RN Nursing · Health Assessment · Practice question
The student nurse is auscultating the chest wall of an adult female. The student hears S1 and S2. The faculty member asks the student "What makes the sound of S2?" Identify the best response from the student.
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"S2 is the aortic and tricuspid valves closing."
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"S2 is the mitral and tricuspid valves closing."
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✓
"S2 is the aortic and pulmonic valves closing."
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"S2 is the mitral and aortic valves closing."
Answer & explanation
Correct: "S2 is the aortic and pulmonic valves closing."
The second heart sound, S2, is produced by the closure of the semilunar valves at the end of ventricular systole. These are the aortic valve, which closes as systemic pressure exceeds left ventricular pressure, and the pulmonic valve, which closes as pulmonary artery pressure exceeds right ventricular pressure. S2 is best heard at the base of the heart, specifically the aortic area (right second intercostal space) and the pulmonic area (left second intercostal space). S1, by contrast, is produced by closure of the mitral (bicuspid) and tricuspid valves at the onset of ventricular systole, marking the beginning of the heartbeat. Confusing S2 with mitral and tricuspid closure is a common student error — those valves close to produce S1, not S2. Stating that S2 involves the aortic and tricuspid valves or the mitral and aortic valves is incorrect because these pairings mix atrioventricular and semilunar valves inappropriately. The only anatomically accurate and physiologically correct answer is that S2 is produced by the aortic and pulmonic valves closing at the end of systole.
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