In a newborn with right axis deviation, what is expected in the precordial leads (V1-V3)?

In a newborn with right axis deviation, the expectation in the precordial leads (V1-V3) is the presence of R waves. Right axis deviation can occur due to several reasons, including physiological variations in the heart's positioning and due to the newborn’s anatomy.

In this scenario, an upright R wave in V1 and increasing R wave amplitude in the subsequent precordial leads (V2 and V3) indicates an expected electrical pattern consistent with right axis deviation. The transition from V1 to V3 typically reflects increased R wave heights, which highlights the rightward electrical dominance in the heart's electrical activity caused by anatomical and physiological factors present in the newborn's heart.

Other options such as deep S waves, small R waves, or Q waves are less characteristic of right axis deviation in this context. Deep S waves would typically imply left axis deviation or other conduction abnormalities; small R waves might indicate absence of normal ventricular depolarization patterns, which are not expected in right axis deviation; Q waves are associated with myocardial necrosis and are not a normal finding in this scenario. Thus, R waves are the expected and correct finding for this question.