NAECB Inhaler Technique & Delivery Devices 2

Question 1

A patient with severe hand tremors and poor hand-breath coordination has difficulty using a standard pressurized MDI. Which device would BEST address this limitation?

Accepted Answer

A breath-actuated MDI that fires automatically on inhalation

Answer

A standard pMDI used without a spacer

Answer

A high-resistance DPI requiring strong inspiratory effort

Answer

A large-volume nebulizer requiring extended treatment time

Question 2

Which spacer or valved holding chamber configuration is most appropriate for an 18-month-old child requiring inhaled corticosteroid therapy?

Accepted Answer

Spacer fitted with an appropriately sized face mask

Answer

Standard adult-sized spacer with mouthpiece

Answer

Standard MDI used without any accessory device

Answer

Low-resistance DPI with dose counter

Question 3

When cleaning a metered-dose inhaler mouthpiece, the recommended method is to:

Accepted Answer

Remove the canister and rinse the plastic mouthpiece with warm water, then air-dry

Answer

Submerge the entire canister assembly in a bowl of water

Answer

Wipe only the outside of the canister with a dry cloth

Answer

Use alcohol wipes directly on the canister to sterilize the valve

Question 4

A patient using a pressurized metered-dose inhaler should hold the device in which orientation?

Accepted Answer

Upright with the canister on top and mouthpiece at the bottom

Answer

Upside down with the canister on the bottom

Answer

Horizontal with the canister on the side

Answer

Any orientation is equally effective

Question 5

The soft mist inhaler (SMI), such as the Respimat, differs from a standard pressurized MDI primarily because it:

Accepted Answer

Produces a slow-moving, long-lasting aerosol cloud without a propellant

Answer

Requires a chlorofluorocarbon propellant for drug delivery

Answer

Demands a faster peak inspiratory flow than a DPI

Answer

Cannot be used with any form of spacer or holding chamber

Question 6

Which patient would be LEAST appropriate for a dry powder inhaler (DPI) as the primary delivery device?

Accepted Answer

A 3-year-old child with recurrent severe wheezing

Answer

A 14-year-old with moderate persistent asthma

Answer

An adult with newly diagnosed mild asthma

Answer

A 65-year-old with stable well-controlled asthma

Question 7

How frequently should a valved holding chamber (spacer) typically be replaced under normal use conditions?

Accepted Answer

Every 6–12 months or per the manufacturer's recommendation

Answer

Every week to prevent electrostatic charge buildup

Answer

Every month regardless of condition

Answer

Only when the device is visibly cracked or damaged