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While Auscultating Heart Sounds on a 7-Year-Old Child for a Routine

Question 25
Multiple Choice

While auscultating heart sounds on a 7-year-old child for a routine physical,the nurse hears an S₃,a soft murmur at left midsternal border,and a venous hum when the child is standing.Which of these would be a correct interpretation of these findings? A) S3 is indicative of heart disease in children. B) These can all be normal findings in a child. C) These are indicative of congenital problems. D) The venous hum most likely indicates an aneurysm.

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Q 26
During the precordial assessment on an patient who is 8 months pregnant,the nurse palpates the apical impulse at the fourth left intercostal space lateral to the midclavicular line.This finding would indicate: A) right ventricular hypertrophy. B) increased volume and size of the heart as a result of pregnancy. C) displacement of the heart from elevation of the diaphragm. D) increased blood flow through the internal mammary artery.
Q 27
In assessing for an S₄ heart sound with a stethoscope,the nurse would listen with the: A) bell at the base with the patient leaning forward. B) bell at the apex with the patient in the left lateral position. C) diaphragm in the aortic area with the patient sitting. D) diaphragm in the pulmonic area with the patient supine.
Q 28
A 70-year-old patient with a history of hypertension has a blood pressure of 180/100 mm Hg and a heart rate of 90 beats per minute.The nurse hears an extra heart sound at the apex immediately before S₁.The sound is heard only with the bell while the patient is in the left lateral position.With these findings and the patient's history,the nurse knows that this extra heart sound is most likely a(n): A) split S1. B) atrial gallop. C) diastolic murmur. D) summation sound.
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