NR 509 Week 4 Midweek Comprehension Quiz

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


 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



 Neck-vein distention


 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?






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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