The nurse prepares to administer a shift assessment to a patient who is recovering from a stroke. The nurse knows that tone is assessed clinically by:
a. passively flexing and extending the patient's limbs and noting the resistance of the muscles.
b. asking the patient to hold a muscle contraction against maximal resistance.
c. asking the patient to balance on one foot.
d. tapping the tendon with a reflex hammer and noting the briskness of the muscle response elicited.
Answer: a. passively flexing and extending the patient's limbs and noting the resistance of the muscles.
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