NAECB Inhaler Technique & Delivery Devices 3

Question 1

A patient's DPI dose counter still shows doses remaining, but the patient feels no therapeutic effect after inhalation. What is the MOST likely explanation?

Accepted Answer

Both B and C are plausible causes that an educator should investigate

Answer

The medication has chemically expired inside the device

Answer

The patient is not generating sufficient inspiratory flow to aerosolize the powder

Answer

The DPI has been stored improperly in a high-humidity environment

Question 2

When observing MDI technique, which error would result in the GREATEST amount of medication being deposited in the oropharynx rather than the lungs?

Accepted Answer

Actuating the canister before beginning to inhale

Answer

Using a valved holding chamber with the MDI

Answer

Exhaling fully to functional residual capacity before actuation

Answer

Breathing in slowly over 3–5 seconds

Question 3

A patient requires both a short-acting beta-agonist (SABA) and an inhaled corticosteroid (ICS) via MDI. What is the correct order of administration?

Accepted Answer

SABA first, then ICS after the bronchodilator has time to act

Answer

ICS first, then SABA 10 minutes later

Answer

Either order is equally effective for drug delivery

Answer

Both should be mixed in a single nebulizer cup

Question 4

During an observed DPI technique assessment, which finding would MOST indicate that the patient is not receiving an effective dose?

Accepted Answer

Exhaling forcefully into the DPI before each inhalation

Answer

Using a spacer attached to the DPI mouthpiece

Answer

Holding the breath for 10 seconds after inhalation

Answer

Priming the DPI by clicking it once before the first dose

Question 5

Which statement about dry powder inhalers (DPIs) is TRUE?

Accepted Answer

DPIs rely entirely on the patient's inspiratory effort to disaggregate and deliver the medication

Answer

DPIs require priming with test sprays before first use, just like MDIs

Answer

DPIs are appropriate for patients during severe acute exacerbations with very low peak flow

Answer

DPIs deliver medication more slowly to the lungs than pressurized MDIs

Question 6

An asthma educator observes a patient tilting their head back while actuating an MDI. How does this position affect drug delivery?

Accepted Answer

It may increase oropharyngeal deposition by directing the spray toward the back of the throat

Answer

It improves delivery by straightening the trachea and reducing airway resistance

Answer

It has no measurable effect on drug deposition patterns

Answer

It allows better lower lung deposition due to gravity assistance

Question 7

When should an asthma educator advise a patient NOT to use a dry powder inhaler for acute symptom relief?

Accepted Answer

During a severe acute exacerbation when peak inspiratory flow is markedly reduced

Answer

During mild exercise-induced bronchoconstriction with normal inspiratory flow

Answer

For daily maintenance therapy of moderate persistent asthma

Answer

When used as a rescue bronchodilator during moderate symptoms