Neurologic And Sedation Issues Practice Test

A 71-year-old man with atrial fibrillation is intubated after aspiration. After stopping sedation, he awakens but has new right gaze preference and left hemiplegia. Exam: NIHSS high; pupils equal/reactive. Labs: glucose 140, platelets 180k; CT head without contrast shows no hemorrhage. Current regimen: propofol recently stopped, fentanyl 25 mcg/hr. What diagnostic test should be prioritized to assess the patient's neurologic status?

A 72-year-old man is in the ICU after subdural hematoma evacuation. Over 2 hours he develops worsening headache, vomiting, and decreased responsiveness. Exam: GCS drops from 14 to 10, left pupil 5 mm sluggish, right 3 mm reactive; new right arm weakness. Vitals: BP 178/92, HR 52, irregular respirations on ventilator triggering. Labs: INR 1.1, platelets 210k. CT head earlier today shows postoperative changes with small residual hematoma. Current regimen: fentanyl 50 mcg/hr, propofol 20 mcg/kg/min. What diagnostic test should be prioritized to assess the patient's neurologic status?