input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 39-year-old man presents to the emergency department because of progressively worsening chest pain and nausea that started at a local bar 30 minutes prior. The pain radiates to the epigastric area. He has a 5-year history of untreated hypertension. He has smoked 1 pack of cigarettes daily for the past 5 years and started abusing cocaine 2 weeks before his emergency room visit. The patient is diaphoretic and in marked distress. What should be the first step in management?   (A) Diltiazem   (B) Labetalol   (C) Propranolol   (D) Reassurance and continuous monitoring
output: ['(D) Reassurance and continuous monitoring <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Diltiazem  (B) Labetalol  (C) Propranolol  (D) Reassurance and continuous monitoring <> possible answers', '  A 39-year-old man presents to the emergency department because of progressively worsening chest pain and nausea that started at a local bar 30 minutes prior. The pain radiates to the epigastric area. He has a 5-year history of untreated hypertension. He has smoked 1 pack of cigarettes daily for the past 5 years and started abusing cocaine 2 weeks before his emergency room visit. The patient is diaphoretic and in marked distress. What should be the first step in management? <> context']