1. 1. An older adult patient who has just arrived in the emergency department has a pulse deficit of 46 beats.The nurse should expect that the patient may require: a. cardiac catheterization. b. emergent cardioversion. c. hourly blood pressure checks. d. electrocardiographic monitoring.: Answer D Pulse deficit is a difference between simultaneously obtained apical and radial pulses. It indicates that there may be a cardiac dysrhythmia that would best be detected with ECG monitoring.Frequent BP monitoring, cardiac catheterization, and emergent cardioversion are used for diagnosis and/or treatment of cardiovascular disorders but would not be as helpful in determining the immediate reason for the pulse deficit. 2. 2. The nurse isreviewing the 12-lead electrocardiograph (ECG)for a healthy older adult patient who is having an annual physical examination. What finding should be of most concern to the nurse? a. A right bundle branch block. b.The PR interval is 0.21 seconds. c.The QRS duration is 0.13 seconds. d.The heart rate (HR) is 41 beats/min.: Answer D The resting HR does not change with aging, so the decrease in HR needs further investigation. Bundle branch block and slight increases in PR interval or QRS duration are common in older individuals because of increases in conduction time through the AV node, bundle of His, and bundle branches. 3. 3. During a physical examination of an older patient, the nurse palpates the point of maximal impulse (PMI) in the sixth intercostal space lateral to the left midclavicular line. What would be the most focused follow-up action for the nurse to take? a. Ask about risk factors for atherosclerosis. b. Determine family history of heart disease. c. Assess for symptoms of left ventricular hypertrophy. d. Auscultate carotid arteries for the presence of a bruit.: Answer C The PMI should be felt at the intersection of the fifth intercostal space and left midclavicular line. A PMI found outside these landmarks indicates possible cardiac