The nurse in the post-delivery unit is encouraging skin-to-skin contact for a mother and neonate after cesarean delivery. Which action, if noticed by the nurse, requires immediate intervention by the nurse?

Correct Answer: B

Rationale: B is the correct answer because having the mother in a supine position with the neonate prone on her chest can potentially increase the risk of neonatal suffocation or accidental injury due to the baby slipping off. This position restricts the baby's ability to breathe properly and may lead to adverse outcomes. A: Sitting up with the neonate prone on her chest allows for better supervision and support for the baby's breathing. C: The neonate facing to the side is a safe position for skin-to-skin contact and breastfeeding. D: Neonate resting in semi-Fowler's position is a safe and comfortable position that allows for proper breathing and bonding between mother and baby.

Correct Answer: A

Rationale: The correct answer is A: Unruptured membranes. Internal monitoring devices are inserted through the cervix and into the uterus, which can introduce bacteria and increase the risk of infection if the membranes are not ruptured. This can lead to serious complications for both the mother and the baby. Choice B (intravenous fluid) is incorrect because IV fluids are commonly used during labor to maintain hydration and provide necessary nutrients. Choice C (Fetus has known heart defect) is incorrect because internal monitoring devices are used to assess fetal heart rate and detect any abnormalities, making this condition a reason for monitoring rather than a contraindication. Choice D (must act quickly to improve placental blood flow and fetal oxygen supply) is incorrect because internal monitoring devices are usually used for continuous monitoring and do not require immediate intervention to be placed.

Correct Answer: D

Rationale: The correct answer is D because oxytocin can cause increased uterine contractions, potentially impacting uteroplacental exchange and reducing oxygen delivery to the fetus. This can lead to fetal distress, making continuous electronic fetal monitoring crucial to detect any signs of distress promptly. A: Fetal chemoreceptors being stimulated is not directly related to the need for continuous monitoring with oxytocin administration. B: Maternal hypotension is a potential side effect of oxytocin but does not directly necessitate continuous fetal monitoring. C: Maternal fluid volume deficit is a concern with oxytocin, but it does not directly link to the need for continuous fetal monitoring.

Correct Answer: B

Rationale: The correct answer is B: Variable decelerations. When the mother's membranes rupture during active labor, variable decelerations should be observed in the fetal heart rate. This is because the rupture of membranes can lead to umbilical cord compression, causing variable decelerations in the fetal heart rate pattern. Variable decelerations are characterized by abrupt and visually apparent decreases in heart rate variability. A: Early decelerations are usually associated with head compression during contractions and are benign. C: Nonperiodic accelerations are not a typical pattern seen in response to ruptured membranes during labor. D: An increase in baseline variability is a positive sign and does not specifically indicate the occurrence of variable decelerations related to umbilical cord compression.

Correct Answer: D

Rationale: The correct answer is D: Sympathetic stimulation. Sympathetic stimulation increases heart rate by releasing norepinephrine, which acts on beta-adrenergic receptors in the heart. This leads to an increase in heart rate. Choices A and B are incorrect because inhibition of epinephrine or norepinephrine would not cause an increase in heart rate. Choice C is incorrect because stimulation of the vagus nerve would actually decrease heart rate by releasing acetylcholine, which acts on muscarinic receptors in the heart.