A 72-year-old male with a history of COPD presents to the emergency department with acutely worsened dyspnea, increased cough, and purulent sputum. He is tachypneic (RR 28/min) and hypoxic (SpO2 88% on room air). Auscultation reveals diffuse wheezing. Which of the following is the most appropriate initial therapeutic intervention?
✓ Correct Answer: Option B
The immediate priority in a severe COPD exacerbation is to improve bronchodilation and oxygenation. Nebulized short-acting bronchodilators (beta-agonists and anticholinergics) are critical. Supplemental oxygen should also be provided. NIPPV might be considered, but bronchodilators are initial.