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: An event that can cause serious injury to a client that should never happen in a hospital is not the best description of a sentinel event, because it is too vague and broad. It does not specify the degree of injury or the nature of the event. It also implies that some events that cause serious injury are acceptable in a hospital, which is not true.

Choice B reason: Specific events that enable a hospital to maximize reimbursement is not a description of a sentinel event, but rather a description of quality indicators or performance measures. These are criteria that reflect the quality of care provided by a hospital and affect its payment from payers. They are not related to sentinel events, which are adverse events that require immediate investigation and response.

Choice C reason: An unexpected event involving death or serious physical or psychological injury is the best description of a sentinel event, because it captures the essence and severity of the event. According to the Joint Commission, a sentinel event is "an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof" . Examples of sentinel events include wrongsite surgery, medication error, suicide, or abduction.

Choice D reason: Operating room event involving the use of unsafe equipment is not a description of a sentinel event, but rather an example of a potential sentinel event. It is not a general definition that applies to all sentinel events, but a specific scenario that may or may not result in death or serious injury. It also does not indicate the unexpectedness of the event, which is a key characteristic of a sentinel event.

Choice A reason: Heberden's nodes are not a symptom of lupus. Heberden's nodes are bony swellings that form on the distal interphalangeal joints of the fingers. They are a sign of osteoarthritis, which is a degenerative joint disease that causes pain, stiffness, and reduced mobility.

Choice B reason: Chvostek's sign is not a symptom of lupus. Chvostek's sign is a facial twitch that occurs when the facial nerve is tapped near the ear. It is a sign of hypocalcemia, which is a low level of calcium in the blood. Hypocalcemia may be caused by various conditions, such as hypoparathyroidism, vitamin D deficiency, or renal failure.

Choice C reason: OsgoodSchlatter's disease is not a symptom of lupus. OsgoodSchlatter's disease is a condition that affects the growth plate of the tibia, which is the shin bone. It causes pain, swelling, and tenderness below the knee. It is common in adolescents who are active in sports that involve running, jumping, or bending the knee.

Choice D reason: Butterfly rash is a classic symptom of lupus. Butterfly rash is a malar rash that appears across the cheeks and the bridge of the nose. It is a common sign of systemic lupus erythematosus (SLE), which is an autoimmune disease that causes inflammation and damage to various organs and tissues. The rash may flare up or fade depending on the disease activity and exposure to sunlight.