A nurse is reinforcing teaching about passive range-of-motion exercises with the family of a client who has had a stroke. Which of the following instructions should the nurse include in the teaching?

Passive range-of-motion (ROM) exercises are performed when a client is unable to actively move their limbs, such as after a stroke, to maintain joint mobility and prevent complications like contractures and muscle atrophy. These exercises require the caregiver or nurse to move the client’s joints through their natural range while ensuring proper body alignment and safety. Correct technique is essential to avoid injury, pain, or joint damage. Proper support and gentle movement help maintain musculoskeletal integrity during recovery. Rationale: A. Supporting the extremity above and below each joint is the correct technique for passive range-of-motion exercises. This stabilization prevents unnecessary stress on joints, ligaments, and muscles while allowing controlled movement. It ensures proper alignment and reduces the risk of injury or dislocation, especially in weakened or flaccid limbs after a stroke. B. Positioning the bed at mid-thigh level is not directly related to performing passive ROM exercises. Although proper bed height may improve caregiver ergonomics and reduce strain, it does not influence the safety or effectiveness of joint movement. The key focus is correct limb support and controlled motion rather than bed positioning. C. Moving each joint just past the point of resistance is incorrect because it can cause tissue injury, pain, or joint damage. Passive ROM should always be performed gently and only to the point of slight resistance or the client’s natural limit. Forcing movement beyond resistance may lead to microtears or inflammation in soft tissues. D. Repeating each exercise movement 10 times may not be appropriate for all clients and should be individualized based on tolerance and provider recommendations. Although repetition is important to maintain joint function, excessive repetition can cause fatigue or discomfort in a post-stroke client. The priority is proper technique and gentle movement rather than a fixed number of repetitions.