<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 63-year-old man is brought to the emergency department for evaluation of abdominal pain. The pain started four days ago and is now a diffuse crampy pain with an intensity of 610. The patient has nausea and has vomited twice today. His last bowel movement was three days ago. He has a history of hypertension and recurrent constipation. Five years ago, he underwent emergency laparotomy for a perforated duodenal ulcer. His father died of colorectal cancer at the age of 65 years. The patient has been smoking one pack of cigarettes daily for the past 40 years. Current medications include lisinopril and lactulose. His temperature is 37.6C 99.7F, pulse is 89min, and blood pressure is 12080 mm Hg. Abdominal examination shows distention and mild tenderness to palpation. There is no guarding or rebound tenderness. The bowel sounds are high-pitched. Digital rectal examination shows no abnormalities. An x-ray of the abdomen is shown. In addition to fluid resuscitation, which of the following is the most appropriate next step in the management of this patient?? A: Ciprofloxacin and metronidazole, B: PEG placement and enteral feeding, C: Colonoscopy, D: Nasogastric tube placement and bowel rest, E: Surgical bowel decompression,  <response>: This is a patient with abdominal pain, nausea, vomiting, constipation, and abdominal distention concerning for bowel obstruction. The key findings are the crampy abdominal pain, constipation, distention, and high-pitched bowel sounds, which are classic for mechanical bowel obstruction. The x-ray shows dilated loops of small bowel consistent with obstruction. The most likely causes in this patient are adhesions from his prior abdominal surgery or colon cancer given his family history. The next step should be decompression of the obstructed bowel rather than antibiotics, feeding, or immediate colonoscopy. D: Nasogastric tube placement and bowel rest 