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A 92-year-old woman was admitted to the hospital with a severe left-sided ischemic stroke causing altered mental status (i.e., a score of 9 on the Glasgow Coma Scale, on which scores range from 3 to 15, with higher scores indicating increased consciousness), weakness on the right side, and dysphagia. An initial attempt to insert a small-caliber nasogastric tube for feeding was unsuccessful, with coiling of the tube in the mouth. A subsequent attempt with a stiff stylet resulted in easy insertion, without cough or respiratory distress. While awaiting radiography to confirm positioning of the tube, the patient had shortness of . . .