A nurse is assessing a client who has Graves’ disease. The nurse should expect which of the following laboratory results?
Decreased thyroxine (T4) level.
Decreased triiodothyronine (T3) level.
Decreased thyroid-stimulating immunoglobulins (TSI) percentage.
Decreased thyroid-stimulating hormone (TSH) level.
The Correct Answer is D
Choice A Reason:
A decreased thyroxine (T4) level is not expected in a client with Graves’ disease. Graves’ disease is an autoimmune disorder that leads to hyperthyroidism, where the thyroid gland produces excessive amounts of thyroid hormones, including T4. Therefore, the T4 level is typically elevated, not decreased.
Choice B Reason:
Similarly, a decreased triiodothyronine (T3) level is not expected in Graves’ disease. Like T4, T3 levels are usually elevated due to the overactive thyroid gland. T3 is the active form of thyroid hormone and is often increased in hyperthyroid conditions.
Choice C Reason:
Decreased thyroid-stimulating immunoglobulins (TSI) percentage is incorrect. In Graves’ disease, TSI levels are elevated because these antibodies stimulate the thyroid gland to produce more thyroid hormones. TSI mimics the action of TSH, leading to increased production of T3 and T4.
Choice D Reason:
Decreased thyroid-stimulating hormone (TSH) level is the correct answer. In Graves’ disease, the excessive thyroid hormones (T3 and T4) exert negative feedback on the pituitary gland, leading to suppressed TSH production. Therefore, TSH levels are typically low in patients with Graves’ disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A: Severe Hypertension
Severe hypertension can be a sign of increased intracranial pressure (ICP), but it is not typically the earliest sign. Hypertension often occurs as a compensatory mechanism to maintain cerebral perfusion pressure. While it is a significant finding, it usually follows other more immediate signs of increased ICP.
Choice B: Dilated and Nonreactive Pupils
Dilated and nonreactive pupils are a late sign of increased ICP and indicate severe brainstem compression. This finding suggests that the pressure has reached a critical level, leading to brain herniation. It is a very serious sign but not the earliest indicator of increasing ICP.
Choice C: Decreased Level of Consciousness
A decreased level of consciousness is often the earliest and most sensitive indicator of increasing ICP. Changes in consciousness can range from confusion and lethargy to complete unresponsiveness. This symptom reflects the brain’s response to increased pressure and reduced cerebral perfusion, making it a critical early sign that requires immediate attention.

Choice D: Projectile Vomiting
Projectile vomiting can occur with increased ICP due to pressure on the vomiting centers in the brainstem. However, it is not typically the earliest sign. Vomiting often accompanies other symptoms such as headache and changes in consciousness.
Correct Answer is A
Explanation
Choice A reason:
Baclofen is primarily used to treat muscle symptoms caused by multiple sclerosis, including muscle spasms, stiffness, and pain1. It acts on the spinal cord nerves to decrease the number and severity of muscle spasms, thereby improving muscle movement2. The effectiveness of baclofen in managing multiple sclerosis symptoms is best evaluated by assessing the reduction in muscle spasms.

Choice B reason:
While mood and affect are important aspects of a patient’s overall well-being, they are not the primary indicators of baclofen’s effectiveness. Baclofen does not have a direct impact on mood and affect, as its main function is to relieve muscle spasms and improve muscle movement.
Choice C reason:
Appetite is not a primary concern when evaluating the effectiveness of baclofen. This medication is not known to significantly affect appetite. The main therapeutic goal of baclofen is to reduce muscle spasms and improve mobility in patients with multiple sclerosis.
Choice D reason:
Sleep pattern, although important for overall health, is not the primary measure of baclofen’s effectiveness. Baclofen’s primary role is to alleviate muscle spasms and improve muscle function. While it may have some impact on sleep due to its muscle-relaxing properties, this is not the main criterion for evaluating its effectiveness.
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