Which of the following signs suggests that a patient has a closed musculoskeletal injury?

The presence of swelling and tenderness is a common indication of a closed musculoskeletal injury. Closed injuries often result in damage to the muscles, ligaments, or bones without breaking the skin, leading to internal bleeding or inflammation. The swelling occurs as the body responds to injury, sending fluid to the affected area, and the tenderness is a result of nerve endings becoming irritated or damaged due to the injury.

This option effectively captures the typical signs of a closed injury, which are characterized by the absence of external wounds while still manifesting significant internal effects. In contrast, visible bone fragments and open wounds are indicative of open injuries, while skin bruising alone may not provide enough information to conclude the presence of a closed injury without additional context about the underlying structures affected.