Acute Neurologic Emergencies Practice Test

A 60-year-old man presents with acute-onset confusion and right-sided weakness. He is unable to provide a history. His wife states his symptoms started approximately 1 hour ago. In the emergency department, his blood pressure is 180/100 mm Hg. What is the most appropriate initial diagnostic test to guide immediate management?

A 68-year-old man with a history of hypertension and atrial fibrillation, for which he takes metoprolol and apixaban, is brought to the emergency department by his wife. She states that he was watching television when he suddenly complained of the "worst headache of his life," followed by vomiting and a decreased level of consciousness over several minutes. On examination, his blood pressure is 190/110 mm Hg, heart rate is 95/min and irregular, and respirations are 12/min. He withdraws from painful stimuli and has nuchal rigidity. A non-contrast CT scan of the head is ordered.