NAECB Asthma Education 5 — Questions and Answers
Question 1: Which biologic medication targets IgE and is indicated for moderate-to-severe allergic asthma in patients aged 6 and older?
- Mepolizumab (Nucala)
- Dupilumab (Dupixent)
- Omalizumab (Xolair) (Correct answer)
- Benralizumab (Fasenra)
Correct answer: Omalizumab (Xolair)
Omalizumab is a monoclonal anti-IgE antibody approved for moderate-to-severe allergic asthma in patients ≥6 years with elevated IgE levels.
Question 2: A school-age child with asthma participates in sports. Which of the following is the most appropriate recommendation?
- The child should avoid all physical activity to prevent EIB
- The child should take a SABA 15-30 minutes before exercise if prone to EIB (Correct answer)
- The child should use a LABA before every exercise session without an ICS
- Exercise is only safe if asthma is in remission
Correct answer: The child should take a SABA 15-30 minutes before exercise if prone to EIB
Pre-treatment with a SABA 15-30 minutes before exercise is effective prophylaxis for EIB and allows children to participate in physical activity.
Question 3: According to motivational interviewing principles used in asthma education, which approach best supports patient behavior change?
- Telling patients firmly what they must do to control their asthma
- Exploring the patient's own motivation and ambivalence about self-management (Correct answer)
- Providing standardized lecture-format education to all patients
- Using fear-based messaging about asthma complications
Correct answer: Exploring the patient's own motivation and ambivalence about self-management
Motivational interviewing explores and resolves ambivalence by drawing on the patient's intrinsic motivations, which is more effective than directive instruction.
Question 4: A patient in the yellow zone of their asthma action plan should be instructed to:
- Continue current medications with no changes and recheck in 1 week
- Call 911 immediately
- Take rescue bronchodilator, reassess, and contact their provider if not improving (Correct answer)
- Stop all controller medications until symptoms resolve
Correct answer: Take rescue bronchodilator, reassess, and contact their provider if not improving
The yellow zone (peak flow 50-79% of personal best or worsening symptoms) calls for rescue medication use, reassessment, and provider contact if not improving.
Question 5: Which indoor air quality intervention has the strongest evidence for reducing asthma morbidity in sensitized patients?
- Using air fresheners to mask irritant odors
- Installing high-efficiency HEPA air filters and encasing mattresses/pillows in allergen-proof covers (Correct answer)
- Keeping windows open to increase air circulation year-round
- Using scented candles to reduce stress-related asthma triggers
Correct answer: Installing high-efficiency HEPA air filters and encasing mattresses/pillows in allergen-proof covers
HEPA filtration and allergen-impermeable mattress/pillow covers significantly reduce dust mite and other allergen exposure in sensitized asthma patients.
Question 6: Which of the following statements about asthma and obesity is correct?
- Obesity has no effect on asthma severity or control
- Obese patients typically respond better to ICS than normal-weight patients
- Obesity is associated with more difficult-to-control asthma and a different inflammatory phenotype (Correct answer)
- Weight loss worsens asthma due to changes in lung mechanics
Correct answer: Obesity is associated with more difficult-to-control asthma and a different inflammatory phenotype
Obesity is associated with a non-eosinophilic, neutrophilic asthma phenotype that responds less well to ICS, and weight loss generally improves asthma control.
Question 7: A patient asks why they should use a spacer (valved holding chamber) with their metered-dose inhaler. What is the BEST reason to give?
- A spacer makes the inhaler more portable and convenient
- A spacer increases drug delivery to the lungs and reduces oropharyngeal deposition (Correct answer)
- A spacer eliminates the need to coordinate inhalation with actuation
- A spacer stores extra medication doses for use between refills
Correct answer: A spacer increases drug delivery to the lungs and reduces oropharyngeal deposition
Spacers slow the aerosol plume, allowing more drug to reach the lower airways and reducing deposition in the mouth and throat.
NAECB Asthma Education 5
Which biologic medication targets IgE and is indicated for moderate-to-severe allergic asthma in patients aged 6 and older?