<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 28-year-old man is admitted to the emergency department with a gunshot wound to the abdomen. He complains of weakness and diffuse abdominal pain. Morphine is administered and IV fluids are started by paramedics at the scene. On admission, the patients blood pressure is 9060 mm Hg, heart rate is 103min, respiratory rate is 17min, the temperature is 36.2C 97.1F, and oxygen saturation is 94 on room air. The patient is responsive but lethargic. The patient is diaphoretic and extremities are pale and cool. Lungs are clear to auscultation. Cardiac sounds are diminished. Abdominal examination shows a visible bullet entry wound in the left upper quadrant LUQ with no corresponding exit wound on the flanks or back. The abdomen is distended and diffusely tender with a rebound. Aspiration of the nasogastric tube reveals bloody contents. Rectal examination shows no blood. Stool guaiac is negative. Which of the following is the next best step in management?? A: Exploratory laparotomy, B: Focused assessment with sonography for trauma FAST, C: Abdominal X-ray, D: Abdominal CT, E: Diagnostic peritoneal lavage,  <response>: This is a question about the initial management of a patient with an abdominal gunshot wound. The key findings in the stem are hypotension, tachycardia, abdominal tenderness and distension, bloody nasogastric aspirate, and no evidence of rectal bleeding. This indicates likely intra-abdominal hemorrhage. The next step should be to rapidly identify and control the source of bleeding. Choices A, D, and E can achieve this, while choices B and C will delay definitive management. Of these options, exploratory laparotomy allows for direct control of bleeding and is the fastest way to achieve hemostasis. A: Exploratory laparotomy 