The AGACNP is evaluating a patient who reportedly fell down a flight of steps. Her history is significant for several emergency room visits, but she denies any significant medical conditions. Some documentation in her chart indicates that she may have been subjected to physical abuse. Today she presents with a periorbital ecchymosis of the left eye and swelling in the left side of the face. Her neurologic examination is within normal limits. Which head imaging study would be most useful in assessing for findings consistent with a history of abuse?

Correct Answer: A

Rationale: An MRI (Magnetic Resonance Imaging) would be the most useful head imaging study in assessing for findings consistent with a history of abuse in this patient. MRI is superior to CT in detecting subtle changes in the brain, such as small hemorrhages, edema, or shearing injuries, which may be present in cases of physical abuse. In cases of suspected abuse, it is important to evaluate for both acute and chronic changes that may not be clearly visible on other imaging modalities. While CT scans can detect acute hemorrhages or fractures, they may miss more subtle findings that can be seen on MRI. Therefore, an MRI would provide a more comprehensive evaluation of the brain and surrounding structures in this case.

Correct Answer: D

Rationale: Emptying the breast completely during breastfeeding helps prevent mastitis.

Correct Answer: A

Rationale: Erb’s palsy results from damage to the C8 and T1 cervical nerve roots.

Correct Answer: A

Rationale: In patients with Cushing's syndrome due to an ACTH-producing pituitary tumor, removal of the tumor can result in a transient rebound release of remaining pituitary hormones. This occurs because the suppressed pituitary gland begins to recover and overproduce hormones in response to the sudden decrease in negative feedback from the removed tumor. As a result, patients may experience transient hormonal fluctuations before the pituitary gland establishes a new equilibrium. Therefore, when seeing the patient in follow-up after surgery, the AGACNP should anticipate a transient rebound release of remaining pituitary hormones rather than immediate and rapid reversal of symptoms or markedly improved test results. Additionally, hyponatremia and compensatory SIADH are less likely in this scenario unless there are other underlying factors contributing to it.

Correct Answer: B

Rationale: Forceps delivery is typically used in the second stage of labor when there is delay.