A client comes to the clinic due to shoulder discomfort and intermittent pain while swimming laps. To identify normal range of motion (ROM) of the client's shoulder, which assessment technique should the nurse ask the client to perform?

Choice A rationale Shoulder flexion, which involves extending the arms up to 180 degrees beside the ears, represents the full normal range of motion for the glenohumeral joint. This movement assesses the combined function of the deltoid, supraspinatus, and biceps brachii muscles, indicating optimal mobility of the shoulder joint. A normal range is 0 to 180 degrees of flexion. Choice B rationale Holding arms up at 90 degrees while arms are pushed downward tests muscle strength against resistance, specifically of the deltoid. While an important component of shoulder assessment, it evaluates strength rather than the full range of motion. This maneuver assesses the integrity of the rotator cuff and surrounding musculature. Choice C rationale Alternating both index fingers to touch the tip of the nose accurately is a test of cerebellar function and coordination, assessing proprioception and fine motor control. This technique is not used to evaluate the range of motion of the shoulder joint. It helps identify neurological deficits, such as ataxia. Choice D rationale Extending arms straight out and holding without drifting, commonly known as the Romberg test (when standing) or pronator drift, assesses balance and subtle motor weakness, especially indicative of upper motor neuron lesions. This technique does not specifically measure the range of motion of the shoulder.