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A 38-Year-Old Woman Comes to the Physician with the Complaint

question 188

Multiple Choice

A 38-year-old woman comes to the physician with the complaint of severe abdominal pain for 8 hours. The pain is crampy and periumbilical and occurs every 4 to 5 minutes. It is not improved with positional changes, and there is no radiation to the back. She has vomited 3 times since the pain began. Her last bowel movement was 18 hours ago. She denies any reflux symptoms, hematemesis, melena, or hematochezia. The patient's medical problems include depression, fibromyalgia, and hypothyroidism. Her surgical history includes appendectomy for a ruptured appendix 20 years ago, tonsillectomy, and breast lumpectomy. She does not use tobacco, alcohol, or illicit drugs.
Her temperature is 37.3 C (99.1 F) , blood pressure is 110/80 mm Hg, pulse is 92/min, and respirations are 16/min. The abdomen is tender in the periumbilical area. There is no significant abdominal distension, rebound tenderness, or rigidity. Rectal examination shows an empty rectal vault, and test for occult blood is negative.
Laboratory results are as follows:
Urine pregnancy test is negative.
Which of the following is the most appropriate next step in this patient's management?

Definitions:

Net Realizable Value

The estimated selling price of goods minus the cost of their sale or completion, used primarily in inventory valuation and accounts receivable.

Historical Cost

Historical cost is the original monetary value of an economic item purchased or incurred, used as a basis for accounting and financial reporting.

Replacement Cost

The current cost of replacing an asset with a similar one at its current market price.

Reorganization

A process aimed at restructuring a company's financial or operational aspects for efficiency or to facilitate a smoother operation.