A nurse is caring for a client who has Graves' disease. The nurse understands that this condition is caused by what type of hypersensitivity? (Select all that apply.)

Choice A reason:

Type I hypersensitivity is not involved in Graves' disease, as it does not involve IgE antibodies or mast cells.

Choice B reason:

Type II hypersensitivity is involved in Graves' disease, as it involves IgG antibodies that bind to the thyroid-stimulating hormone (TSH) receptors on the thyroid gland and stimulate the production of thyroid hormones. This leads to hyperthyroidism and manifestations such as goiter, exophthalmos, tachycardia, weight loss, or tremors.

Choice C reason:

Type III hypersensitivity is not involved in Graves' disease, as it does not involve immune complexes or complement activation.

Choice D reason:

Type IV hypersensitivity is not involved in Graves' disease, as it does not involve cytotoxic T cells or helper T cells.

Choice E reason:

Type V hypersensitivity is also involved in Graves' disease, as it involves the stimulation of target cells by antibodies that act as agonists for cell surface receptors. This leads to an increased function of the target organ or tissue.

Choice A reason:

This is an incorrect answer because an induration of 5 mm or more is considered a positive reaction only for certain high-risk groups, such as people who are HIV-positive, have recent contact with a person with active tuberculosis, or have chest radiograph findings consistent with prior tuberculosis.

Choice B reason:

This is a correct answer because an induration of 10 mm or more is considered a positive reaction for most people, including those who are recent immigrants from high-prevalence countries, injection drug users, residents or employees of high-risk settings, children younger than 4 years old, or people with certain medical conditions that increase the risk of tuberculosis.

Choice C reason:

This is an incorrect answer because an induration of 15 mm or more is considered a positive reaction only for people who have no known risk factors for tuberculosis.

Choice D reason:

This is an incorrect answer because an induration of 20 mm or more is not a criterion for a positive reaction, as it exceeds the maximum threshold for any group.