Answer to Question 4
The fourth heart sound is often heard in the older adult related to a stiff noncompliant left ventricle. It is strongly associated with coronary artery disease. An S3 sound is associated with CHF, children, and pregnancy. An ejection click is seen in Aortic or Pulmonic stenosis. A pericardial friction rub is heard in clients who have a inflammation of the pericardial sacs.