CRE Technology & Digital Tools 2 — Questions and Answers
Question 1: A patient with COPD uses a smart inhaler. Which primary data does the device transmit to the respiratory educator's dashboard?
- Medication lot number and expiration date
- Time-stamped actuation events and GPS location (Correct answer)
- Serum drug levels and bioavailability
- Inhaler internal temperature and humidity
Correct answer: Time-stamped actuation events and GPS location
Smart inhalers record time-stamped actuation events and GPS location to track adherence patterns and identify high-risk environments.
Question 2: Which spirometry quality criterion ensures a technically acceptable FVC maneuver per ATS/ERS standards?
- Peak expiratory flow reached within 0.5 seconds of maneuver onset
- Exhalation lasted at least 6 seconds with a plateau in the volume-time curve (Correct answer)
- FEV1/FVC ratio is above 0.70
- The patient performed at least two maneuvers within 5% of each other
Correct answer: Exhalation lasted at least 6 seconds with a plateau in the volume-time curve
ATS/ERS standards require exhalation of at least 6 seconds (or a clear plateau) to confirm a complete FVC maneuver.
Question 3: A telehealth respiratory visit requires which technical safeguard to comply with HIPAA during video transmission?
- Consumer-grade video platforms such as FaceTime without additional controls
- End-to-end encryption on a HIPAA-compliant platform with a signed BAA (Correct answer)
- Password protection only, without encryption
- Storing video recordings on the educator's local hard drive
Correct answer: End-to-end encryption on a HIPAA-compliant platform with a signed BAA
HIPAA requires end-to-end encryption and a Business Associate Agreement (BAA) with the telehealth platform vendor.
Question 4: When reviewing a patient's CPAP device download, a compliance report shows AHI of 14 events/hour on therapy. The educator's FIRST action should be:
- Conclude therapy is successful because the device is being used
- Assess mask leak data and residual AHI to identify treatment failure cause (Correct answer)
- Immediately switch the patient to BiPAP without further assessment
- Discontinue CPAP and recommend positional therapy
Correct answer: Assess mask leak data and residual AHI to identify treatment failure cause
Residual AHI above 5 events/hour despite CPAP use indicates inadequate control; mask leak data helps distinguish pressure inadequacy from interface problems.
Question 5: A respiratory educator uses a peak flow meter application on a smartphone. Which limitation is most important to communicate to the patient?
- Smartphone apps cannot display color zones
- App-based acoustic peak flow measurement is not yet FDA-cleared for clinical decision-making in all products (Correct answer)
- The app will drain the smartphone battery rapidly
- Smartphone peak flow apps cannot store historical data
Correct answer: App-based acoustic peak flow measurement is not yet FDA-cleared for clinical decision-making in all products
Many smartphone-based spirometry and peak flow apps lack FDA clearance for clinical use, so patients should not make treatment decisions based solely on these readings.
Question 6: In an electronic health record (EHR), a respiratory educator documents a patient education session. Which entry best supports care coordination?
- A free-text note visible only in the educator's module
- A structured note using standardized terminology linked to the patient's care plan (Correct answer)
- A phone memo forwarded by email to the primary care physician
- A handwritten note scanned as a PDF attachment
Correct answer: A structured note using standardized terminology linked to the patient's care plan
Structured notes with standardized terminology integrate with the care plan and are accessible to all treating providers, supporting coordinated care.
Question 7: Which waveform on a ventilator's graphics screen BEST indicates patient-ventilator dyssynchrony?
- A smooth sine wave on the flow-time tracing
- Double-triggering visible as two pressure deflections within a single breath cycle (Correct answer)
- A plateau on the pressure-time curve during an inspiratory hold
- Consistent tidal volumes across consecutive breaths
Correct answer: Double-triggering visible as two pressure deflections within a single breath cycle
Double-triggering appears as two pressure deflections in one breath cycle on the flow-time curve, indicating the patient's neural effort is misaligned with the ventilator cycle.
CRE Technology & Digital Tools 2
A patient with COPD uses a smart inhaler.
Which primary data does the device transmit to the respiratory educator's dashboard?