Quiz 4 Midweek Comprehension Quiz
Question 1
2 / 2 pts
According to the lesson, low-pitched sounds of S3 and S4 and the murmur of mitral stenosis are best
heard using what?
The naked ear
The diaphragm of the stethoscope
Correct!
The bell of the stethoscope
The bell and diaphragm are equally effective for this task
Listen throughout the precordium with the diaphragm, pressing it firmly against the chest. The bell is
more sensitive to the low-pitched sounds of S3 and S4 and the murmur of mitral stenosis. Apply the
bell lightly, with just enough pressure to produce an air seal with its full rim. Use the bell at the apex,
then move medially along the lower sternal border. Resting the heel of your hand on the chest like a
fulcrum may help you to maintain light pressure.
Question 2
1.33 / 2 pts
According to the lesson, heart failure can be assessed using the Framingham criteria. Which of the
following findings are major criteria suggestive of heart failure? (Select all that apply)
You Answered
Ankle edema
Orthopnea
orrect!
Neck-vein distention
Correct!
S3 gallop
For establishing a diagnosis of CHF using the modified Framingham Criteria, 2 major criteria or 1
major and 2 minor criteria must be present. Major criteria are: Paroxysmal nocturnal dyspnea or
orthopnea ; Neck-vein distention; Rales; Cardiomegaly; Acute pulmonary edema; S3 gallop;
Increased venous pressure >16 cm of water; and Hepatojugular reflux.
Question 3
2 / 2 pts
According to the Bates’ Visual Guide video 10.9 Auscultation of Heart Sounds, splitting of S2 is best
heard during inspiration over which area on the chest wall?
Apex
Correct!
Pulmonic
Mitral
Aortic
A split S2 is best heard at the pulmonic valve listening post, as P2 is much softer than A2. Like the S1
heart sound, the S2 sound is described regarding splitting and intensity.
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