MI — MCQs

A 67-year-old man with hypertension and type 2 diabetes is brought to the ED by his wife, who noticed he developed sudden right-sided facial droop and slurred speech approximately 2 hours ago. On arrival, blood pressure is 188/104 mmHg, heart rate 82 bpm, oxygen saturation 97% on room air. Neurological examination reveals right facial weakness, dysarthria, and mild right arm drift. NIHSS score is 7. A non-contrast CT head is performed and shown above. No hemorrhage, early infarct signs, or mass lesion is identified. The patient takes metformin and lisinopril; no anticoagulants. Which of the following is the most appropriate immediate next step?