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Question Id: 449
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A 42-year-old man is brought to the emergency department 1 hour after the onset of severe headache, nausea, vomiting, and confusion. The patient has primary hypertension and chronic kidney disease; he has been prescribed 2 antihypertensive agents but has been noncompliant with therapy recently. Temperature is 36.8 C (98.2 F), blood pressure is 240/150 mm Hg, heart rate is 90/min, and respirations are 20/min. Ophthalmologic examination shows bilateral papil