Chronic obstructive pulmonary disease Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 61-year-old man with a 37-pack-year smoking history presents to the emergency department with worsening shortness of breath, and cough over the past four days. He has a history of chronic obstructive pulmonary disease (COPD) and has been using his albuterol inhaler more frequently lately. Temperature is 37.3°C (99.1°F), blood pressure is 138/91, pulse is 130/min, respiratory rate is 24/min, and oxygen saturation is 85% on room air. The patient is alert and awake and is using accessory respiratory muscles. On lung auscultation, there are diffuse bilateral wheezes. The patient arterial blood gas (ABG) shows pH 7.25, PaCO₂ 55 mmHg, PaO₂ 62 mmHg, and HCO₃- 24 mmEq/L. Which of the following is the best next step in management?

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Empiric antibiotics

Nebulized inhaled bronchodilators

Noninvasive positive pressure ventilation (NIPPV)

Intravenous corticosteroids

Endotracheal intubation and mechanical ventilation