Free BCEN Certified Emergency Nurse (CEN) Practice Question

The correct answer is a grade II ankle sprain. This diagnosis is based on the following key points:

1. Moderate swelling and point tenderness are consistent with a significant ligament injury.
2. A positive anterior drawer test indicates damage to the anterior talofibular ligament (ATFL), the most commonly injured ligament in ankle sprains.
3. The presence of a firm endpoint during the anterior drawer test suggests that the ligament is partially torn but not completely ruptured.

Grade II sprains involve partial tearing of the ligament fibers, resulting in moderate instability. This is in contrast to:

• Grade I sprains: Minimal swelling, negative anterior drawer test, and no significant instability.
• Grade III sprains: Severe swelling, positive anterior drawer test without a firm endpoint, and significant instability.
• Ankle fracture: While possible, the described symptoms are more consistent with a ligament injury than a fracture.

Understanding these distinctions is crucial for proper management and treatment planning in emergency settings.