NAECB Practice exam/ NAECB Self-Assessment Exam 2023.

NAECB Practice exam/ NAECB Self-Assessment Exam 2023. An eight-year-old-female with asthma was seen by her pharmacist for recurrent coughing and wheezing. Her mother complains that she wakes up twice per month with a cou ...

NAECB Practice exam/ NAECB Self-Assessment Exam 2023. An eight-year-old-female with asthma was seen by her pharmacist for recurrent coughing and wheezing. Her mother complains that she wakes up twice per month with a cough in the past two months and needs albuterol twice a week for some relief. The pharmacist knows that according to ERP-3 guidelines, this level of asthma control should be classified as: A. Very poorly controlled B. Not well controlled C. Well controlled D. Very well controlled A patient has a predicted peak flow meter reading of 400 L/min. Today his peak flow reading is 450 L/min. What is your interpretation of today's peak flow? A. Personal best zone B. Green zone C. Red zone D. Yellow zone Uncontrolled asthma may product persistent abnormalities in lung function due to: A. Chronic Inflammation B. Chronic Muscle Contraction C. Chronic Esophageal Reflex D. Chronic Hyperresponsiveness A Sixteen-year-old adolescent develops wheezing after exposure to tobacco smoke. His initial pathophysiologic process causing the wheeze is due to. A.Inflammation B.Smooth muscle contraction C. Excessive mucus secretion D. Esophageal Spasm A five-year-old male came in for asthma recheck. Current symptoms identified by the parents are rhinorrhea, cough, itching and snoring. Which symptoms is most characteristic of Asthma? A. Rhinorrhea B. Cough C. Itching D. Snoring A thirty-six-year old presents with a history of cough that occurred one day last week and resolved with Albuterol used. He has been sleeping through the night without symptoms. Play basketball with his co-workers 3 nights a week. Classify his current asthma severity. A. Intermittent B. Mild persistent C. Moderate Persistent D. Severe Persistent A patient when questioned what triggers her asthma replies flowers, cats, fresh cut grass and gasoline. Which of her triggers is an irritant? A. Flowers B. Cats C. Grass D. Gasoline Genetically susceptible infants are more likely to develop asthma when exposed to this trigger. A. Enteric Coated Aspirin B. Sodium sulfite C. Dog dander D. Tobacco smoke A sixty-five-year-old well controlled patient with asthma presents for asthma education. He was recently started on new medication by his cardiologist and would like to know if any will affect his asthma? A. Carvedilol B. Atorvastatin C. Lisinopril D. Clopidogrel Which trigger of asthma is due to de-humidified and cooled air entering the airway? A. Smoking B. Exercise C. Aspirin D. Respiratory infections A thirty-five-year-old presents with uncontrolled asthma. She is compliant with her medications and has taking proper steps for minimization of triggers. Present co-morbidities: obsity, hypothyroidism, hypertension, and gout. Which of her co-morbidities makes asthma difficult to control? A. Obesity B. Hypothyroidism C. Hypertension D. Gout Which patient is at highest risk for an asthma exacerbation? A. An 18-month-old on daily nebulization of Pulmicort Respules B. A 7-year-old who wheezes when exposed to Alternaria C. A 13-year old who required one course of oral steroid in the last year D. A 22-year-old who fills two Albuterol inhalers monthly At least a 12% change in the lung measurement from baseline is needed to show reversibility of lung obstruction. A. PEF B. FVC C. FEV1 D. FRC Crackles are heard in the right lower lung of a patient with asthma and are caused by: A. Secretion in the alveoli B. Inflammation in the bronchi C. Upper Respiratory Tract infection D. Spasm of the Esophagus A patient's oxygen saturation is 89% on room air. Upon auscultation no bronchovesicular sounds (silent chest) are audible. A. Early warning sign of an asthma exacerbation B. Intermediate warning sign of an asthma exacerbation C. Late warning sign of an asthma exacerbation D. Resolving sign of an asthma exacerbation Which objective measurement is the best at assessing asthma control? A. FVC B. ACT C. FEF 25-75 D. TLC Interpretation of this result is the best to teach patients with asthma who are poor perceivers of symptoms? A. PEF B. ATAQ C RV D. ARH In which patient vignette is there an area of adherence that the asthma educator should address? A. I take my peak flow at night. B. I always take my albuterol in the morning C. My dog is living with my grandma D. My peak flow is greater than 80% of my personal best. In which vignette would the asthma educator assess for the presence of trigger in the workplace causing loss of Asthma control? A. A two-year old exposed to second hand smoke in the home. B. A twenty-three-year-old construction worker well controlled on Fluticasone C. A thirty-seven-year-old elementary school teacher with nighttime cough D. A seventy-seven-year old nursing home resident that snores when sleeping. A seventeen-year-old presents for a follow up visit for asthma education. She smells strongly of tobacco smoke. Patient 1s adherent to controller therapy however required daily reliever use. What is the best patient centered strategy the asthma educator can use to help with symptoms management. A. Tell the patient that symptoms will not get better unless they quit smoking B. Evaluate current tobacco status of patient and area of second-hand exposure. C. Recommend increasing amount of controller medication D. Educated on proper peak flow meter technique and monitoring Which question best expresses and asthma educator's openness to patient concerns? A. What is your average peak flow? B. Have you wheezed since our last visit? C. Did you take your inhaler as prescribed? D. symptoms of asthma keep you up at night? Which medication will provide long term control of asthma symptoms? A. Formoterol B. Albuterol C. Ipratropium D. Dexamethasone Mometasone (Asmanex) Primary mechanism of action work to treat: A. Bronchoconstriction B. Airway inflammation C. Mucus production D. Muscle hypertrophy What is the age appropriate dosing of Montelukast (singular) for a 12-year-old with asthma A. 20mg daily B. 10mg daily C. 5mg daily D. 4mg daily The asthma educator is counseling the parents of a two-year-old child who will be released from the hospital today with a prescription for medium done inhaled corticosteroid and short acting beta agonist. What potential side effect should be discussed with the parents in regard to inhaled corticosteroids? A. Abnormal Glucose Metabolism B. Reduced Growth Velocity C. Permanente Growth Suppression D. Intermitted Expiratory Wheezing A nine-year-old makes his holding chamber whistle every time he takes his controller medication. The asthma educator should. A. Provide redirection to slow inspiratory force B. Provide redirection to increase inspiratory force C. Provide redirection to slow expiratory force D. Provide positive re-enforcement for proper technique. Why would a poorly controlled patient with asthma despite optimizing medication and elimination of environmental triggers gain control of asthma symptoms after initiating Omeprazole (prilosec) for GERD? A. When the upper airway is controlled lower airway, symptoms improve B. When the immune system is controlled lower airway, symptoms improved C. When esophageal irritation is controlled low airway, symptoms improve D. When turbinate erosion is controlled low airway, symptoms improve A volleyball player is requiring her albuterol after every practice. What strategy can be implemented to manage her exercise induced asthma. A. Provide education ten minutes warm up and cool down B. Provide education on breathing holding techniques C. Provide education on diaphragm strengthening exercises D. Provide education on Alternative physical activates such as swimming. A fifty-six-year-old native American presents for an initial asthma education visit. Throughout the encounter he refuses to look the educator in the eyes. Which of the following actions by the asthma educator would foster a partnership in asthma care? A. Continue with hospital approved education protocol B. Demand eye contact in order to gain understanding C. Request elder supervision to gain understanding D. Review cultural norms in order to gain understanding. Which strategy can an asthma educator implement to increase adherence to long term controller medication use. A. Instilling fear of mortality B. Identifying patients preferences C. Dictating a treatment regiment D. Micromanagement of medication utilization. A six-year-old skin tests positive to dust mite. What education can the asthma educator provide in regard to trigger avoidance? A. Keep stuffed animals out of the bed B. Do not allow smoke in the home C. Stay indoors with windows closed D. Stay away from strong odors A thirty-two-year-old patient known for using marijuana is requiring an oral steroid burst for the third time in six months to maintain asthma control. The asthma educator can assist this individual by: A. Insisting on a urine drug screening in regard to marijuana use B. Alerting law enforcement in regard to marijuana use C. Assessing her stage of change in regard to marijuana use D. Increasing controller medication due to marijuana use The asthma education is requested by the hospital to provide a written environmental control brochure for patients newly diagnosed with asthma. What relevant factor should the asthma educator consider when selecting written educational materials? A. Should be sponsored by a drug company B. Should assess literacy level of the material C. Should demonstrate all inhalation devices D. Should not exceed one page in length. A twenty-four-year-old patient is initiated on beclomethasone (QVAR) by his health provider. When integrating medication into his Asthma Action Plan the asthma educator would put the beclomethasone (QVAR) in which of the following zones: A. Green Zone B. Yellow zone C. Orange zone D. Red Zone A twenty-four-year-old The asthma educator is providing peak flow instruction to a twelve-year-old with asthma. When taking a peak flow measurement, a patient should: A. suck in hard and as quickly as possible B. suck in slow and steadily as possible C. blow out as hard and as quickly as possible D. blow out slow and steadily as possible A patient consistently blows PEF of 420 while under good asthma control. Which of the following describes the ranges that the asthma educator would incorporate into the patient's asthma action plan? A. Green>420, Yellow 400-420, Red <400 B. Green>400, Yellow 320-400, Red <320 C. Green >360, Yellow 200-360, Red <200 D. Green >340, Yellow 210-340, Red <210 The asthma educator is working with a family of a five-year-old with asthma who will be discharged from the hospital. When designing the asthma action plan the asthma educator should encourage: A. Incorporation of quick reliever medications in the green zone B. Incorporation of steroid burst therapy into green zone C. Incorporation of the asthma action plan into daily life D. Incorporation of weekly spirometry reading into daily life Which medication is most appropriate for a patient to self-administer when their peak expiratory flow is 1s 350. Green Zone >400, Yellow 250-400, Red <250. A. Quick Reliever Medication B. Long-term Controller Medication C. Short acting Antihistamine D. Long-Acting Bronchodilator Which is a validated tool that maybe used to assess the control of individuals with asthma? A. ICD-9 B. ATAQ C. PHQ-9 D. ATP3 What documentation would most likely be audited in a patient with asthma chart to determine whether self-management actions are being evaluated by the asthma educator? A. Spirometry B. Medication Refill History C. Education Flow Sheet D. Diagnostic lab values A forty-two-year-old single mother is having difficulty paying for her asthma controller medication. The responsibility of the asthma educator is: A. Educate patient that she will need to adjust her budget in order to afford medication B. Recommend evidence-based treatment regardless of the cost C. Recommend discontinuing controller medication use and go to ED as needed D. Educate patient in regard to prescription and community assistant programs Which patient would meet the criteria for referral to an asthma specialist? A. A patient who is meeting goals of asthma therapy B. A three-year-old with Moderate Persistent Asthma C. A thirty-year-old with with Mild Persistent Asthma D. A thirty-year-old with Moderate Persistent Asthma Which of the following needs to be included when counseling a young female adult about asthma? A. Quick relief medications will not provide relief to her symptoms caused by bronchoconstriction B. When she is exposed to a trigger, she will get initial symptoms caused by airway inflammation C. When exercising, she will have increased coughing due to bronchoconstriction D. When exercising, she will have increased coughing due to airway inflammation A teenager comes into your clinic with wheezing, coughing, and shortness of breath after exercising. Which of the following is the main reason for their symptoms? A. Airway Edema B. Mucus production C. Airway inflammation D. Bronchospasm A teenager comes into your clinic with persistent asthma and notes that his current regiment is not controlling his symptoms. He's using albuterol four times daily with a valved-holding chamber. He stopped using his budesonide since he didn't like the taste and thought it wasn't working. Which of the following should you do to improve his asthma control? A. Teach him about environmental triggers so he can avoid them B. Ask him to show you his inhaler technique with his valved-holding chamber C. Change his budesonide to another medication D. Discuss with him the differences about short acting and long acting asthma medications Which technique should be used to help build support when interviewing a female with asthma? A. Address the female by her full name B. Speak clearly and diplomatically C. Maintain full and continuous eye contact D. Encourage the female to set her own asthma goal You are volunteering at a local clinic which is addressing asthma triggers in local schools. Which issue would be more appropriate for the group to discuss? A. Recommend non-aerobic exercises during gym classes B. Recommend non-dairy substitutions for meals C. Recommend high efficiency filters for ventilation systems D. Remove rabbits and animals from science classrooms You are meeting the parents of a 2-year old boy with persistent asthma named Gus. Gus is causing hid parents to struggle and the parents although understand the asthma action plan don't follow it. His parents give Gus albuterol and budesonide nebulizers about four times per week they seem to control Gus's symptoms. The parents unfortunately don't have health insurance for Gus and struggle financially. Gus obtains his medications from patient assistance programs and free sample from the pharmaceutical companies. A referral should be done to which provider? A. Social Worker B. Primary Care Physician C. Pharmacist D. Asthma Specialist The nebulizer cup for a home pari-nebulizer should be replaced every: A. One month B. Two months C. Four months D. Six months You are evaluating the effectiveness of a local asthma program. There's an issue between patient-reported asthma severity and provider-assessed asthma severity. You want to evaluate the impact of this issue is having on asthma morbidity? A. Asthma quality of life survey results B. Use of national asthma guidelines by clinicians C. Prescribing patterns of long-term control asthma medications D. Asthma-related emergency visits Which of the following changes would improve the symptoms of a patient with dust mite sensitivity? A. installing new carpet in the bedroom B. Encasing the mattress and pillows in the bedroom C. Running a room ionizer in the bathroom D. Using a HEPA filter in the living room 16-year-old boy is referred to you for his asthma. He carries an albuterol inhaler. After reviewing his pulmonary function tests (PFTs), you notice the boy has an FEV1 of 70%. The PFTs show an improvement of 15% following a nebulized albuterol. You should recommend the following for the boy: A. He should be taught to recognize symptoms that he may not be aware of B. Prescribe budesonide as he has uncontrolled asthma despite not showing symptoms C. Don't use albuterol unless you have a cough or wheezing D. Don't take your albuterol since your asthma is controlled due to the infrequent symptoms Which lymphocytes start making antibodies to target environmental triggers such as dust mite? A. Cytokines B. B-Lymphocytes C. Type 2 lymphocytes D. T-lymphocytes What type of asthma medication is more consistent than a leukotriene blocker at controlling symptoms and protecting from asthma attacks? A. Inhaled corticosteriods B. Herbal inhalers C. Short-acting beta agonists D. Long-acting beta agonists The symptoms of actuate hypersensitivity pneumonitis would include all of the following except? A. Fatigue B. Fever C. Shortness of breath D. Vomiting Which of the following would be considered the concentration of liquid household detergent and water that should be used once a month to rinse the valved holding chamber (VHC)? A. 1:5000 detergent to water B. 1:1 detergent to water C. 1:500 detergent to water D. 1:1000 detergent to water Aspirin-sensitive asthma will not allow the patient to take what type of medication A. NSAIDs B. Mast Cell Stabilizers C. Long-acting beta agonists D. Inhaled corticosteroids A middle-aged woman with asthma and multiple other medical problems is concerned that one of her medications is making her asthma more difficult to manage. Which of the following may be an issue for this woman? A. Tylenol with codeine B. Timolol C. Celecoxib D. Metformin A useful tool for assessing asthma control is a: A. Spirometer B. Small volume nebulizer C. Pulse oximeter D. Peak flow meter Which of the following are signs of asthma? A. Coughing B. Wheezing C. Shortness of breath D. All of the above A middle-aged woman with asthma and multiple other medical problems is concerned that one of her medications is making her asthma more difficult to manage. Which of the following may be an issue for this woman? A. Tylenol wi