NCLEX OB Postpartum Practice Test

In postpartum hemorrhage, reducing bleeding by inhibiting fibrinolysis is achieved with tranexamic acid, an antifibrinolytic. It works by blocking the activation of plasminogen to plasmin, which slows the breakdown of fibrin clots and helps stabilize the clots that have formed. Giving tranexamic acid early can lessen blood loss and reduce death from hemorrhage when used alongside uterotonics and other standard measures. The usual approach is an IV administration (often a 1 g bolus, with a second gram if bleeding continues, per protocol). The other medications listed don’t have this effect: warfarin is an anticoagulant that would worsen bleeding; ketorolac is an NSAID that can impair platelet function and increase bleeding risk; lidocaine is a local anesthetic and does not affect fibrinolysis.