1|Page
NM 704 FINAL EXAM LATEST 2026-2027 ACTUAL EXAM WITH
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (100%
VERIFIED ANSWERS) |ALREADY GRADED A+| ||PROFESSOR
VERIFIED|| ||BRANDNEW!!!||
What are the signs of placental separation? - ANSWER-1. fresh
flow of blood from vagina
2. umbilical cord lengthens outside vagina
3. uterine fundus rises up
4. uterus goes from discoid and becomes firm and globular
How do we avoid 3rd stage complications? - ANSWER-do not pull
on the cord
do not massage the fundus
What is expectant management of 3rd stage labor? (use SDM) -
ANSWER-Expectant management of third stage in the context of
a physiological labor and birth is a more recent topic of research.
There is a growing body of research whose findings support
expectant management of third stage labor when first and second
stages of labor have been spontaneous and without complication
or intervention. This population of birthing people also has no
,2|Page
prenatal or intrapartum risk factors for PPH. The AMTSL research
did not look at this population.
The current body of evidence has shown the following outcomes
for expectant management of third stage in birthing people at low
risk of PPH who experience a normal labor and birth, as defined
above:
No increase in blood loss compared with AMTSL in a general
population
No increased risk of PPH compared with AMTSL in a general
population
When labor and birth are normal in a healthy and well person,
expectant management of third stage results in comparable
bleeding outcomes as when AMTSL is implemented with a
general population of birthing people at mixed risk for excessive
bleeding.
,3|Page
What is ACTIVE management of 3rd stage labor? (use SDM) -
ANSWER-Three Components of AMTSL according to the
ICM/FIGO Joint Statement (2004) are:
Administration of a uterotonic medication within one minute of the
birth of the baby, after ruling out multiple gestation.
Oxytocin is the preferred medication.
Controlled cord traction to assist with placental expulsion.
Uterine massage immediately after placental expulsion, and then
as needed
What are the medications used during uncomplicated 3rd and 4th
stage of labor? - ANSWER-Typically pitocin is used in active
management of 3rd stage and for increased bleeding
Methergen can be used in increased bleeding in the 4th stage if
pitocin has already been administered and pt is not hypertensive
(2nd line med). Used with massage
Methergen produces a sustained strong contraction to stop the
bleeding
, 4|Page
Hemabate and Transnexamic acid are used in hemmorhage
What is the evaluation of the birthing person in the 4th stage? -
ANSWER-Varneys pgs 1437-1440 and appendix 34a (1471-
1472)
Basics: VS
Brain: psych/emotional response
Breastfeeding
Belly: Fundus and Uterus
Bladder: full?
Bleeding: minimal bright red lochia with walnut sized clots are
normal (larger than a orange is abnormal)
Bottom: evaluate perineum and hemorrhoids
Perineal Lacerations - ANSWER-(First degree)-involves the
superficial vaginal mucosa, disruption of perineal
skins/eputhelium
(Second degree)-involves the vaginal mucosa perineal skin,
posterior fourchette and musculature of the perineum
NM 704 FINAL EXAM LATEST 2026-2027 ACTUAL EXAM WITH
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (100%
VERIFIED ANSWERS) |ALREADY GRADED A+| ||PROFESSOR
VERIFIED|| ||BRANDNEW!!!||
What are the signs of placental separation? - ANSWER-1. fresh
flow of blood from vagina
2. umbilical cord lengthens outside vagina
3. uterine fundus rises up
4. uterus goes from discoid and becomes firm and globular
How do we avoid 3rd stage complications? - ANSWER-do not pull
on the cord
do not massage the fundus
What is expectant management of 3rd stage labor? (use SDM) -
ANSWER-Expectant management of third stage in the context of
a physiological labor and birth is a more recent topic of research.
There is a growing body of research whose findings support
expectant management of third stage labor when first and second
stages of labor have been spontaneous and without complication
or intervention. This population of birthing people also has no
,2|Page
prenatal or intrapartum risk factors for PPH. The AMTSL research
did not look at this population.
The current body of evidence has shown the following outcomes
for expectant management of third stage in birthing people at low
risk of PPH who experience a normal labor and birth, as defined
above:
No increase in blood loss compared with AMTSL in a general
population
No increased risk of PPH compared with AMTSL in a general
population
When labor and birth are normal in a healthy and well person,
expectant management of third stage results in comparable
bleeding outcomes as when AMTSL is implemented with a
general population of birthing people at mixed risk for excessive
bleeding.
,3|Page
What is ACTIVE management of 3rd stage labor? (use SDM) -
ANSWER-Three Components of AMTSL according to the
ICM/FIGO Joint Statement (2004) are:
Administration of a uterotonic medication within one minute of the
birth of the baby, after ruling out multiple gestation.
Oxytocin is the preferred medication.
Controlled cord traction to assist with placental expulsion.
Uterine massage immediately after placental expulsion, and then
as needed
What are the medications used during uncomplicated 3rd and 4th
stage of labor? - ANSWER-Typically pitocin is used in active
management of 3rd stage and for increased bleeding
Methergen can be used in increased bleeding in the 4th stage if
pitocin has already been administered and pt is not hypertensive
(2nd line med). Used with massage
Methergen produces a sustained strong contraction to stop the
bleeding
, 4|Page
Hemabate and Transnexamic acid are used in hemmorhage
What is the evaluation of the birthing person in the 4th stage? -
ANSWER-Varneys pgs 1437-1440 and appendix 34a (1471-
1472)
Basics: VS
Brain: psych/emotional response
Breastfeeding
Belly: Fundus and Uterus
Bladder: full?
Bleeding: minimal bright red lochia with walnut sized clots are
normal (larger than a orange is abnormal)
Bottom: evaluate perineum and hemorrhoids
Perineal Lacerations - ANSWER-(First degree)-involves the
superficial vaginal mucosa, disruption of perineal
skins/eputhelium
(Second degree)-involves the vaginal mucosa perineal skin,
posterior fourchette and musculature of the perineum
