A client is prescribed celecoxib for joint pain. What statement by the client indicates a need for further teaching?

Choice A reason: Anorexia is not a hallmark late sign of RA. It may occur early due to systemic inflammation but is less specific in late stages, where joint damage and systemic complications like Felty syndrome dominate.
Choice B reason: Felty syndrome, a late RA complication, involves neutropenia, splenomegaly, and recurrent infections due to chronic immune activation. It occurs in long-standing RA, reflecting severe disease progression, making it a key late finding.
Choice C reason: Joint deformity (e.g., swan-neck, boutonniere) is a classic late RA sign due to chronic synovial inflammation eroding cartilage and bone, causing joint instability and deformation, significantly impacting function in advanced disease.
Choice D reason: Low-grade fever is an early RA symptom due to systemic inflammation but typically diminishes in late stages. Chronic joint damage and systemic complications are more prominent, making fever less characteristic of late RA.
Choice E reason: Weight loss is a late RA sign due to chronic inflammation, increased metabolic demand, and cytokine activity (e.g., TNF-alpha). It reflects disease severity and systemic impact, common in advanced RA with joint destruction.

Choice A reason: The forward bend test is the standard for scoliosis screening, revealing spinal asymmetry (rib hump) due to lateral curvature. It detects abnormal spinal alignment in preadolescents, when growth spurts exacerbate scoliosis, allowing early intervention to prevent progression.
Choice B reason: Observing gait (heel-to-toe walking) assesses neurological or musculoskeletal function but not spinal curvature. Scoliosis primarily affects spinal alignment, not gait, unless severe, making this less effective for detecting the lateral curvature characteristic of scoliosis.
Choice C reason: Flexing the knees to check knee height assesses leg length discrepancy, not spinal curvature. Scoliosis involves lateral spinal deviation, and knee height is unrelated to detecting the spinal asymmetry critical for diagnosis.
Choice D reason: Observing shoulders and hips while clothed is less effective, as clothing obscures subtle asymmetries. The forward bend test, performed without clothing, better reveals spinal curvature or rib hump, the hallmark signs of scoliosis in preadolescents.