A 10-year-old child with a known history of asthma presents to the clinic with increased coughing, wheezing, and chest tightness, especially at night. The nurse explains that these symptoms are related to the underlying pathophysiology of asthma. Which of the following best describes the primary pathophysiologic processes occurring during an asthma exacerbation?

A. Alveolar collapse (atelectasis) due to surfactant deficiency is typically seen in neonatal respiratory distress syndrome, not asthma. Asthma primarily affects the airways, not alveolar surfactant production. B. In asthma, bronchial smooth muscle constriction occurs, not relaxation. Surfactant production is not a central factor in asthma pathophysiology. C. These features lead to edema and hyperresponsiveness, contraction of smooth muscle around the bronchi and bronchioles, and mucus accumulation, all contributing to the child’s symptoms. D. While upper respiratory infections can trigger asthma exacerbations, sinus obstruction itself is not the primary pathophysiologic process in asthma. The key changes occur in the lower airways.