NAECB Self-Management Plans 3 — Questions and Answers
Question 1: A patient reports their peak flow is consistently at 55% of personal best with worsening nighttime cough. According to a standard action plan, this falls in which zone?
- GREEN zone — continue routine medications
- YELLOW zone — take caution action steps (Correct answer)
- RED zone — take emergency action
- No zone — peak flow below 50% is not included in standard plans
Correct answer: YELLOW zone — take caution action steps
A peak flow of 50–79% of personal best places the patient in the YELLOW zone, indicating caution and the need for step-up management.
Question 2: Which of the following is a key component that MUST be included in a written asthma action plan?
- Patient's insurance policy number
- Instructions for what to do in each symptom/peak flow zone (Correct answer)
- A list of all foods the patient enjoys
- The patient's school or work schedule
Correct answer: Instructions for what to do in each symptom/peak flow zone
A written asthma action plan must include clear instructions for each zone (green, yellow, red) to guide self-management decisions.
Question 3: An asthma educator is working with an adult patient who cannot read. The best approach for the action plan is to:
- Discharge the patient since a written plan is impossible
- Use pictograms, color coding, and verbal instruction with return demonstration (Correct answer)
- Provide only verbal instructions during clinic visits
- Give the plan to a family member and exclude the patient
Correct answer: Use pictograms, color coding, and verbal instruction with return demonstration
Pictograms, color-coded zones, and verbal instruction with return demonstration make action plans accessible to patients with low health literacy.
Question 4: A patient's asthma action plan includes oral corticosteroids. In which zone are oral corticosteroids typically used?
- GREEN zone only
- YELLOW zone as first-line response
- RED zone when rescue inhaler provides insufficient relief (Correct answer)
- They are never included in self-management action plans
Correct answer: RED zone when rescue inhaler provides insufficient relief
Oral corticosteroids are listed in the RED zone action steps for severe exacerbations when the rescue inhaler does not provide adequate relief.
Question 5: How should an asthma action plan address exercise-induced bronchoconstriction (EIB)?
- Advise the patient to stop all exercise permanently
- Include pre-exercise medication instructions and warm-up strategies (Correct answer)
- Place EIB management only in the RED zone
- Recommend antihistamines before exercise as primary prevention
Correct answer: Include pre-exercise medication instructions and warm-up strategies
Action plans for patients with EIB should include pre-exercise SABA use and warm-up strategies to prevent exercise-induced symptoms.
Question 6: A school-age child receives a new asthma action plan. Who should receive a copy?
- Only the child's primary care provider
- The child's parents/guardians and the school nurse (Correct answer)
- Only the emergency department for future visits
- The insurance company as a billing document
Correct answer: The child's parents/guardians and the school nurse
Copies of the action plan should be given to parents/guardians and the school nurse to ensure consistent asthma management across settings.
Question 7: A patient's peak flow drops to 40% of personal best with severe shortness of breath. After two treatments with rescue inhaler, there is minimal improvement. The action plan should direct the patient to:
- Rest and retry rescue inhaler in 4 hours
- Call their provider for a scheduled appointment next week
- Go to the emergency department or call 911 immediately (Correct answer)
- Increase controller medication dose and monitor at home
Correct answer: Go to the emergency department or call 911 immediately
A peak flow below 50% with poor response to rescue inhaler represents a severe exacerbation requiring immediate emergency care.
NAECB Self-Management Plans 3
A patient reports their peak flow is consistently at 55% of personal best with worsening nighttime cough.
According to a standard action plan, this falls in which zone?