The nurse is performing a health history and physical assessment on a patient with chronic rheumatoid arthritis (RA). Which symptom(s) should the nurse anticipate?

A. Non-tender osteophytes of the finger joints: Osteophytes are bony spurs characteristic of degenerative joint disease, not the inflammatory erosion seen in RA. RA is characterized by synovial thickening and bone destruction rather than new bone growth. These spurs are hallmarks of osteoarthritis. B. Deterioration of articular cartilage surfaces: While RA eventually destroys cartilage, this is the primary pathological mechanism of osteoarthritis (OA). In RA, the initial insult is an autoimmune attack on the synovium. The disease process is inflammatory and systemic rather than purely mechanical wear. C. Joint pain that is worse later in the day: Pain that worsens with activity and later in the day is typical of osteoarthritis. RA patients characteristically experience significant morning stiffness that lasts longer than 60 minutes. RA pain typically improves with movement and throughout the day. D. Bilateral swelling and tenderness of joints: Rheumatoid arthritis is a systemic autoimmune disease that typically presents with a symmetrical, bilateral pattern of joint involvement. Swelling, warmth, and tenderness result from chronic synovitis within the affected joints. This symmetry distinguishes it from the asymmetrical nature of OA.