8. D is the correct answer. This patient has pneumoperitoneum on the chest x ray. This is a surgical emergency. In general geriatric abdominal pain presenting the emergency department has a high mortality rate anyway, getting a general surgeon involved as soon as possible is the best management. A CT scan is a long procedure and will take at least 90 minutes to prepare for. Giving the patient pain and nausea medicine is a decent option but not the best option now. Until it is clear exactly where the perforation is at, a NG tube should probably not be inserted yet.
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