MCAT question #44

I cannot reveal my source, but I once again am privy to esoteric wisdom. The following is a question I have obtained from the Medical College Admission Exam (MCAT):

44.  You have an end stage pulmonary fibrosis patient with marked dyspnea.  She smoked a pack and a half packs of cigarettes per day, although she admits to quitting 48 years ago.  Her current ABGs reveal the following on an FiO2 of 40% on 12 lpm venturi mask: 

• pH 7.44
• CO2 53
• PO2 47
• HCO3 36
• SpO2 84%
• BE 10.4

What would be the first best thing to have your respiratory therapist do at this time?

• a.  Intubate
• b.  Decrease oxygen to 35% venturi mask
• c.  Decrease oxygen to a 4lpm nasal cannula and add a bubbler
• d.  Increase oxygen to 50%, monitor the patient, and redraw the ABG in one hour
• e.  Either b or c will suffice due to fears of knocking out her drive to breathe