A 57-year-old male, with past medical history of hypertension and hyperlipidemia, presented with an acute onset of slurred speech and right-sided weakness. He was diagnosed with an acute left middle cerebral artery (LMCA) stroke and IV tPA was administered. He was then admitted to the ICU for close monitoring. On day 3 poststroke, his focal deficits persist, and it is noted that one of his pupils is larger than the other. He subsequently becomes unresponsive and is emergently intubated and hyperventilated. Stat head CT demonstrated increasing cerebral edema and midline shift of 9.6 mm and uncal herniation without signs of cerebral hemorrhage.  What is the most appropriate next step in treatment?

A 68 year old patient presents with progressive tremor at rest, bradykinesia, and rigidity. The patient’s spouse reports the patient has been able to walk or stand with stability. Based on the following symptoms, what is the patient’s most likely diagnosis?

A 22-year-old female with no significant past medical or surgical history is admitted to the intensive care unit (ICU) with worsening respiratory failure. She was being treated on the floor for pneumonia and is receiving noninvasive ventilation. On admission to ICU, she is found to be tachypneic with increasing work of breathing, and her mentation is altered. On airway examination, both thyromental distance and mouth opening are more than 3 fingerbreadth and her Mallampati score is 2. You decide to institute invasive mechanical ventilation. Once equipment and personnel are ready, propofol and succinylcholine are administered to facilitate endotracheal intubation. After 90 seconds, direct laryngoscopy is attempted, but you have difficulty opening her mouth and note marked masseter muscle rigidity. Which among the following conditions is known to be associated with this presentation?

A 48-year-old female with a history of Grave’s disease undergoes an urgent appendectomy. Four hours after surgery she is found to be confused and diaphoretic. Her vital signs are T 102.7, HR 130/min, and BP 184/106 mm Hg and O2 saturation of 93% on RA. On physical examination there is no evidence of rigidity. An arterial blood gas ABG shows pH 7.51, pCO2 30, pO2 98. Thyroid function tests are sent.  Although awaiting the results, which of the following medications would be most appropriate to give?

What feature of delirium differentiates it from dementia?

An AGACNP is attending a soccer match on a hot day is assisting a player who feels hot and appears dehydrated, but who is alert and oriented. What does the AGACNP suspect?

A patient has been hospitalized with Guillain-Barré syndrome (GBS). The patient asks how this could have occurred. What response by the AGACNP is best?

A patient presents with bradycardia, hypotension, and signs of cardiogenic shock following an intentional overdose of a beta-blocker. Which of the following is considered the most appropriate first-line antidote?

A 65-year-old female is admitted to the ICU after being found down at home. Her only medical history is a remote history of Grave’s disease and thyroid ablation. Vital signs are T 89°F, HR 50 bpm, BP 105/61 mm Hg. On physical examination she obtunded, and brittle hair, macroglossia, and periorbital edema are noted. An ABG shows pH 7.30, PaCO2 55, PaO2 65. She is intubated for airway protection ventilatory support. Urine, sputum, and blood cultures are sent, and she is treated with broad spectrum antibiotics. Thyroid function tests are sent and she is started on IV levothyroxine.  Which of the following additional therapies is most appropriate at this time?

A patient with diabetes mellitus type 2 has not taken insulin in several days and has an extremely high blood sugar. What electrolyte would the AGACNP assess as the priority?