You are assessing a healthy adolescent girl as a part of a sports physical. When it comes time to listen to her heart and lungs, you decide to:
A) Perform auscultation with the stethoscope placed firmly over her clothing to protect her privacy.
B) Perform auscultation by holding the diaphragm lightly on her clothing to eliminate the "scratchy noise."
C) Perform auscultation with the diaphragm placed firmly on her skin to minimize extra noise.
D) Defer the exam, because she is healthy and it may agitate the girl.
Ans: C
Feedback: Auscultation should always be performed with the diaphragm placed firmly on the skin to minimize extra noise and with the bell lightly placed on the skin to reduce distortion caused by vibration. Options A and B are incorrect; placing a stethoscope over clothing limits the conduction of sound. Option D is incorrect; performing auscultation is an important part of a sports physical and should never be differed.
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