The nurse observes generalized weakness and diminished deep tendon reflexes on the right side of an older adult client who has a history of a cerebrovascular accident. Which deep tendon reflex response should the nurse document to support the client's clinical assessment?

Choice A reason: A 4+ reflex indicates hyperreflexia, often associated with upper motor neuron lesions. It contradicts the observed diminished reflexes. Choice B reason: A 0 reflex indicates complete absence of response, which may suggest severe peripheral nerve damage or spinal cord injury. It is more extreme than the described diminished reflexes. Choice C reason: A 1+ reflex is considered diminished but present, which aligns with the nurse’s observation of generalized weakness and reduced reflexes on the affected side. Choice D reason: A 2+ reflex is normal and would not support the clinical finding of diminished reflexes.