HESI Registered Nurse EXIT Practice Exam

What finding is most likely to be auscultated in a client with congestive heart failure?

1. S3 ventricular gallop

2. Apical click

3. Systolic murmur

4. Split S2

The correct answer is: S3 ventricular gallop

Auscultation of an S3 ventricular gallop is a significant finding in patients with congestive heart failure (CHF). The presence of an S3 sound, often described as a "galloping" rhythm, indicates increased volume in the ventricles and reduced compliance of the heart muscle, which are common characteristics of heart failure. This sound occurs during the rapid filling phase of the ventricles when blood flows from the atria into the ventricles, and is particularly notable in individuals who have impaired left ventricular function. In the context of CHF, the S3 gallop can serve as an indicator of fluid overload, wherein the heart struggles to effectively manage the volume of blood returning to it. As such, nurses will assess for this auscultatory finding when evaluating a patient suspected of having or presenting with congestive heart failure symptoms, such as dyspnea, edema, and fatigue. This finding can assist in confirming the diagnosis of heart failure and guide treatment decisions, such as the necessity for diuretics to manage fluid overload. Other choices might represent different cardiovascular conditions or scenarios that are not specifically indicative of CHF. For example, an apical click typically suggests mitral valve prolapse rather than heart failure, while a systolic murmur may