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A nurse is caring for a client who has been hospitalized and is performing active range-of-motion exercises. Which of the following body movements should indicate to the nurse that the client has full range of motion of the shoulder?

Abducting the arm to a 90-degree angle from the side of the body

Adducting the arm so that is lies next to the client's side

Flexing the shoulder by raising the arm from a side position to a 180-degree angle

Circumducting the shoulder in a 180-degree half circle

Answer and Explanation

The Correct Answer is C

A. Abducting the arm to a 90-degree angle from the side of the body

This is only partial abduction; full ROM involves more than 90 degrees.

B. Adducting the arm so that it lies next to the client's side

Adduction is part of the range, but not a complete indicator of full shoulder ROM.

C. Flexing the shoulder by raising the arm from a side position to a 180-degree angle

This demonstrates full shoulder flexion, from rest to above the head.

D. Circumducting the shoulder in a 180-degree half circle

Circumduction is a circular movement, but a 180° half-circle isn’t a full demonstration of the shoulder’s capacity.

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Correct Answer is D

Explanation

A. Determining the client's mobility

Important for safety and fall prevention, but not the first priority during care planning.

B. Explaining the roles of the RN, licensed practical nurse, and assistive personnel

This is part of orientation and education but does not help in personalized care planning.

C. Introducing health care team members to the client

While courteous and important for building rapport, it’s not the first step in individualized care planning.

D. Understanding the client's routine for his own care at home

This helps in personalizing the care plan to maintain the client’s independence and preferences, especially for older adults in long-term care.

A. left the patient with the lap robe tucked underneath. B. left the brakes of the wheelchair unlocked. C. placed the patient's feet centered on the footrests. D. placed slippers on the patient.

Correct Answer is B

Explanation

A. Left the patient with the lap robe tucked underneath.

A lap robe is used for warmth and comfort; tucking it under does not pose a risk.

B. Left the brakes of the wheelchair unlocked.

Wheelchair brakes must be locked during transfers to prevent the chair from moving and causing a fall.

C. Placed the patient's feet centered on the footrests.

Feet should be properly placed to avoid dragging or injury.

D. Placed slippers on the patient.

This is appropriate as long as the slippers are non-skid, providing safe footing during transfer.

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A nurse is caring for a client who has been hospitalized and is performing active range-of-motion exercises. Which of the following body movements should indicate to the nurse that the client has full range of motion of the shoulder?

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