#august2020mccqe1
A 74-year-old woman is admitted to the hospital after sustaining a severe left hemispheric ischemic stroke while alone at home. She was last known to be normal 8 hours ago. The patient has hypertension for which she takes enalapril but no history of ischemic heart disease or heart failure.
On physical examination, blood pressure is 190/105 mm Hg, pulse rate is 80/min, and respiration rate is 16/min. The patient has right hemiparesis, right facial droop, aphasia, and dysarthria. The remainder of the physical examination, including the cardiovascular examination, is normal. Results of laboratory studies, including serum creatinine level, are normal. A CT scan shows ischemic changes that occupy most of the left middle cerebral artery territory. An electrocardiogram and chest radiograph show normal findings. Which of the following is the most appropriate treatment of her hypertension at this time?
(A) Intravenous labetalol
(B) Intravenous nicardipine
(C) Oral nifedipine
(D) No treatment at this time
A 74-year-old woman is admitted to the hospital after sustaining a severe left hemispheric ischemic stroke while alone at home. She was last known to be normal 8 hours ago. The patient has hypertension for which she takes enalapril but no history of ischemic heart disease or heart failure.
On physical examination, blood pressure is 190/105 mm Hg, pulse rate is 80/min, and respiration rate is 16/min. The patient has right hemiparesis, right facial droop, aphasia, and dysarthria. The remainder of the physical examination, including the cardiovascular examination, is normal. Results of laboratory studies, including serum creatinine level, are normal. A CT scan shows ischemic changes that occupy most of the left middle cerebral artery territory. An electrocardiogram and chest radiograph show normal findings. Which of the following is the most appropriate treatment of her hypertension at this time?
(A) Intravenous labetalol
(B) Intravenous nicardipine
(C) Oral nifedipine
(D) No treatment at this time
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