of the following factor(s) places a patient at risk for
postpartum hemorrhage? (Select all that apply.) Answer: Rapid
labor, Macrosomia, Maternal fever, Oxytocin use during labor - Rapid
labor, macrosomia, and oxytocin use during labor all place additional
stress on the uterine muscle and may lead to muscle fatigue and
failure of the muscle to effectively contract post-birth. Maternal fever
indicating intrauterine infection may also impair the effectiveness of
the uterine muscle to contract and control bleeding from the
placental site. Preterm birth is not a risk factor for postpartum
hemorrhage.
◉ While assessing the patient's fundus, the nurse notes that with
massage the uterus becomes firm, but then it relaxes again and the
bleeding increases. Which of the following causes of excessive
bleeding does the nurse suspect? Answer: Retained tissue- The
presence of retained placental tissue prevents contraction of the
uterine muscle and occlusion of vessels at the placental site. With
uterine atony, the uterus does not firm up with massage. With a
laceration, there is excessive bleeding in the presence of a firm
uterus. A hematoma is not related to the tone of the uterus.
, ◉ A complication of postpartum hemorrhage is hemorrhagic shock.
Which of the following set of signs would alert the nurse to the
development of hemorrhagic shock? Answer: Tachycardia,
hypotension, and decreased urine output - Tachycardia,
hypotension, and decreased urine output are signs of poor tissue
perfusion and the body's attempt to compensate to maintain vital
functions. They are consistent with the development of hemorrhagic
shock. Bradycardia, decreased hematocrit levels, and low platelets
are late signs of the body's response to the blood loss and the
consequences of hypovolemic shock.
◉ A patient is hemorrhaging after giving birth. When inspected, an
area of the placenta was frayed. The provider suspects that placental
fragments are retained within the uterus. What is the expected
treatment for this condition? Answer: Evacuation of the uterus
followed by oxytocin administration - Evacuation of the retained
tissue from the uterus is the first step. This is usually done manually
by the provider. Then oxytocin is administered to help maintain
uterine contraction. Uterine massage with the administration of
methylergonovine maleate or oxytocin administration followed by
carboprost tromethamine administration will stimulate contraction
of the uterus while the placental fragments are still inside. Uterine
inversion is a medical complication, not an intervention.
◉ Why should the patient's level of consciousness be assessed
during management of postpartum hemorrhage? Answer: To
evaluate cerebral perfusion - Level of consciousness will provide
DOCUMENTATION ACTUAL TEST PAPER 2026
QUESTIONS ANSWERS SOLUTIONS GRADED
A+
◉ Which of the following factor(s) places a patient at risk for
postpartum hemorrhage? (Select all that apply.) Answer: Rapid
labor, Macrosomia, Maternal fever, Oxytocin use during labor - Rapid
labor, macrosomia, and oxytocin use during labor all place additional
stress on the uterine muscle and may lead to muscle fatigue and
failure of the muscle to effectively contract post-birth. Maternal fever
indicating intrauterine infection may also impair the effectiveness of
the uterine muscle to contract and control bleeding from the
placental site. Preterm birth is not a risk factor for postpartum
hemorrhage.
◉ While assessing the patient's fundus, the nurse notes that with
massage the uterus becomes firm, but then it relaxes again and the
bleeding increases. Which of the following causes of excessive
bleeding does the nurse suspect? Answer: Retained tissue- The
presence of retained placental tissue prevents contraction of the
uterine muscle and occlusion of vessels at the placental site. With
uterine atony, the uterus does not firm up with massage. With a
laceration, there is excessive bleeding in the presence of a firm
uterus. A hematoma is not related to the tone of the uterus.
, ◉ A complication of postpartum hemorrhage is hemorrhagic shock.
Which of the following set of signs would alert the nurse to the
development of hemorrhagic shock? Answer: Tachycardia,
hypotension, and decreased urine output - Tachycardia,
hypotension, and decreased urine output are signs of poor tissue
perfusion and the body's attempt to compensate to maintain vital
functions. They are consistent with the development of hemorrhagic
shock. Bradycardia, decreased hematocrit levels, and low platelets
are late signs of the body's response to the blood loss and the
consequences of hypovolemic shock.
◉ A patient is hemorrhaging after giving birth. When inspected, an
area of the placenta was frayed. The provider suspects that placental
fragments are retained within the uterus. What is the expected
treatment for this condition? Answer: Evacuation of the uterus
followed by oxytocin administration - Evacuation of the retained
tissue from the uterus is the first step. This is usually done manually
by the provider. Then oxytocin is administered to help maintain
uterine contraction. Uterine massage with the administration of
methylergonovine maleate or oxytocin administration followed by
carboprost tromethamine administration will stimulate contraction
of the uterus while the placental fragments are still inside. Uterine
inversion is a medical complication, not an intervention.
◉ Why should the patient's level of consciousness be assessed
during management of postpartum hemorrhage? Answer: To
evaluate cerebral perfusion - Level of consciousness will provide
