146) ANSWER

A) Swan-neck deformity and ulnar deviation

RATIONALE

Swan-neck deformity occurs at the proximal interphalangeal (PIP) joint and ulnar deviation occurs as a result of joint destruction with disease progression. Heberden’s and Bouchard’s nodes are commonly found in clients with osteoarthritis. Tophi (firm, moveable nodules) are associated with gout. Charcot’s joint is considered a neuropathic disorder that falls under the broader category of rheumatism. It is not specific to RA and is more likely to be seen as a complication in clients with diabetes. The core issue of the question is identification of signs and symptoms of RA. Use nursing knowledge and the process of elimination to make a selection.