4 Days Of Worsening in Medicine / Internal Medicine — 66yo Woman | Respiratory / Pulmonology | SMLE Q#17149

SMLE Question #17149

Medicine / Internal Medicine Respiratory / Pulmonology

Objective: OBJ-123

Last updated: February 2026
A 66-year-old woman with severe COPD presents with 4 days of worsening dyspnea and productive cough. She has moderate respiratory distress with accessory muscle use despite frequent inhaled bronchodilators and systemic corticosteroids. She is alert, cooperative, and protecting her airway. What is the most appropriate next step in management?

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