During a cardiovascular assessment, the nurse knows that an S4 heart sound is:
a. Heard at the onset of atrial diastole.
b. Usually a normal finding in the older adult.
c. Heard at the end of ventricular diastole.
d. Heard best over the second left intercostal space with the individual sitting upright.
ANS: C
An S4 heart sound is heard at the end of diastole when the atria contract (atrial systole) and when the ventricles are resistant to filling. The S4 occurs just before the S1.
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