A male client is admitted to the emergency department (ED) while vomiting dark brown, foul-smelling emesis. He reports having a surgical repair of a recurrent inguinal hernia a week ago and is troubled by intense abdominal pain. After finding that his bowel sounds are hyperactive, which prescription should the nurse implement first?

A. Insert a nasogastric tube (NGT) and attach to low intermittent suction (LIS): The client’s symptoms suggest bowel obstruction. Inserting an NG tube relieves gastric distension, prevents aspiration, and reduces further vomiting, making this the priority intervention. B. Give a prescribed analgesic for temperature above 101° F (38.3°C), orally: Oral medications are inappropriate in suspected bowel obstruction, as absorption is impaired and they may worsen nausea and vomiting. C. Place an indwelling urinary catheter and attach a bedside drainage unit: Catheterization can help monitor fluid balance, but it does not immediately address the acute risk of obstruction-related vomiting and abdominal pressure. It is a secondary intervention. D. Send the client to x-ray for a flat plate of the abdomen: Imaging is necessary to confirm obstruction, but before diagnostic testing, the immediate priority is to decompress the stomach with an NG tube to stabilize the client and prevent complications.