Which of the following signs and symptoms is most closely associated with respiratory failure in a COPD patient?
a. Bilateral wheezing
b. Changes in mental status
c. Dyspnea on exertion
d. Excessive sputum production
ANS: B
Late signs of COPD may include use of accessory muscles of respiration (e.g., sternocleidomas-toid), edema from cor pulmonale, mental status changes caused by hypoxia or hypercapnia (espe-cially in acute exacerbations of chronic, severe disease), or asterixis (i.e., involuntary flapping of the hands when held in an extended position, as in "stopping traffic").
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