A nurse is assessing a newborn who has a coarctation of the aorta. Which of the following should the nurse recognize is a clinical manifestation of coarctation of the aorta?

Rationale: A. Decreased blood pressure in the arms with increased blood pressure in the legs is incorrect because coarctation of the aorta narrows the aortic arch near the ductus arteriosus, usually after the vessels that supply the head and arms. This results in higher pressure in the upper extremities compared with the lower extremities, not the reverse. B. Increased blood pressure in the arms with decreased blood pressure in the legs is correct because the obstruction in the aorta causes restricted blood flow to the lower extremities, leading to weak or delayed femoral pulses and lower blood pressure in the legs. Conversely, the upper extremities receive normal or elevated blood flow, resulting in higher blood pressure. This is a hallmark finding in coarctation of the aorta. C. Decreased blood pressure in both the arms and the legs is incorrect because blood flow to the upper extremities is typically preserved or even increased, not decreased. Low pressure in both the arms and legs would suggest generalized shock or severe heart failure, not isolated coarctation. D. Increased blood pressure in both the arms and the legs is incorrect because the obstruction limits perfusion to the lower body. While upper extremity pressure may be elevated due to increased resistance, lower extremity pressure is reduced, not increased.