A nurse is caring for a group of patients. Which patient will the nurse see first?

A) An adult with an S₄ heart sound
B) A young adult with an S₃ heart sound
C) An adult with vesicular lung sounds in the lung periphery
D) A young adult with bronchovesicular breath sounds between the scapula posteriorly

A fourth heart sound (S₄) occurs when the atria contract to enhance ventricular filling. An S₄ is often heard in healthy older adults, children, and athletes, but it is not normal in adults. Because S₄ also indicates an abnormal condition, report it to a health care provider. An S₃ is considered abnormal in adults over 31 years of age but can often be heard normally in children and young adults. Vesicular lungs sounds in the periphery and bronchovesicular lung sounds in between the scapula are normal findings.