<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:The serum brain natriuretic peptide and N-terminal pro-BNP are elevated. A diagnosis of heart failure with preserved ejection fraction is made. In addition to supplemental oxygen therapy, which of the following is the most appropriate initial step in management?? A: Intermittent hemodialysis, B: Intravenous morphine therapy, C: Thoracentesis, D: Intravenous dobutamine, E: Intravenous furosemide therapyn,  <response>: This is a clinical vignette describing a patient with heart failure with preserved ejection fraction HFpEF. The question is asking about the most appropriate initial management step.Choice A hemodialysis would not be indicated as an initial therapy unless the patient had kidney failure requiring dialysis. Choice B morphine would not be first-line for HFpEF. Choice C thoracentesis may be indicated if the patient had a pleural effusion causing dyspnea, but is not the most appropriate initial therapy.Choice D dobutamine is a positive inotrope and would not be used in HFpEF where the ejection fraction is already preserved. Choice E furosemide is a loop diuretic that can help relieve congestion through increased diuresis. This would be the most appropriate initial therapy in HFpEF to improve symptoms.E: Intravenous furosemide therapy 