Fundamental Final Exam

Particulate respirator, gown, and gloves

125. The nurse is preparing to give a bed bath to an immobilized client with tuberculosis. The nurse should wear which items when performing this care?

I should sleep on my my left side

126. The nurse is providing instructions to a client and the family regarding home care after right eye cataract removal. Which statement by the client would indicate an understanding of the instruction?

The male urethra is more vulnerable to injury during insertion.

127. The health care provider has ordered an indwelling catheter inserted in a hospitalized male patient. What consideration would the nurse keep in mind when performing this procedure?

An increased pH and an increased HCO3-

128. A client with a 3-day history of nausea and vomiting presents to the emergency department. The client is hypoventilating and has a respiratory rate of 10 breaths/minute. The electrocardiogram (ECG) monitor displays tachycardia, with a heart rate of 120 beats/minute. Arterial blood gases are drawn and the nurse reviews the results, expecting to note which finding?

-Check the residual volume. -Aspirate the stomach contents. -Turn off the suction to the nasogastric tube. -Test the stomach contents for a pH indicating acidity.

129. The nurse is preparing to administer medication using a client's nasogastric tube. Which action should the nurse take before administering the medication?

Soybean oil

13. The nurse is preparing to administer lipid emulsion to a client who has just been started on total parenteral nutrition. Before administering the lipid emulsion, the nurse asks the client about allergies. The nurse should withhold the lipid emulsion and contact the health care provider if the client identifies an allergy to which food item?

A victim experiencing dyspnea

130. The nurse is the first responder at the scene of a six-car crash on a highway. Which victims should the nurse attend to first?

"I need to remove the restraints at least every 2 hours to perform range-of-motion exercises"

131. The nurse is providing instructions to the assistive personnel (AP) who will be caring for a client with hand restraints. The nurse asks the AP to repeat the instructions to ensure that the AP understands the care. Which statement, if made by the AP, indicates an understanding of the care for this client?

A gown and gloves

132. An RN is providing instructions to an AP assigned to give a bed bath to a client who is on contact precautions. The RN instructs the AP to use which protective item when giving the bed bath?

"This is mostly used in a walk-in clinic or emergency department."

133. The registered nurse (RN) is educating a new RN on conducting a problem-based or focused assessment on a client. Which statement by the new RN indicates that the teaching has been effective?

Bacon Steak

14. The nurse is instructing a client with hypertension on the importance of choosing foods low in sodium.The nurse should teach the client to limit intake of which food?

Metabolic acidosis

15. The nurse is caring for a client with hyperglycemia and diabetic ketoacidosis (DKA) who now has developed Kussmaul respirations. The nurse knows that the purpose of this type of breathing is to correct what imbalance?

Gloves, gown, goggles, and a mask or face shield

83. Contact precautions are initiated for a client with a health care-associated (nosocomial) infection caused by methicillin resistant Staphylococcus aureus (MRSA). The nurse prepares to provide colostomy care and should obtain which protective items to perform this procedure?

Cranberry juice.

85. The nurse is evaluating a client's ability to select food items for low-potassium diet. Which food items, if selected by the client, would indicate an understanding of this diet?

Standard

86. A man is attached to the hospital with the diagnosis of uretithiths secondary to chlamydial infection. What precaution should the nurse implement for the client?

High-efficiency particulate air (HEPA) filter mask

87. A chest with pulmonary tuberculosis (TB) is on airborne isolation precautions. Which item(s) is essential for the nurse wear?

Place the client in high-Fowler's position

88. Following infusion a unit of packed red blood cells the client has developed new onset of tachycardia, bounding pulses, crackles, and wheezes. Which action should the nurse implement first?

-Auscultating lung sounds -Obtaining the client's temperature -Obtaining information about the client's respirations

89. The clinic nurse is assisting to perform a focused data collection process on a client who is complaining of symptoms of a cold, a cough, and lung congestion. Which should the nurse include for this type of data collection? Select all that apply.

Vital Sign

9. The nurse has obtained a unit of blood from the blood bank and has checked the blood bag properly with another nurse. Just before beginning the transfusion, the nurse assesses which priority item?a. Vital signsb. Skin colorc. Urine outputD. Latest hematocrit level

Tomatoes

92. A client is recovering from abdominal surgery and has a large abdominal wound. The nurse should encourage the client to eat which food item that is naturally high in vitamin C promote wound healing?

5% dextrose in 0.9% sodium chloride

93. A client has a prescription to receive a unit of packed red blood cells. The nurse should obtain which intravenous (IV) solution from the IV storage area to hang with the blood product at the client's bedside?

-Respirations that are increased in rate -Respiration that are abnormally deep

94. The nurse is caring for a client with diabetic ketoacidosis and documents that the client is experiencing Kussmual's respirations.

Assign the client to a private room.

96. A client is being transferred to the nursing unit after receiving a radiation implant for bladder cancer. The nurse should take who

Margarine, cream cheese, luncheon meats

97. The nurse is planning to teach a client with malabsorption syndrome about the necessity of following a low-fat diet. The nurse develops a list of high-fat foods to avoid and should include which food item on the list?

Supine in semi-Fowler's

98.A hospitalized client has a diagnosis of pelvic inflammatory disease (PID). The nurse should encourage the client to assume which therapeutic position when in bed?

Vitamin C and zinc

116. Due to his prolonged history of alcohol abuse, an alcoholic client will most likely have deficiencies of which of the following nutrients?

Removing the gown without rolling it from inside out

118. Two nurses are leaving the room of a client whose care required them to wear a gown, mask, and gloves. Which action by these nurses could lead to the spread infection?

Potassium level 6.3mEq/L

17. A client with IDDM (Insulin Dependent Diabetes Mellitus) is given IV insulin for a blood glucose level of 520 mg/dL. Life threatening complications may occur initially, so the nurse will monitor him closely for serum:

-Prepare to administer antibiotics -Document to occurrence, the actions taken, and the clients response -Continue to use the central venous catheter until another one is placed.

18. Which interventions are essential to perform when a central venous site is suspected of being infected? Select all that apply.

Contact the electrical maintenance department for assistance

19. The nurse is preparing to initiate an IV line containing a high dose of potassium chloride and plans to use a IV infusion pump. The nurse brings the pump to the bedside, prepares to plug the pump cord into the wall, and notes that no receptacle is available in the wall socket. The nurse should take which action next?

14:00

20. The nurse is picking up a unit of packed red blood cells at the hospital blood bank. After putting the pen down, the nurse glances at the clock, which reads 13:30. The nurse calculates that the transfusion must be started by which time?.

The disease is transmitted by droplet nuclei.

21. A client with tuberculosis (TB) asks the nurse about precautions to take after discharge to prevent infection of other. The nurse develops a response to the client's question based on which correct understanding of TB transmission?

The client's pain rating

24. The home health care nurse is caring for a client with cancer who is complaining of acute pain. The most appropriate determination of the client's pain should include which assessment?

smoked sausage

31. The Nurse is instructing a client with hypertension on the importance of choosing foods low in sodium. The nurse should teach the client to limit intake of which food?

Sweet Potato

33.The school nurse is providing a nutritional counseling session to a group of adolescents. The school nurse should instruct the adolescents that which item is a good source of vitamin C?

-Tall peaked T waves. -Widened QRS complexes

41. The nurse reviews the electrolyte results of an assigned client and notes that the potassium level is 5.7 mEq/L (5.7 mmol/L). Which patterns would the nurse watch for on the cardiac monitor as a result of the laboratory value?

Orthopneic or sitting position

42. The Facilitate maximum air exchange, the nurse should position the client in:

Take a deep breath, hold it, and bear down.

117. The nurse is preparing to change the parenteral nutrition (PN) solution bag and tubing. The client's central venous line is located in the right subclavian vein. The nurse asks the client to take which essential action during the tubing change?

-Checks the expiration date -Hangs the blood within the specified time frame per agency policy

16. The nurse who is about to begin a blood transfusion knows that blood cells start to deteriorate after a certain period of time. The nurse takes which actions in order to precent a complication of the blood transfusion as it relates to detraction of blood cells? Select all that apply

Chicken

81. A 20 year-old male client is being treated for protein deficiency. If he likes all the following foods, which one would the nurse recommend increasing in the diet?

A pair of scissors

82. The nurse is preparing to care for a client with esophageal varies who needs a Sengstaken-Blakemore tube inserted because other treatments were unsuccessful. The nurse gathers supplies, knowing that which item most be kept at the bedside at all times?

Measuring weight daily

99.A nurse is assessing infants in the NICU for fluid balance status. Which nursing action would the nurse depend on as the most reliable indicator of a patient's fluid balance status?

Obtain an Order radiographic examination of the tube.

75. A patient who is moved to a hospital bed following throat surgery is ordered to receive continue tube feeding through a small-bore nasogastric tube. Following placement of the tube, which nursing action would the nurse initiate to ensure correct placement of the tube?

Respiratory acidosis

39. A 35-year-client is admitted to the hospital with diabetic ketoacidosis. Results of arterial blood gases are pH 7.2, PaO2 90, PaCO2 45, and HCO3 16. The nursing assessment of arterial blood gases indicate the presence of:

Wear a gown and gloves.

70. The home health nurse visits a client with suspected scabies. Which precaution should the nurse institute during the assessment of the client?

A tuning fork

71. The nurse is preparing to perform a Weber test on a client. The nurse should obtain which item needed to perform this test?

-Client postoperative day 1 after inguinal herniorrhaphy, vital signs stable -Client 5 days after a myocardial infarction, vital signs stable, absence of dysrhythmias -Client 1 day after cardiac catheterization, normal study results, groin site free of hematoma

11. The nurse manager of a medical-surgical unit is asked to select the hospitalized clients who can be discharged so that hospital beds can be made available for victims of a community disaster. Which clients can be safely discharged? Select all that apply.

-Keeping pregnant women out of the client's room -Placing the client in a private room with a private bath -Wearing a lead shield when providing direct client care

1. When caring for a client with an internal radiation implant, the nurse should observe which principles? select all that apply

125 gtt/min

110. A 1000-mL does of DSW 12 normal saline is to be infused in 8 hours. The drop factor for the tubing is 60 gtt/min. How many drops per minute should the nurse administer?

Droplet precautions

26. The nurse employed on a medical unit in a hospital receives a telephone call from the admission office and is told that a client with a diagnosis of mycoplasma pneumonia will be admitted to the unit. The nurse prepares for the admission and stains the necessary supplies to place the client on which type of transmission based precautions.

A gown and gloves.

27. A Registered Nurse(RN) is providing instructutors to an assistive personnel (AP) assigned to give a bed bath to a client who is on contact precaution. The RN instructs the AP to use which protective item when giving the bed bath?

Applying safety device straps that do not tighten when force is applied against them.

35. The nurse obtains a prescription from a primary health care provider to restrain a client and instructs an assistive personnel (AP) to apply the safety device to the client. Which observation of unsafe application of the safety device would indicate that further instruction is required for the AP?

A client with asthma who requested a breathingtreatment during the previous shift

3. The nurse is assigned to care for four clients. In planning client rounds, which client should the nurse

Decrease PN Rate to 50 mL/hour

36. A client is being weaned from parenteral nutrition (PN) and is expected to begin taking solid food today. The ongoing solution rate has been 100 mL/hour. The nurse anticipates that which prescription regarding the PN solution will accompany the diet prescription?

9

4. Client is to receive Dopiamine (infropin) 2 mcg/kg.min. The client weights 187 pound. The available dose is 300 mg per 250 mi DSNS. How many milliliters should the nurse administer each hour?

After a shower or bath

68. The nurse is instructing a client how to perform a testicular self-examination (TSE). The nurse should explain that which is the best time to perform this exam?

Respiratory acidosis from inadequate ventilation

5. The nurse is caring for a client with several broken ribs. The client is most likely to experience what type of acid base imbalance?

Apricots

53. The nurse has conducted dietary teaching with a client diagnosed with iron deficiency anemia. The nurse instructs the client that which food item is a good dietary source of iron?

Increase HCO3

59. Which of the following would differentiate acute from chronic respiratory acidosis in the assessment of the trauma client?

The client is probably hyperventilating.

124. The nurse is caring for a client having respiratory distress related to an anxiety attack. Recent arterial blood gas values are pH = 7.53, Pao2 = 72 mm Hg (72 mm Hg), Paco2 = 32 mm Hg (32 mm Hg), and HCO3- = 28 mEq/L (28 mmol/L). Which conclusion about the client should the nurse make?

Place a surgical mask on the client for transport.

101. The nurse is caring for a client who is on airborne precautions. The nurse notes that the client is scheduled for magnetic resonance imaging (MRI). Which nursing action is more appropriate in preparing the client for the test?

-A client with extensive burns -A client with cancer who is septic -A client with severe exacerbation of Crohn's disease -A client with persistent nausea and vomiting from chemotherapy

102. The nurse caring for a group of adult clients on an acute care medical -surgical nursing unit determines the which clients would be the most likely candidates for parenteral nutrition (PN)? Select all that apply

Inspection, Palpation, Auscultation, and percussion

103. The nurse is performing an abdominal assessment. Which is technique should the nurse perform for physical assessment of the abdomen?

The nurse dips a cotton-tipped applicator into sterile saline solution and gently cleans around the insertion site.

104. A nurse is caring for newly placed gastronomy tube of a postoperative patient. Which nursing action is performed correctly?

The student dons the sterile gloves without washing the hands.

105.The nursing instructor is observing a student nurse donning a pair of sterile gloves and preparing a sterile field. Which observation made by the instructor indicates the need for further teaching?

Legumes

106. The nurse is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has the best understanding of the dietary measures to follow if the client states an intention to increase the intake of which food?

Hypotension

107. The nurse is monitoring the respiratory status of a client after creation of a tracheostomy . Which coexisting condition in the client may cause an inaccurate pulse oximetry reading?

Decrease oozing of blood from puncture sites and gums

109. A client has received a translation of platelets. The nurse evaluates that the client is benefiting most from this therapy if the client exhibits which finding?

Client's temperature

111. The nurse is changing the central line dressing of a client receiving parenteral nutrition (PN) and notes that the catheter insertion she appears redeemed. The nurse should next assess which item?

Potassium level of 3.0 mEq/L (3.0 mmol/L)

113. The nurse is caring for a client who is on a mechanic ventilator. Blood gas results indicate a pH of 7.50 and a Paco2 of 30 mm Hg (30 mm hg). The nurse has determined that the client is experiencing respiratory alkalosis. Which laboratory value would most likely be noted in this condition?

Metabolic alkalosis

114. A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which priority problem?

-a "Try to drink at least six to eight glasses of water each day." -"c "Limit sugar, salt, and alcohol in your diet." -d "Report side effects of medications you are taking, especially diarrhea. -f "Weigh yourself daily and report any changes in your weight."

115. A nurse is caring for an older patient with type II diabetes who is living in a long-term care facility. The nurse determines that the patient's fluid intake and output is approximately 1200 mL daily. What patient teaching would the nurse provide for this patient? Select all that apply.

3+ pitting edema

119. A nurse is performing a physical assessment of a patient who is experiencing fluid volume excess. Upon examination of the patient's legs, the nurse documents: "Pitting edema; 6-mm pit; pit remains several seconds after pressing with obvious skin swelling." What grade of edema has this nurse documented?

Document in the nurse's notes and notify the physician after redressing the site.

12.While changing the dressing on a clients central line, the nurse notices redness and warmth at the needle insertion site. Which of the following actions would be appropriate to implement based on this finding?

On the nonoperative side with the legs abducted

120. The nurse is caring for a client who is 1 day postoperative for a total hip replacement . Which is the best position in which nurse should place the client?

On the nonoperative side with the legs abducted.

120. The nurse is caring for a client who is 1 day postoperative for a total hip replacement. Which is the best position in which is the nurse should place the client?

Wash hands and place a high-efficiency particulate air (HEPA) respirator mask over the nose and mouth.

122. The nurse places a hospitalized client with active tuberculosis in a private, well ventilated isolation room. In addition which action should the nurse take before entering the clients room?

Blood bank

123. The nurse has discontinued a unit of blood that was infusing into a client because the client experienced a transfusion ratio. After documenting the incident appropriately the nurse sends the blood bag and tubing to which department?

Upright in a chair

2.The nurse is caring for an older client with dysphagia who is at risk for aspiration. When preparing the client for eating, the nurse should place the client in which position to minimize the risk for aspiration?

Blood warming device

22. A client with severe blood loss resulting from multiple trauma requires rapid transfusion of several units of blood. The nurse asks another health care team member to obtain which device for use during the transfusion procedure to help reduce the risk of cardiac dysrhythmias?

Standard precautions

23.A man has been admitted to the surgical unit after a hernia repair surgery. The medical record reports that the client is human immunodeficiency virus (HIV) positive. The nurse should implement which precautions for this client?

Weakness, thirst, and increased urine output

25. The nurse monitors the client receiving parenteral nutrition (PN) for complication of the therapy and should assess the client which manifestation of hyperglycemia?

Metabolic alkalosis

28. The nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client for manifestations of which disorder that the client is at risk for?

-Chills -Chest pain -Lower back pain -Difficulty breathing

29. The nurse is assisting in monitoring a client who is receiving a translation of packed red blood cells (PRBCs). Before leaving the room, the nurse tells the client to immediately report which symptoms of a transfusion reaction? Select All that apply.

summer squash

49. A client with hypertension has been told to maintain a diet low in sodium. The nurse who is teaching this client about foods that are allowed should include which food item in a list provided to the client?

The client has a rash on the chest and arms.

30. The nurse is documenting the findings of a physical examination in a client's record. Which finding should the nurse determine to be objective data?

Discontinue the infusion and start an infusion of normal saline using new tubing.

32. The nurse is monitoring a client who is receiving a blood transfusion. After 30 minutes of the infusion, the client begins to have chills and back pain. His temperature is 100.1°F (37.8°C). What action should the nurse take first?

Kiwi

34. The nurse provides dietary instructions to a client at risk for hypokalemia about which foods are high potassium and should be included in the daily diet. The nurse should tell the client the which fruit is highest in potassium?

Closes the doors to the other clients' rooms

37. The nurse discovers a fire in the trash basket in a client's bathroom. The nurse assists the client out of the hospital room to a sale place, activates the fire alarm, and takes which action next?

Use warm water and gentle pressure to remove the clog.

38. A nurse is administering a tube feeding for a patient who is post bowel surgery. When attempting to aspirate the contents, the nurse notes that the tube is clogged. What would be the nurse's next action following this assessment?

The 53-year-old client with heart failure who has gained 4 pounds (1.8 kg) since yesterday and is short of breath

45. The nurse has received her client assignment for the day. Which client should the nurse care for first?

Allergic Transfusion Reaction

46. A client's transfusion of packed red blood cells has been infusing for 2 hours. She is complaining of a raised, itchy rash and shortness of breath. She is wheezing, anxious, and very restless. The nurse knows these assessment findings are congruent with:

Respiratory acidosis without compensation

47. A client who is found unresponsive has arterial blood gases drawn and the results indicate the following: pH is 7.12, Paco2 is 90 mm Hg (90 mol/L), and HCO3- is 22 mEq/L (22 mmol/L). The nurse interprets the results as indicating which condition?

Bottle of albumin (Plasma) with vented tubing

40.The nurse is told by a primary health care provider that a client in hypodermic shock will require plasma expansion. The nurse should prepare which supplies for transfusion?

The client with problems clearing the airway related to abdominal incision pain

43. The nurse assigned to 4 clients on a postoperative surgical unit at a rural hospital. When prioritizing the care, the nurse recognizes that the highest priority is focused on which client?

At a specific day of the month and on that same day every month thereafter

44. The nurse is teaching breast self-examination (BSE) to a client who has had a hysterectomy. The appropriate instruction regarding when the BSE should be performed is at which time?

-"They prevent transmission of organisms from client to client." -"They prevent transmission of organisms from health care providers to clients." -"They prevent transmission of organisms from clients to health care providers." -"They prevent transmission of organisms from health care providers and clients to people outside of the hospital."

50. The nursing instructor determines that the nursing student understandings the purposes of standard and transmission-based precautions if which statements are made? select all that apply.

Registered Nurse (RN)

55. The nurse has just obtained a unit of blood from the blood bank to transfuse into a client as prescribed. Before preparing the blood for transfusion, the nurse looks for which member of the heath care team to assist in checking the unit of blood?

-U Wave -Inverted T waves -Depressed ST segment

56. The nurse review a client's electrolyte laboratory report and notes that K+ level is 2.5 mEq/L. Which patterns should the nurse watch for on the EKG as a result of the lab value?

Obtains a different bottle of solution

57. The nurse is preparing a hang fat emulsion (lipids) and notes that fat globules are visible at the top of the solution. The nurse should take which action?

Run normal saline at a keep-vein-open rate.

58. The nurse determines that client is having a transfusion reaction. After the nurse stops the transfusion, which action should be taken next?

The client who has sustained a traumatic burn

6.Which client is at risk for the development of a potassium level of 5.5 mEq/L (5.5 mmol/L)?

The patient reports fullness and diarrhea after breakfast.

60. A nurse is assessing a patient who has been NPO (nothing by mouth) prior to abdominal surgery. The patient is ordered a clear liquid diet for breakfast, to advance to a house diet as tolerated. Which assessments would indicate to the nurse that the patient's diet should not be advanced?

pH 7.25, Pco2 50 mm Hg

61. The nurse reviews the blood gas results of a client with atelectasis. The nurse analyzes the results and determines that the client is experiencing respiratory acidosis. What result validates the nurse's finding?

Blood glucose level

62. A client who has been receiving total parenteral nutrition (TPN) by way of a central venous access device complains of shakiness and is diaphoretic. Based on these findings, the nurse should perform which assessment next?

Prepare to send them to the laboratory for culture.

63. A Client receiving parenteral nutrition (PN) suddenly develops a fever. The nurse notifies the primary health care provider (PHCP), and the PHCP initially prescribes that the solution and tubing be changed. What should the nurse do with the discontinued materials?

Septicemia

64.A client receiving a transfusion of packed red blood cells (PRBCs) begins to vomit. The client's blood pressure is 90/50 mm Hg from a baseline of 125/78 mm Hg. The client's temperature is 100.8º F (38.2º C) orally from a baseline of 99.2º F (37.3º C) orally. The nurse determines that the client may be experiencing which complication of a blood transfusion?

Supine

65. After a liver biopsy, the best position for the client is:

Listen to bowel sounds in all 4 quadrants.

66. The nurse is performing an abdominal assessment and inspects the skin on the client's abdomen. Which assessment technique should the nurse next?

Cabbage

67. The nurse is providing dietary instructions to a client about food items that are high in vitamin C. Which food item does the nurse recommend as being the highest in vitamin C?

Wearing a gown and gloves

69. The nurse prepares to give a bath and charge the bed linens of a client with cutaneous Kaposi's sarcoma lessons. The lessons are open and draining a scant amount of serous fluid. Which would the nurse incorporate into the plan during the bathing of this client?

Reassess the client.

7. The nurse has just assisted a client back to bed after a fall. The nurse and health care provider have assessed the client and have determined that the client is not injured. After completing the incident report, the nurse should implement which action next?

Wheezes

74. A client with a diagnosis of asthma is admitted to the hospital with respiratory distress. Which type of adventitious lung sounds should the nurse expect to hear when performing a respiratory assessment on this client?

Electronic infusion pump

76. The nurse is preparing to hang the first bag of parenteral nutrition (PN) solution via the central line of the assigned client. The nurse should obtain which most essential piece of equipment before hanging for the solution?

Placing the client in a semiprivate room at the end of the hallway.

77. The nurse is reviewing a plan of care for a client with an internal radiation implant. Which intervention, if noted in the plan, indicates the need for revision of the plan?

Circulatory overload

78. The nurse enters a client's room to asses the client, who began receiving a blood transfusion 45 minutes earlier, and notes that the client flushed and dyspeptic. On assessment, the nurse auscultates the presence of crackles in the lung bases.

Pericardial friction rub and pan on deep inspiration

79. Assessment of the client with pericarditis may reveal which of the following?

The restraints were applied tightly.

8.A primary health care provider has written a prescription for wrist restraints to be applied on a client from 10:00 PM to 7:00 AM because the client becomes disoriented during the night and is at risk for pulling out the nasogastric tube and the intravenous catheter. At 11:00 PM, the charge nurse makes rounds on all of the clients in the unit. When assessing the client with the restraints, which observation by the charge nurse indicates that the nurse who applied the restraints performed an unsafe action?

Taking an oral temperature for a client with a cough and nasal congestion

80. The nurse is explain the appropriate methods for measuring an accurate temperature to assistive personnel (AP). Which method, if noted by the UAP as being an appropriate method, indicates the need for further teaching?

Picture 1

The clinic nurse is preparing to assess the client's apical pulse. The nurse correctly palpates over which area?