TEST INSTRUCTIONS Read the article. The test for this CE activity is to be taken online at www.nursingcenter.com/CE/NP. Tests can no longer be mailed or faxed. You'll need to create (it's free!) and log in to your personal CE Planner account before taking online tests. Your planner will keep track of all your Lippincott Professional Development online CE activities for you. There's only one correct answer for each question. A passing score for this test is 8 correct answers. If you pass, you can print your certificate of earned contact hours and access the answer key. If you fail, you have the option of taking the test again at no additional cost. For questions, contact Lippincott Professional Development: 1-800-787-8985. Registration deadline is June 6, 2025. PROVIDER ACCREDITATION

Lippincott Professional Development will award 2.0 contact hours and 0.5 pharmacology contact hours for this continuing nursing education activity.

Lippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, West Virginia, New Mexico, South Carolina, and Florida, CE Broker #50-1223. Your certificate is valid in all states.

Payment: The registration fee for this test is $21.95.

Climate change and its impact on asthma

Learning Outcomes: A majority of participants in this activity will demonstrate knowledge of climate change and its impact on asthma by achieving a passing score on the posttest.

Learning Objectives: After reading the article and completing the posttest, the participant will be able to:

Recognize how climate change–driven phenomena and prescribed asthma medications impact the environment. Describe the respiratory system's response when exposed to specific common air pollutants. Explain how environmental factors and climate change can adversely impact vulnerable populations and create health disparities.

Posttest: Knowledge-based questions

An effect of climate change that can lead to increased levels of pollen and allergens that contribute to poor respiratory health is decreased rain. rising temperatures. increased frost on plants. The traffic-related air pollutant that is a significant irritant to the respiratory system and is associated with increased morbidity in patients with asthma is ozone. nitrogen dioxide. volatile organic compounds. A compound that causes airway inflammation, hyperresponsiveness, and epithelial cell injury upon exposure is ozone. nitrogen oxide. carbon dioxide. A climate change–driven event that can produce particulate matter and contribute to oxidative stress and inflammation in the lungs is a wildfire, particularly due to the smoke. a hurricane, particularly heavy indoor fungi growth after the event. a flood, as floodwaters carry allergens that can be released when they recede. The negative impacts of climate change on asthma are less pronounced for those living in urban areas. disproportionately affect certain vulnerable populations. affect all populations equally regardless of social determinants of health. Due in part to smaller peripheral airways and increased ventilatory rates, this population is more vulnerable to the adverse reactions of environmental pollutants. children patients with disabilities people who have less education than others As the NP working in an asthma clinic seeking to contribute to environmental protection, you understand that the asthma inhalers with the highest global warming potential are soft mist inhalers. dry powder inhalers. pressurized metered-dose inhalers. Of greenhouse gas emissions related to healthcare, the US is responsible for less than half of the emissions of most other countries. one eighth of the world's healthcare emissions, which is similar to other countries. one quarter of the world's healthcare emissions, which is higher than any other country. Epidemiologic studies have demonstrated that elevations in ambient ozone levels are associated with increased asthma morbidity. greater school and sports attendance. higher rates of scheduled medical utilization. GL is a 3-year-old patient diagnosed with asthma who arrives with her mother for a problem visit at the pediatric clinic. The mother states that GL was prescribed an HFA-227ea inhaler at her last visit but is still having difficulty with controlling her asthma. As the NP caring for GL and thinking about climate change issues, your best response is to prescribe a soft mist inhaler to replace the HFA-227ea inhaler and provide education on technique for its use and on how it is a better choice for reducing global warming. continue GL on the HFA-227ea inhaler, advising the mother that it is best for GL and for the climate. prescribe a dry powder inhaler for GL since this is the recommended choice for pediatric patients.