Progressive Care Nursing Certification (PCCN) Practice Exam

Which heart sound is most suggestive of mitral regurgitation?

1. Diastolic murmur

2. Extra heart sound late in diastole

3. Pansystolic murmur

4. Snap heard after S2

The correct answer is: Pansystolic murmur

The presence of a pansystolic murmur is most suggestive of mitral regurgitation. This type of murmur occurs continuously throughout systole due to the retrograde flow of blood from the left ventricle into the left atrium during ventricular contraction. In the case of mitral regurgitation, the incompetent valve allows blood to flow back into the atrium, leading to an audible sound that can be best heard at the apex of the heart and may often be transmitted to the left axilla. Understanding heart sounds is crucial in diagnosing different heart conditions. For example, a diastolic murmur often indicates issues like aortic regurgitation or mitral stenosis, while an extra heart sound late in diastole could suggest heart failure or volume overload, neither of which typically describes mitral regurgitation. Additionally, a snap heard after S2 is associated with mitral stenosis, particularly when there is a thickened valve leaflet and does not relate directly to regurgitation problems. Recognizing the distinct characteristics of heart sounds allows healthcare professionals to enhance their diagnostic accuracy, which is essential in progressive care nursing.