Practice Question
A nurse is auscultating a client's heart sounds and hears an extra heart sound before what should be considered the first heart sound S1. The nurse should document this finding as which of the following heart sounds?
Answer Choices:
Correct Answer:
The fourth heart sound (S4)
Rationale:
💠 S4 is heard before S1 because it is a presystolic sound caused by atrial contraction pushing blood into a stiff, non-compliant ventricle.
💠 It is strongly associated with left ventricular hypertrophy, long-standing hypertension, or ischemic heart disease.
💠 The timing of S4 helps clearly differentiate it from S3, which occurs after S2, and from valve disorders.
💠 Identifying S4 is important because it signals diastolic dysfunction, indicating reduced ventricular compliance.
Incorrect Options (Emoji Eliminations)
❌ S3: Occurs after S2, not before S1.
❌ Split S1: Still part of S1; not a presystolic extra sound.
❌ Friction rub: A scratchy sound from pericarditis, not a low-pitched atrial sound.
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This question is from RN Medsurg 2025 Exam which contains 42 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI MedSurg
- Answer Choices: 4