Med Surg 2 Hesi Practice Questions - Free HESI Exam Practice Test (2024).

HESI HINT: Nonsurgical management of a client with cholecystitis includes: - low-fat diet. The nurse notes that the patient’s blood pressure is 80/50 mmHg. Traction applied, but client is frustrated because client keeps calling nurse for help with repositioning. teach symptoms of Cushing syndrome. The troponin levels will elevate within 2-3 hours indicating myocardial ischemia, followed by the CK-MB cardiac markers within 6-9 hours, peaking within 12 to 20 hours after myocardial infarction (MI). Study with Quizlet and memorize flashcards containing terms like The nursing is caring for a patient with accelerated silicosis. Obtain a pair of slipper socks for the client. Three resources I used to score a 1217 on the Med Surg HESI: Once you feel super confident in knowing how to prioritize ABCs and using Maslows as your backup, you are on your way to earning a high score on your Med Surg HESI. hesi med surg exam practice questions and answers 100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached Previously searched by you. is obtaining the admission history for a client with suspected peptic ulcer disease. Light housekeeping is permitted but avoid heavy lifting c. (HESI) exam is a crucial step in your journey towards becoming a healthcare professional. blood storage, blood filtrations, production of bile, synthesis of clotting factors, removal of clotting factors, metabolism of carbs, fats and proteins-- the liver also detoxifies the blood and is a storage area for vit ADEK and iron. Craven Practice Questions for Complex Disease Test 1. Jan 7, 2021 · Our nursing test bank includes over 6,500 nursing practice questions covering a wide range of nursing topics from medical- surgical nursing to nursing pharmacology and more! These test banks are absolutely free and no registration is required! Answer all of our mock exams to help you prepare and review for any nursing school exams (including. Explain taking the medal to surgery is against the policy. This Agreement sets forth the terms and conditions governing your access to the HESI Practice Exam powered by. -Captopril (Capoten)-Enalapril (Vasotec)Decrease fluid retention by decreasing the production of aldosterone. Require the client to sleep with the head of the bed elevated. These pre-built exams are designed to assess your knowledge and concepts learned and begin to prepare you for standardized testing with NCLEX examination style questions. Which of the following actions should the nurse take? (Select all that apply) a. The bradycardic heart rate is acceptable in an athletic …. I absolutely bombed (imo) my health assessment HESI…scored in the 770s, despite Ace-ing every unit exam. The HESI Pharmacology exam typically includes multiple-choice questions that cover a wide range of topics, including but not limited to: Drug classification and mechanism of action. Rationale: HHS is seen primarily in clients with type 2 diabetes mellitus, who experience a relative deficiency of insulin. Flank pain and acute pyelonephritis. Quiz yourself with questions and answers for med surg 2 final exam Iggy practice questions, so you can be ready for test day. If the extended leg (the left leg, in this example) remains on the table, the test is negative. Tell the client to carry a medical alert card that explains his condition. A patient is admitted to the ED complaining of severe abdominal pain, stating that he has been vomiting "coffee-ground" like emesis. Our HESI A2 practice tests are based on standardized, computer-based tests taken by prospective and current nursing students. The majority of the questions are multiple choice, but a few are fill-in-the-blank. (A) is an inaccurate stereotype. , Demonstrate the use of visual scanning during meals to the client and family. MedSurg2 Final Exam Practice Questions. Discuss the withdrawal procedure with the family and offer support D. By focusing on these key areas and practicing with our 4000 Hesi Health Assessment Practice Questions & Rationales at hesi exam, you can build a strong foundation in health assessment, crucial for your success in the exam and your future nursing practice. MED-SURG 2 PRACTICE QUESTIONS & ANSWERS UPDATED 2022-2023. A 63-year-old patient is newly diagnosed with type 2 diabetes. A Correct: Urge all people to avoid dehydration by drinking at least 2 to 3 liters of fluids daily, especially during strenuous exercise or work associated with diaphoresis. 100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached. com makes it easy to get the grade you want!. Monitor urine output during administration 3. Respiratory rate of 30 breaths per minute. Then locate the link for the sample interview questions. Turn off the mechanical ventilator and note the time of death. 2021 HESI RN Maternity V1 – Notes Practice Questions 1. which client should be assessed first? A. HESI FUNDAMENTALS RATIONALES MEDICAL SURGICAL VERSION 2 QUESTIONS HESI FUNDAMENTALS. 2023 HESI Med Surg Exit Exam (V1, Version 1) (All 160 Questions and Answers) Verified Solutions Graded A+, Latest Update 2023/2024 (Best Guide) While assessing a client with diabetes mellitus, the nurse observes an absence of hair growth on the client's legs. The priority is to determined if the tube is functioning correctly, which would relieve the client's nausea. (C) is most likely false there are many factors that cause increased temporary confusion. Which patient do you see first? A)A 55-year-old male with heart failure and 3+ pitting edema scheduled to receive his Lasix (Furosemide) 30 minutes ago. 14 pages 2021/2022 100% (2) 2021/2022 100% (2) Save. Exam (elaborations) - Hesi biology …. It tests your knowledge on everything from patient care to medical procedures, encompassing various aspects of …. 18, 19, and 20 Periop, Pre-op, Post-op. HESI MED SURG 55 QUESTIONS ANSWERS 2021 RN V1 LATEST VERSION. 4% indicates prediabetes, and a level of 6. Monitor the client’s blood pressure and apical rate every four (4) hours. The nurse should tell the client to follow which instructions if chest pain is not relieved after taking 3 NTG tables 5 min apart. About us; Ask AI; Studocu World University Ranking 2023; E-Learning Statistics; Doing Good; Academic Integrity; Jobs;. b) beef steak with steamed broccoli and orange slices. Exam (elaborations) - Hesi a2 practice test question and answer 2023. RN Adult Medical Surgical Online Practice 2019 A for NGN answers. Take this free Medical Surgical Nursing Practice Exam to see what types of questions are on the Medical Surgical Nursing Exam. Medical-Surgical HESI Study Questions (Saunders HESI 7th Edition) 125 terms. Drinking cola beverages only once daily. This document is the V1 of HESI RN Med Surg 2021. com/presentation/d/1asgwIFfI-OpQPN058BcqSQI96Meb4Kko/edit?usp=sharing&ouid=118222075929744291095&rtpof. osteoarthritis is noninflammatory and is characterized by degeneration of cartilage (wear. By focusing on these key areas and utilizing our 1000 Hesi PN Fundamentals Exam Practice Questions, you can prepare effectively for the exam. 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Hemarthrosis is a possible complication. com/503886897/hesi-med-surg-1-test-flash-cards/Third Test:https://quizl. Contact the primary health care provider to obtain a prescription for a sedative 4. Administer an intravenous antiemetic as prescribed. The six competencies are:, The mission of the Academy of Medical-Surgical Nurses (AMSN) is to:, Medical-Surgical Nursing Certification Board (MSNCB) offer the certification of: and more. Our extensive set of 2500 Hesi Medical Surgical Practice Questions is tailored to these key topics, offering a comprehensive preparation tool. increasing the IV flow rate to 250 mL/hr. Avoid drinking caffeine before bedtime, 2. The nurse should withhold the digoxin if the apical pulse is less than 60/min (D). Which patient teaching would be appropriate for a nursing diagnosis of impaired breathing pattern related to anxiety? Hesi med surg 2022 medsurg 55 questions rnv1 (most …. A nurse assesses clients on the medical-surgical unit. Which intervention should the nurse implement first? a. The client appears anxious, restless, and mildly cyanotic. recommendation could differ from time to time, the answers of below questions were made up to our best knowledge and elimination of wrong answers – and remember that most of the time there are more than a correct answer but …. NCLEX Questions and AnswersVisit us at: https://nursestudy. Wash the armpits and genitals with a gentle cleanser daily. Wheezes and crackles in all lung fields. Most require surgical intervention. hobby lobby newspaper frame Which of the following injection sites should the nurse use to administer this medication safely?, The nurse is preparing …. Medsurg 2 (NUR104) Week 3 practice questions; Nurs100 Study Outline; Chapter 29 infection; Related Studylists Transitions. Exam (elaborations) - Ah1 renal hesi nclex questions and answers latest 2021/2022(a level test) 37. Fashion exam practice questions. 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Administer oxygen via nasal cannula. Python has become one of the most popular programming languages in recent years, thanks to its simplicity and versatility. He is short of breath, febrile, and coughing green colored sputum. For a deeper exploration of Hesi …. "AML is the most common nonlymphocytic leukemia. Smoking is a modifiable risk factor and should be. 7 (3 reviews) A 54-year-old patient admitted with type 2 diabetes asks the nurse what "type 2" means. ATI RN Adult Medical Surgical Practice 2019 -2023 with NGN. Study with Quizlet and memorize flashcards containing terms like Neutrophil count- The patient is experiencing infection, so a nurse should review the neutrophil count before contacting the HCP. A) Have the patient assume a prone position. Med-Surg II HESI Test Bank 2022/2023 Questions and Answers;(perfect guide for your final) . "With type 2 diabetes, the body of the pancreas becomes inflamed. 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Which of the following descriptions of your patient when receiving report on the unit would make the nurse anticipate the pt is in heart failure. For which of the following adverse effects should the nurse monitor?. Med Surg Hesi 2022/2023 practice questions with complete solutions The nurse is assessing a 48-year-old client with a history of smoking during a routine clinic …. The UAP reports to the nurse that the client's HR is 90 BPM, and BP is 110/50. MED SURG 2024 HESI PRACTICE QUESTIONS AND ANSWERS. pdf from PHARMACOLO 210 at Gurnick Academy Of Medical Arts. A Doppler ultrasound is indicated for further evaluation. Flashcards; Learn; Match; Q-Chat; Created by. Complete the quiz: Ensure that you answer the entire quiz. Its headquarters are located in the brain where the hypothalamus and the pituitary gland release a variety of hormones that can lead to profound effects systemically. Know PARKLAND FORMULA By 8 pm will have 3500. List five important teaching aspects for clients who are beginning corticosteroid therapy. Absolutely the best HESI prep tool out there!. - A nurse is caring for a client who is postoperative following a tracheostomy, and has copious and tenacious secretions. On a 1 to 10 scale, the client tells the nurse that her epigastric pain is at 7. Exam (elaborations) - Hesi med surg practice questions and answers latest 2022 with complete solution 36. Which actions should the nurse take to plan for preparation and administration of the potassium? Select all that apply. One of the most important keys to being successful in medical-surgical nursing is to use your time wisely. Check the client status and lead placement. A brief description of each resident's family life. Quiz yourself with questions and answers for Med Surg 3 Final Exam, so you can be ready for test day. Study with Quizlet and memorize flashcards containing terms like An adult client who is hospitalized after surgery reports sudden onset of chest pain and dyspnea. ESSENTIALS: EXAM 1 (clinical judgment, safety) Medication Administration EAQs. A nurse is caring for a client who has a spinal cord injury at T-4. The patient has an order to receive 30 mg enoxaparin (Lovenox). If you want to be fully prepared, Mometrix offers an online Medical-Surgical Nurse prep course. ATI Capstone Content Review Med Surg 1; Head Injury - PICO Worksheet and Search Strategy Feb 2023; HESI MED SURG 2 - HESI practice; MED SURG 201 Medical Surgical Final Exam- Questions and Answers; A nurse is caring for a client who is being treated with interferon alfa-2b for malignant melanoma. Study with Quizlet and memorize flashcards. Study with Quizlet and memorize flashcards containing terms like Chapter 55 1. This drug is relatively inexpensive. Plan how his needs will be met while he is on bed rest. ducks unlimited gun texas HESI MED SURG / MED SURG 55 QUESTIONS RN V1 (MOST ANSWER(S) 1. (Ans- Hypovolemia and ECG changes HESI Med-Surg Hypovolemia - low extracellular fluid Which nursing problem should be included in the plan of care for a client with heart …. HESI MED SURG 55 Questions Answers 2018 RN V1. Ask HCP for prescription of mild sedative at bedtime C. test the drainage for the presence of glucose. Exam (elaborations) - Hesi a2 practice test questions with correct answers 21. The usual activity patterns of each member of the group. After initiating antibiotic therapy on a client with syphilis, the nurse suspects a Jarisch-Herxheimer reaction (JHR). Manifestations may include polyuria, polydipsia, dehydration, mental status alterations, weight loss, and weakness. ATI Capstone Content Review Med Surg 1; Head Injury - PICO Worksheet and Search Strategy Feb 2023; Module 5 Ethics class group activity; HESI MED SURG 2 - HESI practice; A nurse is caring for a client who is being treated with interferon alfa-2b for malignant melanoma. B) Serum carcinoembryonic antigen (CEA) level is low. The nurse should assess this client for: 1. Exam (elaborations) - Hesi - medical surgical nursing question and answer 2023. Which finding should the practical nurse report to the healthcare provider for follow-up? A) Hemoglobin 9. HESI MED SURG II (Elsevier) Question & Answers. D) If you are in your menstrual period it is not a good time to check for lumps. Medsurg 2 hesi practice questions. Capillary refill is less than 3 seconds 2. The client is uncomfortable with the nurse. Teach the patient to perform Buerger Allen exercises daily. These practice questions and rationales cover the essentials of surgical procedures, from preoperative assessm. MED-SURGE HESI RN QUESTIONS & ANSWERS / MED-SURGE HESI RN QUESTIONS & ANSWERS|VERIFIED AND 100% CORRECT Q & A, …. 10 pages 2021/2022 100% (23) 2021/2022 100% (23) Save. A) Use a laryngoscope to check for a foreign body lodged in the esophagus. circulatory problems that can be due to arterial or venous pathology. A nurse is caring for a client who had a cerebrovascular accident (CVA). 2023 Hesi Medical Surgical (Med Surg)Exit Exam Version 2 (V2) All 55 Q&A Next-Generation Format - A++ Guaranteed. Serum calcium 5mg/dL (hypocalcemia, hyperphosphatemia, hyperkalemia, hyperuricemia) ABG ranges. A client is unable to void following a procedure so the nurse obtains a prescription to perform a straight catheterization after inserting the catheter the nurse ask that the client has an immediate output of 500 mL of clear yellow urine which action should the nurse implement. In today’s competitive job market, it is crucial for job seekers to stand out from the crowd. A) Place a chair at a right angle to the bedside. The nurse should reinforce which instruction? A. HESI 2021 EXIT RN LATEST VERSION 3 A GRADED. Med Surg Hesi practice questions and answers already passed The nurse is assessing a 48-year-old client with a history of smoking during a routine clinic visit. A 38-year-old client with a diagnosis of systemic lupus erythematosus. Med Surg 1 HESI Final Exam Blueprint Answers. HESI Practice Tests, Nursing Tests. Encourage the client to consume plenty of warm liquids D. One hour after the IV initiation the client begins screaming, "I can't breathe!" The nursing priority action is: 1. Quiz yourself with questions and answers for Med surg 2 Exam #2, so you can be ready for test day. Dosage Exam1 - ATI Practice Questions. 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Increase the client's oral fluid intake. cvs black santa 2022 A client is admitted to the hospital with a diagnosis of severe acute diverticulitis. 4 (22 reviews) A central venous catheter has been inserted via a jugular vein, and a radiograph has confirmed placement of the catheter. Specific to this type of heart failure, the nurse expects the client to state: 1. Chronic open-angle glaucoma is also known as simple adult primary …. instruct the client regarding the need for the covering c. Teacher 102 NPTE Practice Questions. A 56-year-old who is taking metformin for diabetes mellitus d. docx from HESI A2 at Chamberlain College of Nursing. by Ethan Martinez on NursingTip. Begins at time of injury and concludes with the restoration of capillary permeability. (D) may be true but does not offer the family a sense of security about the care. Founded in 2010, the go-to place to buy study notes for 14 years now. WVU EXPH 240: Cardiovascular System & Respiratory System State Nurse Practice Act. 1: A patient with COPD is receiving oxygen therapy via nasal cannula. Enjoys a hamburger once a month. 2) Flank pain on the affected side. Which content about self-care should the nurse include in the teaching plan of a client who has genital herpes? (Select all that apply. swgoh ability block Is attempting to physically restrain the patient. HESI ADV MED SURG 2019 v2 Study Guide|ADVANCED HESI MED SURG TEST BANK|HESI FUNDAMENTALS RATIONALES MEDICAL SURGICAL VERSION 2|Hesi Fundamentals RN |Hesi Fundamentals Practice Questions|Hesi Fundamentals EXIT|PN2 HESI Exam 2|PN3 HESI Exam 3|Mental Health $34. RN Adult Medical Surgical Online Practice 2019 A for NGN answers EXIT HESI Med surg 2. University Miami Regional University. For which of the following adverse effects should the nurse monitor? (Select all that apply. 48 Likes, TikTok video from _learnexams (@_learnexams): “(Complete 140 Q&A) Med-Surg II HESI Test Bank 2023#HESIMEDSURG #HESI #BSN . Study Flashcards On HESI Med-Surg Review Questions at Cram. B)A 36-year-old female who received IV …. The nurse should recognize that the client is at risk for autonomic dysreflexia. TLS results in hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia. 0 (2 reviews) A patient with heart failure has an ejection fraction of 25%. HESI Med-Surg Next Gen Questions. HESI A2 Exam V1 With A&P UPDATED 2022-2023 ALL ANSWERS ARE CORRECT. Press the recorder button on the ECG console. Saunders practice questions; Show 7 more documents Show all 15 …. C) Facial weakness and paralysis. an optimal functioning of mind, body and spirit within the environment B. Assess for allergies and change the IV to an intermittent infusion device, A nurse is assessing a client with a diagnosis of early left ventricular heart failure. The following sample questions are similar to those on the Medical-Surgical Nursing Examination but do not represent the full range of content or levels of difficulty. These HESI practice questions and rationales will help you hone your skills and sharpen your abilities. HESI EXIT COMPREHENSIVE REVIEW B UPDATED 2022-2023. We’ve made a significant effort to provide you with the most informative rationale, so. Identified Q&As 100+ Solutions available. Airway, breathing, and circulation are priorities in client assessment and treatment. The nurse should assess the client for: A. A 45-year-old client receiving daily external radiation therapy treatments for breast cancer. Med Surg Hesi 2022/2023 practice questions with complete solutions The nurse is assessing a 48-year-old client with a history of smoking during a routine clinic visit. Emptying the catheter's collection reservoir every hour. Download Med-Surg Practice Exam and enjoy it on your iPhone, iPad and iPod touch. 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When developing an individualized care plan for her, the nurse determines that the most important risk factors for peripheral artery disease (PAD) that …. A weight loss of 5 pounds since the last monthly home visit. C) Help the client to sit and dangle legs on the side of the bed. What does this information indicate to the nurse about the patient's health status? 1. Measuring intake and output every four hours. Neurodiagnostic studies showed a basal skull fracture in the middle fossa. Pain reported as 6 on a scale of 0 to 10. The nurse is caring for clients on a med-surg floor. Med Surg HESI Review (120Q & As) Med Surg HESI Review Questions and Answers 100% verified answers 2022 Med Surg HESI Review (120Q & As) Med Surg HESI Review Questions and Answers 100% verified answers 2022 Graded A+. Biology Mary Ann Clark, Jung Choi, Matthew Douglas. • B A 67-year-old woman who lives alone is admitted after tripping on a rug in her home and fractures her hip. Rapidly progressing symptoms b. Med Surg Chapter 23 - Practice questions and answers for the exam. Initial assessment indicates beats/minute and irregular, respirations 36 breaths/minute, blood pressure 168/100 mmHg. 3: Patient lived in a city which extremely high levels of pollution for many years. HESI Med-Surg Proctored Exam Test Bank 2023 (36 Exam Versions)/ Med-Surg HESI Exam Test Bank 2023 / HESI Med Surge Proctored Exam Test Bank 2023 / Med Surge HESI Exam. There are 8 questions on anatomy, 8 questions on biology, 8 questions on chemistry, 8 questions on grammar, 8 questions on mathematics, 7 questions on reading, 7 questions on vocabulary and 6 questions on …. HESI MED SURG 2 - HESI practice; A nurse is caring for a client who is being treated with interferon alfa-2b for malignant melanoma. NUR 204 ATI Physiological Integrity. MED SURG HESI - NUR 311 Med-Surg Evolve HESI Practice Quiz CACI. The Skills questions will evaluate your ability to do the following: Collect health history. 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Coagulations studies (A) and re-warming procedures (C and D) can be initiated after a review of the ECG tracing. c) The patient asks for pain medication. assess the patient's perception of what it means to have type 2 diabetes. According to the holistic model, a narrow definition of holistic health includes: A. Study with Quizlet and memorize flashcards containing terms like A nurse is caring for a client who is postprocedure following lumbar puncture and reports a throbbing headache when sitting upright. trane air conditioner dealers near me Which action should the nurse take first?A. The nurse interprets that these symptoms are related to what pathophysiologic change? a. Relocation often results in confusion among older clients and is stressful to clients of all ages. Welcome to our collection of free NCLEX practice questions to help you achieve success on your NCLEX-RN exam! This updated guide for 2024 includes 1,000+ practice …. Semester II Mental Health Nursing Care Plan Rubric. 2022-23 Med-Surg HESI Practice Questions 43 studiers today 4 (89 reviews) Students also viewed Terms in this set (46) Try Magic Notes and save time. docx - Do as many practice questions Do as many practice questions as you can. Encourage the client to consume plenty of warm …. motor mounts nissan altima But the reverse is not always true. napa oil filter cross reference chart Quickly memorize the terms, phrases and much more. Quiz yourself with questions and answers for Hesi Med-Surg Practice Tests, so you can be ready for test day. (C) indicates infection (D) is an expected finding. The nurse reports the findings in the following way: "Physical Exam: All systems within normal except left lower extremity, casted d/t to heel fracture. craigslist missed connections philadelphia "AML does have a very poor prognosis for poorly differentiated cells. Exam (elaborations) - Hesi med-surg practice questions & key terms with complete solution 35. Advanced Medical Surgical (MSN5410) 68 Documents. mylowes card registration 2022 Hesi Med Surg Test Bank Answers. weigh daily, and report gain of >5 lb/wk 4. tiktok ip finder Nursing topics include medication administration, dosage calculations, general concepts about nursing pharmacology, cardiovascular drugs, antibiotics and anti-infectives, neurological medications, psychiatric medications, drugs for the respiratory system. Who did you hear that from?" 2. Levin's tube is a single lumen tube with no air vent, suction should be intermittent; continuous suction appropriate for a Salem tube. Frequent use of chewable and liquid antacids for indigestion. The nurse is developing a plan care for a client who reports intermittent- The client’s skin on. First, what are the key words in the question? What is the diagnosis?: 1. A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid ventricular response. Ask leading questions to assist in obtaining health data. Our questions are designed to test your critical thinking skills and to prepare you for the real exam. There are 326 questions of the HESI A2. A Med Tech, or Medical Technologist, plays a. - meds for pain and clotting if required. BSN 266 HESI Med Surg Practice V2 (New 2023/ 2024 Update) Questions and Verified Answers with Rationales|100% Correct| Grade A- Nightingale. Which assessment finding should the nurse expect this client to exhibit? A. skiers wait longer for any truly all-inclusive options. change in usual bowel/bladder fx. Intake includes all liquid taken by mouth, any foods that turn to liquid at room temperature and IV fluids or tube feedings. light housekeeping is permitted but avoid heavy lifting A male adult comes to the urgent care clinic 5 days after being diagnosed with influenza. 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Ask another nurse to go back with the medication when the client's hung up the phone. Post- postion on right side, frequent v. Sep 30, 2022 · Rub the client's feet briskly for several minutes. Caution the client not to travel outside the United States alone. The most useful information initially would be an assessment of each individual's adjustment …. , The client who is taking corticosteroids daily for severe …. - 4 An Ankle-Brachial Index of 0. Before reporting this finding to the health care provider, the nurse should evaluate which laboratory value? A Platelet count. Which Intervention should the nurse implement first? A. 3rd degree strains are considered "mild". Management and education of patients regarding drug therapy. Study with Quizlet and memorize flashcards containing terms like During a clinic visit, a client reports to the practical nurse (PN) that they felt a solid mass in their breast during self. 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Study as you follow along as Liz defines the parts of . Test your competence in the assessment, diagnosis, and nursing management of patients with cancer. The client reports feeling as tired as at the last visit by the nurse. Advanced Medical-Surgical HESI Study Guide, Practice Test Questions (latest Update 2023), 100% Correct and Complete Answers with Explanations, Highly Recommended, Download to Score A+ Work Cited: All information was found in HESI book & Junior Med Surg book The difference between open & closed angle glaucoma. lower left quadrant pain and low grade fever. Which observation by the nurse warrants immediate intervention? Apical heart rate of 60.