Free NCLEX RN Practice Test Practice Question
A client has increasing pain in both hands. On examination, the nurse notes that the metacarpophalangeal and proximal interphalangeal joints are enlarged and swollen, swanneck deformity is evident, and the fingers on both hands show ulnar deviation. These findings are consistent with which of the following disorders?
Correct Answer: B
Rationale: The presence of symmetrical joint swelling, particularly in the metacarpophalangeal and proximal interphalangeal joints, along with swan neck deformity and ulnar deviation, strongly indicates rheumatoid arthritis. This autoimmune disorder typically affects joints symmetrically and leads to characteristic deformities.
Option A, osteoarthritis, usually presents with joint pain and stiffness but does not cause symmetrical swelling or the specific deformities noted. Option C, gouty arthritis, is characterized by sudden, severe pain and swelling in a single joint, often the big toe, and does not present with the described deformities. Option D, psoriatic arthritis, can cause joint swelling but is often accompanied by skin lesions and may not present with the same symmetric joint involvement or deformities.
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