A 58-year-old man presents to the emergency department 2 hours after developing sudden-onset right-sided weakness and aphasia. His NIHSS score is 12. Non-contrast head CT shows no evidence of hemorrhage. His blood pressure is 160/90 mmHg. Which of the following is the most appropriate next step in management?

The correct answer to the question "A 58-year-old man presents to the emergency department 2 hours after developing sudden-onset right-sided weakness and aphasia. His NIHSS score is 12. Non-contrast head CT shows no evidence of hemorrhage. His blood pressure is 160/90 mmHg. Which of the following is the most appropriate next step in management?" is Option A: Administer intravenous alteplase.

The other options — B) Administer aspirin and clopidogrel, C) Initiate antihypertensive therapy to lower BP below 140/90 mmHg, D) Prepare for mechanical thrombectomy — are incorrect for this USMLE Exam Prep question. As explained above: For acute ischemic stroke presenting within 4.5 hours and without contraindications (like hemorrhage or uncontrolled hypertension