NCLEX-RN® Question of the Day: Juvenile idiopathic arthritis

In This Article

Today’s NCLEX-RN® question of the day focuses on a assessments for juvenile idiopathic arthritis. Do you know the answer? Let’s find out!

The nurse in the rheumatology clinic is caring for a patient who is being evaluated for juvenile idiopathic arthritis (JIA). Which assessment finding(s) support this diagnosis? Select all that apply.

A. Age younger than 16 years

B. Joint swelling present for 4 weeks

C. Joint stiffness lasting greater than 30 minutes

D. Presence of joint effusion

E. Joint stiffness that improves with rest

F. Limited range of motion

Scroll down for the correct answer!

The correct answer to today’s NCLEX® Question is…

A. Age younger than 16 years

Rationale: This assessment finding supports the diagnosis of JIA. By definition, JIA has an onset before 16 years of age.

C. Joint stiffness lasting greater than 30 minutes

Rationale: This assessment finding supports the diagnosis of JIA. Patients commonly report morning joint stiffness or stiffness lasting more than 30 minutes that improves with movement.

D. Presence of joint effusion

Rationale: This assessment finding supports the diagnosis of JIA. Joint effusions are a common manifestation of inflammation and may be noted on physical examination.

F. Limited range of motion

Rationale: This assessment finding supports the diagnosis of JIA. Chronic joint inflammation may result in a decreased or limited range of motion during assessment.

Main Takeaway

Juvenile idiopathic arthritis, or JIA for short, describes a broad group of autoimmune conditions associated with inflammatory synovitis and arthritis, which can potentially result in bony erosion and joint destruction. It is important to diagnose and treat JIA early to limit joint damage, preserve joint functionality, and avoid chronic pain. Based on the history, physical exam, and lab finding, healthcare providers classify JIA into several subtypes, such as oligoarticular, polyarticular, systemic, enthesitis-related, and psoriatic JIA.

When evaluating a patient for JIA, the nurse should obtain a focused history and physical examination. Key assessment findings include onset before 16 years of age, persistent arthritis or joint swelling for at least 6 weeks, joint warmth or pain, and stiffness lasting longer than 30 minutes after waking or following periods of inactivity that improves with movement. Physical examination findings may include joint effusion, tenderness to palpation, and a limited range of motion resulting from chronic inflammation.

Incorrect Answer Explanations

B. Joint swelling present for 4 weeks

Rationale: This assessment finding does not support the diagnosis of JIA. Symptoms must be present for at least 6 weeks for the diagnosis to be considered.

E. Joint stiffness that improves with rest

Rationale: This assessment finding does not support the diagnosis of JIA. Joint stiffness typically worsens after periods of inactivity and improves with movement.