Neonatal Nurse Practitioner Practice Exam

Which clinical sign may indicate pulmonary edema in a neonate with congenital heart disease?

1. Cyanosis

2. Tachypnea

3. Bradycardia

4. Hypotonia

The correct answer is: Tachypnea

The presence of tachypnea in a neonate with congenital heart disease can be a significant clinical sign that suggests pulmonary edema. In this context, tachypnea, or an increased respiratory rate, often occurs as the body attempts to compensate for inadequate oxygen exchange due to fluid accumulation in the lungs. Pulmonary edema can result from congestive heart failure, which is a common complication in neonates with congenital heart defects. As the heart struggles to maintain adequate circulation, fluid can leak into the alveolar spaces due to increased pressures in the pulmonary circulation. This fluid interferes with gas exchange, leading the neonate to increase their respiratory effort in an attempt to obtain sufficient oxygen, thereby presenting with tachypnea. Other options may present with different clinical manifestations: cyanosis indicates a lack of oxygen in the blood, bradycardia refers to an abnormally slow heart rate, and hypotonia signifies decreased muscle tone, none of which are as directly indicative of pulmonary involvement as tachypnea. Thus, tachypnea serves as a clear indicator of potential pulmonary edema in this clinical scenario.