What is a sign that a client with asthma is getting worse?

• A. Increased wheezing
• B. Decreased wheezing
• C. Productive cough with green sputum
• D. No shortness of breath

Answer: (B)

Worsening asthma can follow a pattern where air movement through the narrowed airways becomes so limited that the breath sounds diminish. Wheezing comes from turbulent airflow through constricted passages, so when the obstruction becomes very severe, there’s less air moving and the wheeze can actually decrease or disappear. That reduced or absent wheezing, sometimes described as a “silent chest,” is a dangerous sign that the client’s condition is deteriorating and requires urgent assessment and treatment.

In contrast, an increasing wheeze is more typical of ongoing bronchospasm, but it doesn’t carry the same urgent warning as a diminishing sound. A productive cough with green sputum points more to infection than to asthma progression, and having no shortness of breath would indicate stability rather than worsening.