The Nurse Is Attempting to Assess the Patient's Apical Pulse

The nurse is attempting to assess the patient's apical pulse and cannot palpate it. In which of the following patients would it be difficult to palpate the patient's apical pulse? Select all that apply.

A) The female patient with small breasts
B) The male patient with enlarged pectoral muscles
C) The patient who has chronic obstructive pulmonary disease
D) The patient who is underweight
E) The patient who has fluid around the heart