CRE Risk Assessment & Management 3 — Questions and Answers
Question 1: A respiratory educator is conducting a home visit and notices the patient is storing pressurized oxygen cylinders in a closet next to a gas stove. Which risk management action is the priority?
- Document the finding for the next clinic visit
- Educate the patient on safe oxygen storage away from heat and ignition sources (Correct answer)
- Reduce the prescribed oxygen flow rate
- Refer the patient to a pulmonologist
Correct answer: Educate the patient on safe oxygen storage away from heat and ignition sources
Storing oxygen near ignition sources creates a fire and explosion hazard; immediate patient education on safe storage is the priority intervention.
Question 2: Which exacerbation risk factor is quantified by the GOLD ABCD assessment tool in addition to spirometric severity?
- Blood eosinophil count
- Number of exacerbations in the prior year and symptom burden (Correct answer)
- 6-minute walk distance
- Diffusing capacity (DLCO)
Correct answer: Number of exacerbations in the prior year and symptom burden
The GOLD ABCD tool categorizes patients by prior exacerbation history (none/1 moderate, 2+ moderate, or ≥1 hospitalization) combined with CAT or mMRC symptom scores.
Question 3: A pediatric asthma patient's parent describes needing to make three urgent care visits in the last six months. According to risk stratification principles, which action is most indicated?
- Continue current management and reassess in 12 months
- Step up therapy and identify uncontrolled triggers (Correct answer)
- Switch from ICS to oral corticosteroids
- Discontinue controller therapy since the child is between visits
Correct answer: Step up therapy and identify uncontrolled triggers
Frequent urgent care visits signal uncontrolled asthma; stepping up therapy and identifying triggers are evidence-based risk reduction interventions.
Question 4: Which nutritional risk factor is independently associated with increased COPD exacerbation frequency and should be assessed during a comprehensive respiratory evaluation?
- Vitamin D deficiency (Correct answer)
- High sodium intake
- Excessive fiber consumption
- Elevated serum potassium
Correct answer: Vitamin D deficiency
Vitamin D deficiency is associated with impaired immune function and increased respiratory infection susceptibility, raising exacerbation risk in COPD.
Question 5: A respiratory educator reviews medication reconciliation for a patient with COPD and discovers the patient is taking a non-selective beta-blocker for hypertension. What is the primary respiratory risk?
- Increased mucus production
- Bronchospasm due to beta-2 receptor blockade (Correct answer)
- Reduced oxygen-carrying capacity
- Suppression of cough reflex
Correct answer: Bronchospasm due to beta-2 receptor blockade
Non-selective beta-blockers block beta-2 receptors in the airways, potentially precipitating bronchospasm in patients with reactive airway disease.
Question 6: During a risk assessment, a patient reveals they live alone and cannot describe what to do if dyspnea acutely worsens. What is the most appropriate risk management response?
- Advise the patient to call 911 for any dyspnea
- Develop a written asthma/COPD action plan with escalation steps and emergency contacts (Correct answer)
- Prescribe a higher-dose bronchodilator as a precaution
- Refer directly to an emergency department
Correct answer: Develop a written asthma/COPD action plan with escalation steps and emergency contacts
A personalized written action plan provides structured guidance for self-managing worsening symptoms and identifies when to seek emergency care.
Question 7: Which occupational exposure represents the highest risk for accelerating spirometric decline in a patient with mild COPD?
- Occasional exposure to diesel exhaust in a well-ventilated area
- Daily unprotected exposure to grain dust in a grain elevator (Correct answer)
- Sedentary office environment with central air filtration
- Intermittent exposure to paint fumes outdoors
Correct answer: Daily unprotected exposure to grain dust in a grain elevator
Chronic high-level exposure to organic dusts such as grain dust in enclosed spaces is strongly associated with accelerated lung function decline.
CRE Risk Assessment & Management 3
A respiratory educator is conducting a home visit and notices the patient is storing pressurized oxygen cylinders in a closet next to a gas stove.
Which risk management action is the priority?