HESI Registered Nurse EXIT Practice Exam

In a child with suspected coarctation of the aorta, which of the following pulse findings is expected?

1. Strong pedal pulses

2. Diminishing carotid pulses

3. Normal femoral pulses

4. Bounding pulses in the arms

The correct answer is: Bounding pulses in the arms

In a child with suspected coarctation of the aorta, bounding pulses in the arms are expected due to altered blood flow dynamics caused by the narrowing of the aorta. Coarctation typically occurs distal to the left subclavian artery, which results in increased blood flow and pressure to the upper body, including the arms. This increased pressure leads to bounding pulses in the arms as these vessels receive blood that has not yet been impeded by the coarctation. Conversely, the blood flow to the lower body is significantly reduced due to the narrowing, which would result in weaker or diminished pulses in the lower extremities. This discrepancy between upper and lower body pulses is a critical diagnostic indicator of coarctation. The other findings, such as diminished or weak carotid and femoral pulses, would not be characteristic of this condition when considering the classic presentation, as they do not accurately reflect the typical hemodynamics seen in coarctation of the aorta. Normal femoral pulses are also unlikely because the reduced blood flow past the site of coarctation would lead to weaker pulses in the lower extremities rather than normal findings.