RN Nursing · Cardiovascular Assessment · Practice question
The student nurse auscultates the chest wall of an adult male, and the student can identify the S1 and S2 sounds of the patient. During the post-conference, the nursing Instructor asked this student to describe the phases of the heart based on the heart sounds he heard in his patient. The student states:
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"S1 indicates the lub sound, and S2 indicates the 'Kentucky' sound"
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✓
"S1 indicates the beginning of systole, and S2 indicates the beginning of diastole"
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"S2 indicates the lub sound, and S1 indicates the dub sound"
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"S1 indicates the beginning of diastole, and S2 indicates the end of systole"
Answer & explanation
Correct: "S1 indicates the beginning of systole, and S2 indicates the beginning of diastole"
S1 is produced by the closure of the mitral and tricuspid (atrioventricular) valves at the onset of ventricular systole, so it marks the beginning of systole. S2 is produced by the closure of the aortic and pulmonic (semilunar) valves at the end of systole and the onset of ventricular diastole, so it marks the beginning of diastole. Therefore, the correct statement is that S1 indicates the beginning of systole and S2 indicates the beginning of diastole. The phrase describing S1 as the 'lub' sound and S2 as the 'dub' sound is partially accurate in lay terms, but describing S2 as the 'Kentucky' sound is incorrect; 'Kentucky' is a mnemonic used to describe a S3 gallop (lub-dub-Kentucky). The option stating that S2 indicates the 'lub' sound and S1 indicates the 'dub' sound reverses the correct associations. The option claiming S1 marks the beginning of diastole and S2 marks the end of systole is also reversed and physiologically inaccurate, since both of these events (beginning of diastole and end of systole) are concurrent and correspond to S2, not S1. Understanding that S1 opens the systolic period and S2 closes it is fundamental to cardiac auscultation and rhythm interpretation.
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