A 14-year-old girl sprained her ankle. She rates her pain 5/10. On examination, she has moderate tenderness and swelling with decreased range of motion secondary to pain. Although quite painful, she is able to ambulate. What is the grade of this ankle sprain

When there is either a partial or complete tearing on ligaments that are responsible for supporting the joint of the ankle then it causes an ankle sprain.
Based on the exam findings as well as the loss in functionality of the ankle, an ankle sprain can be categorized as grade I, II or III.
In the given situation the 14-year-old girl has a grade II ankle sprain which is characterized by an incomplete tear of the ligaments along with moderate pain (as she rates it 5/10), moderate tenderness, loss of range of some functions, and swelling.
All of the characteristics of the sprain resemble those of the grade II ankle sprain tear and hence, it is characterized as a grade II ankle sprain.