Orthopaedic Nurses Certification Board (ONCB) Metabolic/Inflammatory/Tumors Practice Exam

In a patient with rheumatoid arthritis, what symptom would you expect to find?

1. Pain only in the morning

2. Asymmetric joint involvement

3. Symmetric joint swelling

4. Joint warmth exclusively

The correct answer is: Symmetric joint swelling

In the context of rheumatoid arthritis, symmetric joint swelling is a hallmark symptom. This condition is characterized by symmetrical involvement of the joints, which means that if one joint is affected, the corresponding joint on the opposite side of the body is likely to be affected as well. Such swelling often occurs in the small joints of the hands and feet, making it a key indicator of the disease. The nature of rheumatoid arthritis entails that inflammation affects joints in a symmetrical pattern, distinguishing it from other types of arthritis, where asymmetric involvement might be more common. This symmetric feature helps clinicians in diagnosing rheumatoid arthritis, as it aligns with the typical presentation of the disease. Furthermore, while pain can be more prominent in the morning and lead to stiffness after periods of inactivity, stating that pain occurs exclusively in the morning does not capture the full picture of the symptomatology, as symptoms can persist throughout the day with varying intensity. Joint warmth can occur but generally is not the sole symptom; it is usually accompanied by swelling and tenderness, making it less representative of the overall presentation of rheumatoid arthritis.