The nursing student is teaching a patient about rheumatoid arthritis (RA). Which of the following statements would indicate that the student understands the pathophysiology of the disease?

Choice A reason: RA is a systemic autoimmune disease that typically affects multiple joints symmetrically. It does not affect single joints only. Early involvement often includes small joints of the hands and feet. Choice B reason: RA is a progressive disease that does not improve over time without treatment. If left untreated, it leads to joint destruction, disability, and systemic complications. Disease-modifying antirheumatic drugs (DMARDs) are essential to slow progression. Choice C reason: While RA can occur in older adults, the typical onset is between ages 30 and 50. It is not primarily a disease of the elderly, although late-onset RA does exist. Choice D reason: The presence of autoantibodies such as rheumatoid factor and anti-citrullinated protein antibodies (ACPAs) is central to the pathogenesis of RA. These antibodies trigger immune responses that lead to synovial inflammation, pannus formation, and joint destruction.