3 Hours Of Worsening in Medicine / Internal Medicine — 24yo Woman | Respiratory / Pulmonology | SMLE Q#887
SMLE Question #887
Medicine / Internal Medicine
Respiratory / Pulmonology
Objective: OBJ-123
Last updated: February 2026
A 24-year-old woman with mild intermittent asthma presents with 3 hours of worsening dyspnea and wheeze after cigarette-smoke exposure. She used inhaled salbutamol hourly with minimal relief. She is mildly distressed, speaking in full sentences, with diffuse expiratory wheeze and no accessory muscle use. In evaluating the bedside severity of this asthma exacerbation, what is the first and most important thing to assess?
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