PANCE Exam Practice Questions: Quiz 375

A 64-year-old man presents with acute exacerbation of chronic obstructive pulmonary disease. The patient had a long smoking history before quitting 2 years ago. In spite of his poor baseline lung function, he has been able to maintain an independent lifestyle. The patient is in obvious respiratory distress and appears tired. He has difficulty greeting you secondary to shortness of breath. Respiratory rate is 32/minute. Auscultation of the lungs reveals minimal air movement. ABGs show pH = 7.28, PaCO2 = 77, and PaO2 = 54. One dose of IV methylprednisolone has already been administered. What is the best next step in the management of this patient’s disease?
- a. Urgent institution of BiPAP (bilevel positive airway pressure)
- b. Urgent endotracheal intubation
- c. Administration of 100% FiO2 by face mask
- d. Arrangement for admission to monitored ICU bed

Reader Interactions