failed my boards because i couldnt find mans apical pulse neither could the observer!

[bradycakesmom]

I failed my boards because I could not hear the actors heartbeat during the apical pulse, he said his doctor has trouble finding it and he is on meds that affect it too, my observer tried to listen for it, couldnt find it, gave the stethescope to the actor and he couldnt find it. I had 35 min. to complete all 5 tasks and I searched his chest for 22 min. and failed because i could not find it!!Help! what do i do in this situation??????

[doc2bmo]

My advice would be to request a different stethoscope....those double earpiece "teaching" scopes SUCK! You can't hear jack scratch...I would use a good cardiology scope, find the pulse, hold the diaphragm in place and then let the "observer" have a listen....Sorry they're making things so difficult! Good luck!

[Jules A, MSN]

This is a little late to help you with this case but in the future try asking them to lean forward.

[Virgo_RN, BSN, RN]

The PMI can shift in patients with heart disease, so the apical pulse may not be in the expected location.

[TopazLover, BSN, RN]

I think that the actor is not an appropriate subject if the observer could not hear either. I wish the proctor had offered another option for you to try, since she had the same problem. I think there is room in the rules for proctoring these exams to look at options. At least when I have proctored, I have had that latitude.

I would go back to your instructor and review how to do the task, just so you get some positive feedback of your ability. You can go to the BON but I doubt they will be able to do anything for you. They certainly can require that actors are appropriate. What if you had been asked to do a pedal pulse and an actor had none in one leg?

I have always felt the practical exam was to have the CNA be able to recognize normal and report abnormal findings. In the real world you would have gone to your nurse and reported that you were not able to count the apical but radial, etc. were wnl.

Retake the test and I am sure yo will do well. Best of luck.

[Tolle_lege]

Is there any way to protest with the school you went to? I does seem odd that they would pick a patient that has difficult heart rate to use as an "actor". I would definitely fight it!