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A 63-Year-Old Man Comes to the Emergency Department Due to 8

question 394

Multiple Choice

A 63-year-old man comes to the emergency department due to 8 hours of constant epigastric pain, which has become more severe and diffuse over the past 2 hours. He also has nausea and has had one episode of vomiting containing bile but no blood. The patient has been having episodic upper abdominal discomfort that occasionally awakens him from sleep but is relieved by antacids. Other medical conditions include hypertension, hyperlipidemia, type 2 diabetes mellitus, persistent atrial fibrillation, and chronic kidney disease. Medications include atorvastatin, lisinopril, metoprolol, warfarin, insulin lispro, and glargine. Temperature is 38.2 C (100.9 F) , blood pressure is 110/70 mm Hg, and pulse is 100/min and irregular. BMI is 36 kg/m². The patient is in moderate distress due to pain. The abdomen is diffusely tender to palpation with rigidity, guarding, and rebound tenderness. Bowel sounds are absent. Laboratory findings are as follows: An upright chest x-ray shows a small amount of free air under the right diaphragm. Nasogastric suction, intravenous crystalloid, and antibiotics are started, and an urgent surgery is planned. Which of the following additional interventions is most appropriate at present?

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African-Americans

An ethnic group in the United States with ancestry tracing back to the black racial groups of Africa.

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Implicit prejudice refers to unconscious biases or attitudes individuals hold against others, which can influence behavior and decisions without conscious awareness.

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The unjust or prejudicial treatment of different categories of people or things, especially on the grounds of race, age, or gender.