COMPREHENSIVE PROFESSIONAL NURSING
EXAMINATION
Pediatric Nursing: Juvenile Idiopathic Arthritis (JIA)
& Related Conditions
200 Clinical-Grade Examination Questions with Detailed Rationales
SECTION I: PATHOPHYSIOLOGY, CLINICAL
MANIFESTATIONS, & INITIAL ASSESSMENT
Question 1: A nurse is assessing a school-age child who has juvenile
idiopathic arthritis (JIA). Which of the following findings should the
nurse expect?
A. Joint pain and swelling that are typically worse in the evening
after school activities.
B. Joint stiffness that is most pronounced in the morning or
following periods of inactivity.
C. Symmetrical joint deformities with immediate bone erosion
evident within weeks of onset.
D. Painless subcutaneous nodules distributed along extensor
surfaces of the upper extremities.
Correct Answer: B
Rationale: Juvenile idiopathic arthritis is characterized by chronic
joint inflammation resulting in pain, warmth, tenderness, and
characteristic morning stiffness or gelling after periods of inactivity.
Unlike osteoarthritis, inflammatory arthritis symptoms improve with
gentle movement and worsen after rest.
Question 2: During a routine health screening, a 9-year-old child with
systemic juvenile idiopathic arthritis (sJIA) is evaluated. Which clinical
manifestation is most characteristic of systemic onset JIA?
, A. Joint pain and swelling that are typically worse in the evening
after school activities.
B. Joint stiffness that is most pronounced in the morning or
following periods of inactivity.
C. Symmetrical joint deformities with immediate bone erosion
evident within weeks of onset.
D. Painless subcutaneous nodules distributed along extensor
surfaces of the upper extremities.
Correct Answer: B
Rationale: Juvenile idiopathic arthritis is characterized by chronic
joint inflammation resulting in pain, warmth, tenderness, and
characteristic morning stiffness or gelling after periods of inactivity.
Unlike osteoarthritis, inflammatory arthritis symptoms improve with
gentle movement and worsen after rest.
Question 3: A nurse is caring for an 8-year-old child diagnosed with
oligoarticular JIA. Which joint involvement pattern is the nurse most
likely to observe during physical assessment?
A. Joint pain and swelling that are typically worse in the evening
after school activities.
B. Joint stiffness that is most pronounced in the morning or
following periods of inactivity.
C. Symmetrical joint deformities with immediate bone erosion
evident within weeks of onset.
D. Painless subcutaneous nodules distributed along extensor
surfaces of the upper extremities.
Correct Answer: B
Rationale: Juvenile idiopathic arthritis is characterized by chronic
joint inflammation resulting in pain, warmth, tenderness, and
characteristic morning stiffness or gelling after periods of inactivity.
, Unlike osteoarthritis, inflammatory arthritis symptoms improve with
gentle movement and worsen after rest.
Question 4: An adolescent with polyarticular JIA reports morning
stiffness lasting over 2 hours and generalized fatigue. Which
pathophysiological mechanism explains these symptoms?
A. Joint pain and swelling that are typically worse in the evening
after school activities.
B. Joint stiffness that is most pronounced in the morning or
following periods of inactivity.
C. Symmetrical joint deformities with immediate bone erosion
evident within weeks of onset.
D. Painless subcutaneous nodules distributed along extensor
surfaces of the upper extremities.
Correct Answer: B
Rationale: Juvenile idiopathic arthritis is characterized by chronic
joint inflammation resulting in pain, warmth, tenderness, and
characteristic morning stiffness or gelling after periods of inactivity.
Unlike osteoarthritis, inflammatory arthritis symptoms improve with
gentle movement and worsen after rest.
Question 5: A nurse is assessing a child with JIA for signs of
macrophage activation syndrome (MAS), a severe complication of
systemic JIA. Which laboratory or clinical finding is indicative of MAS?
A. Joint pain and swelling that are typically worse in the evening
after school activities.
B. Joint stiffness that is most pronounced in the morning or
following periods of inactivity.
C. Symmetrical joint deformities with immediate bone erosion
evident within weeks of onset.
, D. Painless subcutaneous nodules distributed along extensor
surfaces of the upper extremities.
Correct Answer: B
Rationale: Juvenile idiopathic arthritis is characterized by chronic
joint inflammation resulting in pain, warmth, tenderness, and
characteristic morning stiffness or gelling after periods of inactivity.
Unlike osteoarthritis, inflammatory arthritis symptoms improve with
gentle movement and worsen after rest.
Question 6: A nurse is assessing a school-age child who has juvenile
idiopathic arthritis (JIA). Which of the following findings should the
nurse expect?
A. Joint pain and swelling that are typically worse in the evening
after school activities.
B. Joint stiffness that is most pronounced in the morning or
following periods of inactivity.
C. Symmetrical joint deformities with immediate bone erosion
evident within weeks of onset.
D. Painless subcutaneous nodules distributed along extensor
surfaces of the upper extremities.
Correct Answer: B
Rationale: Juvenile idiopathic arthritis is characterized by chronic
joint inflammation resulting in pain, warmth, tenderness, and
characteristic morning stiffness or gelling after periods of inactivity.
Unlike osteoarthritis, inflammatory arthritis symptoms improve with
gentle movement and worsen after rest.
Question 7: During a routine health screening, a 9-year-old child with
systemic juvenile idiopathic arthritis (sJIA) is evaluated. Which clinical
manifestation is most characteristic of systemic onset JIA?
EXAMINATION
Pediatric Nursing: Juvenile Idiopathic Arthritis (JIA)
& Related Conditions
200 Clinical-Grade Examination Questions with Detailed Rationales
SECTION I: PATHOPHYSIOLOGY, CLINICAL
MANIFESTATIONS, & INITIAL ASSESSMENT
Question 1: A nurse is assessing a school-age child who has juvenile
idiopathic arthritis (JIA). Which of the following findings should the
nurse expect?
A. Joint pain and swelling that are typically worse in the evening
after school activities.
B. Joint stiffness that is most pronounced in the morning or
following periods of inactivity.
C. Symmetrical joint deformities with immediate bone erosion
evident within weeks of onset.
D. Painless subcutaneous nodules distributed along extensor
surfaces of the upper extremities.
Correct Answer: B
Rationale: Juvenile idiopathic arthritis is characterized by chronic
joint inflammation resulting in pain, warmth, tenderness, and
characteristic morning stiffness or gelling after periods of inactivity.
Unlike osteoarthritis, inflammatory arthritis symptoms improve with
gentle movement and worsen after rest.
Question 2: During a routine health screening, a 9-year-old child with
systemic juvenile idiopathic arthritis (sJIA) is evaluated. Which clinical
manifestation is most characteristic of systemic onset JIA?
, A. Joint pain and swelling that are typically worse in the evening
after school activities.
B. Joint stiffness that is most pronounced in the morning or
following periods of inactivity.
C. Symmetrical joint deformities with immediate bone erosion
evident within weeks of onset.
D. Painless subcutaneous nodules distributed along extensor
surfaces of the upper extremities.
Correct Answer: B
Rationale: Juvenile idiopathic arthritis is characterized by chronic
joint inflammation resulting in pain, warmth, tenderness, and
characteristic morning stiffness or gelling after periods of inactivity.
Unlike osteoarthritis, inflammatory arthritis symptoms improve with
gentle movement and worsen after rest.
Question 3: A nurse is caring for an 8-year-old child diagnosed with
oligoarticular JIA. Which joint involvement pattern is the nurse most
likely to observe during physical assessment?
A. Joint pain and swelling that are typically worse in the evening
after school activities.
B. Joint stiffness that is most pronounced in the morning or
following periods of inactivity.
C. Symmetrical joint deformities with immediate bone erosion
evident within weeks of onset.
D. Painless subcutaneous nodules distributed along extensor
surfaces of the upper extremities.
Correct Answer: B
Rationale: Juvenile idiopathic arthritis is characterized by chronic
joint inflammation resulting in pain, warmth, tenderness, and
characteristic morning stiffness or gelling after periods of inactivity.
, Unlike osteoarthritis, inflammatory arthritis symptoms improve with
gentle movement and worsen after rest.
Question 4: An adolescent with polyarticular JIA reports morning
stiffness lasting over 2 hours and generalized fatigue. Which
pathophysiological mechanism explains these symptoms?
A. Joint pain and swelling that are typically worse in the evening
after school activities.
B. Joint stiffness that is most pronounced in the morning or
following periods of inactivity.
C. Symmetrical joint deformities with immediate bone erosion
evident within weeks of onset.
D. Painless subcutaneous nodules distributed along extensor
surfaces of the upper extremities.
Correct Answer: B
Rationale: Juvenile idiopathic arthritis is characterized by chronic
joint inflammation resulting in pain, warmth, tenderness, and
characteristic morning stiffness or gelling after periods of inactivity.
Unlike osteoarthritis, inflammatory arthritis symptoms improve with
gentle movement and worsen after rest.
Question 5: A nurse is assessing a child with JIA for signs of
macrophage activation syndrome (MAS), a severe complication of
systemic JIA. Which laboratory or clinical finding is indicative of MAS?
A. Joint pain and swelling that are typically worse in the evening
after school activities.
B. Joint stiffness that is most pronounced in the morning or
following periods of inactivity.
C. Symmetrical joint deformities with immediate bone erosion
evident within weeks of onset.
, D. Painless subcutaneous nodules distributed along extensor
surfaces of the upper extremities.
Correct Answer: B
Rationale: Juvenile idiopathic arthritis is characterized by chronic
joint inflammation resulting in pain, warmth, tenderness, and
characteristic morning stiffness or gelling after periods of inactivity.
Unlike osteoarthritis, inflammatory arthritis symptoms improve with
gentle movement and worsen after rest.
Question 6: A nurse is assessing a school-age child who has juvenile
idiopathic arthritis (JIA). Which of the following findings should the
nurse expect?
A. Joint pain and swelling that are typically worse in the evening
after school activities.
B. Joint stiffness that is most pronounced in the morning or
following periods of inactivity.
C. Symmetrical joint deformities with immediate bone erosion
evident within weeks of onset.
D. Painless subcutaneous nodules distributed along extensor
surfaces of the upper extremities.
Correct Answer: B
Rationale: Juvenile idiopathic arthritis is characterized by chronic
joint inflammation resulting in pain, warmth, tenderness, and
characteristic morning stiffness or gelling after periods of inactivity.
Unlike osteoarthritis, inflammatory arthritis symptoms improve with
gentle movement and worsen after rest.
Question 7: During a routine health screening, a 9-year-old child with
systemic juvenile idiopathic arthritis (sJIA) is evaluated. Which clinical
manifestation is most characteristic of systemic onset JIA?
