A client sustains an injury to his heel while the unlicensed assistive personnel and the nurse are moving him in bed. What force caused the injury?

Choice A reason: Popping bursae from standing is not the cause of the grating sound. Bursae are fluidfilled sacs that cushion the joints and reduce friction. Popping bursae may produce a snapping or clicking sound, but not a grating sound.

Choice B reason: A herniated disk in the diseased joint is not the cause of the grating sound. A herniated disk is a condition where the soft inner part of the intervertebral disk bulges out through a tear in the outer layer. A herniated disk may cause pain, numbness, or weakness, but not a grating sound.

Choice C reason: Pieces of bone and cartilage floating is the cause of the grating sound. Osteoarthritis is a degenerative joint disease that causes the breakdown of the cartilage and bone in the joints. Pieces of bone and cartilage may detach and float in the joint space, causing a grating sound when the joint moves.

Choice D reason: Years of an autoimmune process is not the cause of the grating sound. An autoimmune process is a condition where the immune system attacks the body's own tissues. An autoimmune process may cause inflammation, swelling, or damage to the joints, but not a grating sound.

Choice A reason: Psoriasis is a skin abnormality that causes patches of thick, red skin with silvery scales, usually on the elbows, knees, scalp, lower back, or genitals. Psoriasis is a chronic, inflammatory, autoimmune condition that affects the life cycle of skin cells, causing them to build up rapidly on the surface of the skin. Psoriasis can cause itching, burning, pain, or bleeding.

Choice B reason: Rosacea is a skin abnormality that causes redness, flushing, swelling, or pimples, usually on the face, especially the cheeks, nose, chin, or forehead. Rosacea is a chronic, inflammatory, vascular condition that affects the blood vessels and sebaceous glands of the skin. Rosacea can cause sensitivity, stinging, or dryness.

Choice C reason: Scabies is a skin abnormality that causes small, red bumps, blisters, or burrows, usually on the hands, wrists, feet, ankles, or genitals. Scabies is a contagious, parasitic infection that is caused by tiny mites that burrow into the skin and lay eggs. Scabies can cause intense itching, especially at night.

Choice D reason: Stasis dermatitis is a skin abnormality that causes swelling, redness, scaling, or ulcers, usually on the lower legs or ankles. Stasis dermatitis is a chronic, inflammatory condition that results from poor blood circulation in the veins of the legs, causing fluid to leak into the surrounding tissues. Stasis dermatitis can cause pain, itching, or infection.