How should this COPD patient (orthopnea — breathes more easily upright) be positioned for treatment?

Correct answer: B. Treat him sitting upright / semi-supine

• A. Position is highly relevant for cardiopulmonary patients and directly affects safety.
• B. Correct. A patient with COPD/orthopnea cannot breathe comfortably lying flat. An upright or semi-supine chair position keeps the airway and diaphragm mechanics favorable and prevents respiratory distress.
• C. Head-down (Trendelenburg) would worsen breathing and is reserved for managing syncope/hypotension, not for routine treatment of a COPD patient.
• D. A fully supine position can precipitate breathlessness in a patient who already has orthopnea.