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Hypotension is the most critical sign to watch for in the immediate post-operative period as it can indicate significant complications such as hemorrhage, sepsis, or cardiogenic shock. While fever, decreased urine output, and an elevated white blood cell count can be signs of infection or other complications, hypotension is a more urgent concern that requires immediate intervention.

Wernicke’s encephalopathy, a complication of chronic alcohol abuse, is characterized by confusion, ataxia, and nystagmus. It is caused by thiamine deficiency, which leads to damage to the brain's thalamus and hypothalamus. Delirium tremens typically presents with agitation and tremors, while a stroke or seizure disorder would have different clinical features.

The nurse practitioner must obtain written consent from the patient before releasing any medical records unless there is a legal requirement, such as a court order. Patient confidentiality and consent are essential in healthcare practice. If there is uncertainty, referring the lawyer to the hospital’s legal department is also a prudent course of action.

The patient’s symptoms—severe chest pain radiating to the back, diaphoresis, and hypotension—are characteristic of aortic dissection, which occurs when there is a tear in the inner layer of the aorta. The CT scan findings confirm this diagnosis. Acute myocardial infarction, pulmonary embolism, and gastroesophageal reflux disease would present with different clinical features.

The next step in evaluating a lung mass seen on X-ray is a chest CT scan. This will provide more detailed information about the size, location, and characteristics of the mass, which will guide further diagnostic workup and treatment decisions. Bronchoscopy may be necessary later to obtain a biopsy, but CT scan is the next step.