What would the nurse check when assessing the patient with early to moderate rheumatoid arthritis?

priority. Protein aids long-term recovery by promoting bone healing, but infection control is critical to prevent systemic spread or bone necrosis. Nutritional support is secondary to addressing the acute bacterial infection driving the condition.

Choice B reason: Administering antibiotics is the priority in acute osteomyelitis, a bacterial bone infection (often Staphylococcus aureus). Prompt antibiotics target the infection, preventing sepsis, abscess formation, or chronic osteomyelitis. Delaying treatment risks bone destruction and systemic complications, making timely antibiotic administration essential to control the infection and preserve bone integrity.

Choice C reason: Teaching relaxation breathing reduces pain perception by calming the nervous system but does not address the underlying infection in osteomyelitis. Pain management is important but secondary to antibiotics, which target the bacterial cause. Without infection control, pain will persist, and complications like bone damage may worsen.

Choice D reason: Providing antipyretic therapy manages fever, a symptom of osteomyelitis, but does not treat the infection itself. Fever reflects the body’s immune response to bacteria, and while comfort is important, antibiotics are the priority to eradicate the pathogen, preventing progression to sepsis or chronic bone infection.

Choice A reason: Morning stiffness lasting 60 minutes or more is a hallmark of rheumatoid arthritis (RA) due to synovial inflammation in affected joints. This prolonged stiffness, worse after inactivity, reflects autoimmune-mediated synovitis, distinguishing RA from osteoarthritis. Recognizing this guides diagnosis and treatment with disease-modifying antirheumatic drugs (DMARDs) to reduce joint damage.

Choice B reason: Bamboo-shaped fingers are characteristic of psoriatic arthritis, not RA. RA causes joint deformities like swan-neck or boutonnière due to synovial destruction, not a bamboo appearance. Expecting this finding risks misdiagnosis, delaying RA-specific therapies like methotrexate, which target inflammation and prevent progressive joint erosion.

Choice C reason: Asymmetric small joint involvement is typical of osteoarthritis or psoriatic arthritis, not RA. RA features symmetric involvement of small joints, like metacarpophalangeal joints, due to systemic autoimmune inflammation. Assuming asymmetry misguides assessment, potentially overlooking RA’s bilateral pattern critical for early diagnosis and effective immunosuppressive treatment.

Choice D reason: Noninflammatory pain in large joints is not typical of RA, which involves inflammatory pain in small joints due to synovitis. Large joint pain may occur in osteoarthritis or gout. Expecting noninflammatory pain misdirects RA diagnosis, delaying interventions like corticosteroids or biologics to manage inflammation and joint destruction.