Which finding would most support a history of COPD or asthma in a patient with respiratory distress?

• A. Fever.
• B. Hypotension.
• C. Wheezing, smoking history, and elevated ETCO2 readings.
• D. Normal ETCO2 readings.

Answer: (C)

Understanding obstructive airway disease helps explain why this combination fits best. Wheezing signals airway narrowing and bronchospasm seen in COPD and asthma. A smoking history strongly increases the likelihood of COPD, conditioning you to expect chronic airflow limitation. End-tidal CO2 that is elevated indicates CO2 retention from reduced ventilation and air trapping, a common feature as obstruction worsens. Together, wheezing plus smoking history and elevated ETCO2 point toward an obstructive disease history in someone in respiratory distress. Fever would suggest infection rather than a chronic obstructive history, hypotension is a nonspecific sign of shock, and a normal ETCO2 would not explain CO2 retention associated with obstructive disease.