A 65-year-old man with stroke-like symptoms is responsive only to deep painful stimuli and is making a snoring sound. What should you do first?

The correct choice is to insert a nasopharyngeal airway and keep the patient in a position that promotes airway patency because the patient is only responsive to deep painful stimuli and is exhibiting a snoring sound. This sound indicates that the airway may be obstructed, potentially due to the tongue falling back into the oropharynx.

Inserting a nasopharyngeal airway can help maintain an open airway by providing a clear passage for air to flow and keeping the tongue from obstructing the throat. Additionally, keeping the patient in a position that supports airway patency is crucial, especially given the patient’s reduced level of responsiveness.

Administering high-flow oxygen could be beneficial as well; however, without ensuring that the airway is clear and that the patient is able to breathe adequately, oxygen supplementation may be ineffective. Similarly, placing him in a recovery position could help if the airway was already clear, but given the signs of obstruction, ensuring airway management is the priority. Finally, performing chest compressions is inappropriate in this scenario; his heart is likely functioning, and the primary concern is managing the airway to facilitate normal breathing.