Answer and Explanation 1

1.  B is the correct answer.  This patient is presenting with a history concerning for subarachnoid hemorrhage (SAH).  CT scans of the head without contrast are 90-95% sensitive for detecting SAH.  The accepted standard of care is to offer the patient in this situation a lumbar puncture.  Choice D may sound like a good option; however, if a bleed or leaking aneurysm is detected on the study, the provider may have some answering to do.  Especially if there is a delay between the patient encounter, and getting the results of the study.  This should be treated as a seconds to minutes emergency.  An EEG would not be helpful at this point.  Choice A would be plausible if the patient refused admission and refused the spinal tap.