During the admission assessment, the nurse observes that a client has a limping gait. Which assessment should the nurse complete next?

A. This maneuver assesses shoulder strength and endurance but is not a direct measure of the normal range of motion. The test involves resistance but does not provide information on the full range of shoulder movement. It might reveal issues with muscle strength or endurance but does not effectively assess ROM.
B. This assessment technique evaluates shoulder flexion, where the client raises their arms straight up beside the ears, which is a key movement to measure in shoulder ROM. It assesses the ability to lift the arms fully overhead, which is an essential component of shoulder range of motion. This technique directly tests the normal ROM for shoulder flexion and abduction.
C. This maneuver tests coordination and proprioception rather than the range of motion. It is a test for the accuracy of movements and neurological function, particularly useful in assessing cerebellar function, but does not directly measure shoulder ROM.
D. This test assesses shoulder strength and stability rather than range of motion. It is useful for evaluating how well the shoulder can maintain a position but does not provide specific information about the range of motion in different directions.

A. Hyperactive bowel sounds are not typically associated with gastroesophageal reflux disease (GERD). They are more indicative of gastrointestinal disturbances such as increased bowel activity or a bowel obstruction. Since the client's symptoms are related to heartburn, assessing bowel sounds is less relevant to GERD. This choice does not provide useful information for diagnosing or managing GERD.
B. This option is not commonly associated with GERD. In fact, small frequent meals are often recommended as a management strategy for GERD to reduce the occurrence of heartburn, as large meals can exacerbate symptoms by increasing stomach pressure. This choice does not align with typical GERD management strategies and may not be a useful symptom to assess in this context.
C. This finding is highly relevant for GERD. Heartburn that occurs or worsens when lying down, especially at night, is a classic symptom of gastroesophageal reflux disease. When a person lies flat, stomach acid can more easily flow back into the esophagus due to decreased gravitational pressure, leading to heartburn. Identifying this symptom helps confirm GERD and guides management strategies, such as elevating the head while sleeping or avoiding late meals.
D. Light grey and chalky stools are indicative of issues related to bile production and could suggest a problem with the liver or biliary system rather than GERD. This symptom is not associated with GERD and would be more relevant in assessing conditions such as biliary obstruction or liver disease.