Which statement is true about the apical pulse?

• A. The apical pulse is counted at the wrist.
• B. The apical pulse is the heartbeat felt at the neck.
• C. Count the apical pulse for a full 60 seconds to determine BPM.
• D. Apical pulses are never used in critically ill patients.

Answer: (C)

The apical pulse is measured by listening with a stethoscope at the apex of the heart, located at the left fifth intercostal space in the midclavicular line. To determine the heart rate, you count the beats for a full 60 seconds, which gives an accurate number of beats per minute, especially if the rhythm is irregular. This pulse is not at the wrist (that’s the radial pulse) nor felt in the neck (that’s the carotid pulse). While apical auscultation can be used in some critical situations when peripheral pulses are unreliable, it isn’t correct to say it’s never used in critically ill patients.