National Asthma Educator Certification Board (NAECB) Practice Exam

If a nine-year-old makes his holding chamber whistle every time he takes his medication, the educator should:

1. Provide redirection to slow inspiratory force

2. Provide redirection to increase inspiratory force

3. Provide redirection to slow expiratory force

4. Provide positive reinforcement for proper technique

The correct answer is: Provide redirection to slow inspiratory force

In this scenario, the goal is to ensure that the child is using the holding chamber effectively for optimal medication delivery. When a holding chamber whistles, it typically indicates that the child is inhaling too quickly, which can lead to improper medication deposition in the lungs. Redirecting the child to slow down their inspiratory force is crucial; a slow and steady inhalation allows the aerosolized medication to remain suspended longer in the chamber before reaching the lungs, enhancing the likelihood of proper absorption. This technique helps ensure that the medication is delivered efficiently and effectively. Additionally, it is important to note that while positive reinforcement is beneficial in promoting good practice and technique, the immediate concern in this case is addressing the technique itself to minimize the whistling sound. Slowing the inspiratory force is a key step in correcting the technique and ensuring that the child receives the full benefits of the medication.