Progressive Care Nursing Certification (PCCN) Practice Exam

What is the most likely cause of a patient with a history of COPD presenting with pink frothy sputum and shortness of breath?

1. Pulmonary edema

2. Cardiac tamponade

3. Pneumococcal pneumonia

4. ARDS

The correct answer is: Pulmonary edema

The presence of pink frothy sputum combined with shortness of breath in a patient with a history of Chronic Obstructive Pulmonary Disease (COPD) strongly suggests pulmonary edema as the most likely cause. In pulmonary edema, fluid accumulates in the alveoli of the lungs, which can stem from conditions such as heart failure. The excess fluid leaks into the lung tissue, resulting in the characteristic pink, frothy sputum that indicates the presence of blood-stained fluid mixed with respiratory secretions. This symptom is particularly pertinent in patients with existing respiratory conditions like COPD because they may already have compromised lung function and an increased susceptibility to fluid accumulation. Shortness of breath is also a common response as the lungs struggle to accommodate the additional fluid, leading to impaired gas exchange. In contrast, other options may present with different clinical signs. Cardiac tamponade typically presents with signs and symptoms related to compromised hemodynamics rather than respiratory issues alone. Pneumococcal pneumonia generally leads to purulent sputum and does not typically cause the pink frothy appearance associated with pulmonary edema. Acute Respiratory Distress Syndrome (ARDS) usually manifests with severe respiratory distress and hypoxemia due to multiple causes, but the sputum presentation is less commonly pink