Neonatal Nurse Practitioner Practice Exam

What is an expected finding in a neonate with congestive heart failure?

1. Decreased heart rate

2. Pooling of blood in the extremities

3. Cardiac enlargement

4. Hypotension

The correct answer is: Cardiac enlargement

In neonates with congestive heart failure, cardiac enlargement is an expected finding due to the increased workload on the heart, which can lead to ventricular hypertrophy. This occurs because the heart has to work harder to pump blood, often because of conditions such as congenital heart defects or increased blood volume. As a result, the structural changes in the heart lead to an enlargement that can be assessed through physical examination or imaging studies like an echocardiogram. While decreased heart rate, pooling of blood in the extremities, and hypotension can all be associated with various cardiovascular conditions, they are not typical findings specifically linked to congestive heart failure in neonates. Generally, heart rates may be elevated in response to heart failure, pooling of blood in the extremities is not commonly described as a hallmark finding in neonates, and hypotension is often not as prominent as heart enlargement in this population. The predominance of cardiac enlargement in the context of congestive heart failure signifies the heart's adaptation to sustained pressure and volume overload.