While auscultating heart sounds of a patient with heart failure, the nurse hears an extra heart sound immediately after the second heart sound (S2). The nurse should document this as a:
A) First heart sound (S1)
B) Third heart sound (S3)
C) Fourth heart sound (S4)
D) Murmur
Ans: B
Feedback: An S3 is heard following an S2, which commonly occurs in patients experiencing heart failure and results from increased filling pressures. An S1 is a normal heart sound made by the closing of the mitral and tricuspid valves. An S4 is heard before an S1 and is caused by resistance to ventricular filling. A murmur is heard when there's turbulent blood flow across the valves.
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