I've been staying at the Golden Nugget for a week now for work, and I have to say I'm a bit disaappointed with the rooms. This hotel is supposed to be a four star hotel, but it's really a three star in my eyes. The beds are pretty uncomfortable, and the mattress pad they have on my bed doesn't even fit the bed. Further, they have just a flat sheet on top of the mattress pad rather than a fitted sheet, and when I called housekeeping, I was told they didn't have any fitted sheets. Sounds really anal, I'm sure, but the sheet kept coming off the bed overnight.
The A/C is loud, and the plasma TV doesn't have any HDMI inputs so I can hook up my laptop, which seems like a really sad angle to make you buy their movies. There's also no outlets near the bed, which is really annoying. Again, just not what I expect from a 4 star hotel.
The rest of the hotel/casino is great. It's definitely the nicest one downtown, and the food in the diner is delicious -- try the open faced turkey sandwich.