The patient is able to elevate his shoulders bilaterally until the nurse presses down on his shoulders. How should the nurse document his muscle strength?

A. 0/5 This indicates no muscle contraction at all. It would apply if the patient had complete paralysis and could not initiate any movement. Since Marcus can elevate his shoulders, this is not correct. B. 1/5 This means a trace contraction is palpable or visible, but no movement occurs. Again, Marcus is able to move his shoulders against gravity, so this does not fit. C. 2/5 This score is given when the patient can move the joint only if gravity is eliminated, but cannot overcome gravity. Marcus can elevate his shoulders against gravity, so this is not accurate. D. 3/5 This represents full range of motion against gravity but not against resistance. Marcus can elevate his shoulders, but when the nurse applies resistance, he cannot maintain the movement. This matches his presentation. E. 4/5 This indicates full range of motion against gravity and some resistance, but less than normal strength. If Marcus had been able to elevate his shoulders and withstand the nurse’s pressure partially, this would apply. However, he was unable to resist at all, so 4/5 is not correct. F. 5/5 This is normal strength, meaning full range of motion against gravity and full resistance. Since Marcus cannot resist the nurse’s pressure, this is not appropriate.