Family Nurse Practitioner Exam

What should a nurse advise if a 16-year-old girl has a split S2 that disappears during expiration?

1. Refer to a pediatric cardiologist

2. Advise to avoid strenuous physical exertion

3. Refer for a stress EKG

4. Explain that this is a normal finding

The correct answer is: Explain that this is a normal finding

When a nurse encounters a 16-year-old girl with a split S2 that disappears during expiration, it signifies a normal physiological phenomenon. The splitting of S2 is often more pronounced during inspiration due to changes in intrathoracic pressure affecting heart sounds. This splitting typically diminishes or disappears during expiration. In adolescents, this can be a common and benign finding, generally indicating normal cardiac function and variations in heart sound caused by respiration. There is no indication of underlying pathology in this scenario, so other choices suggesting referral to specialists or specific interventions are unnecessary. This finding does not warrant concern, and thus, explaining that it is a normal physiological occurrence is the correct approach. The nurse’s role includes reassuring the patient and her guardians that this is an expected and not alarming heart sound variation.