Which assessment finding indicates effective therapy when a patient is receiving ketoconazole (Nizoral)?

The indication of effective therapy when a patient is receiving ketoconazole, an antifungal agent that can also inhibit cortisol synthesis, is reflected in the finding of a decreased blood glucose level. Ketoconazole is often utilized in the treatment of conditions related to hypercortisolism, such as Cushing's syndrome, where excessive cortisol production can lead to hyperglycemia. Therefore, a reduction in blood glucose levels suggests that the therapy is successfully modulating cortisol levels in the body, potentially leading to improved metabolic control.

An increased blood glucose level would imply that the therapy is not achieving its intended effect on cortisol regulation. Meanwhile, the assessment that the patient reports no pain might not be directly related to ketoconazole's primary effects, and increased urination is not a specific indicator of the medication's success in treating the underlying condition. Thus, the most relevant assessment indicating effective therapy in the context of ketoconazole treatment is a decrease in blood glucose levels.