Question

The nurse is testing superficial reflexes on an adult patient. When stroking up the lateral side of the sole and across the ball of the foot,

the nurse notices the plantar flexion of the toes. How should the nurse document this finding?

a. positive Babinski sign
b. plantar reflex abnormal
c. plantar reflex present
d. plantar reflex "2+" on a scale from "0-4+"

Answer 1

The nurse should document this finding as plantar reflex present.

Step-by-step explanation:

The nurse should document this finding as c. plantar reflex present. When stroking up the lateral side of the sole and across the ball of the foot, the plantar flexion of the toes is a normal response. The plantar reflex is commonly tested in newborn infants to assess neuromuscular function. It is important to note that a positive Babinski sign is characterized by dorsiflexion and splaying of the toes, which is not seen in this case.