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Certified Hand Therapist (CHT) Examination practice questions

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Question 1Evaluation and Assessment

Which measurements are most appropriate to document as a baseline before a patient's first hyperbaric oxygen treatment?

  1. Vital signs and oxygen saturation Correct answer.
  2. Blood cultures and urinalysis
  3. Chest radiograph and full pulmonary function testing
  4. Serum electrolytes and liver enzymes

Explanation

A baseline set of vital signs - heart rate, respiratory rate, blood pressure, temperature and oxygen saturation - is recorded before the first treatment so that later changes can be compared against it. Laboratory and imaging studies are ordered only when clinically indicated, not as routine baseline screening.

Question 2Evaluation and Assessment

Transcutaneous oxygen electrodes used for wound assessment should be calibrated:

  1. whenever the reading exceeds 200 mmHg
  2. once per month by the manufacturer's service technician
  3. before each series of measurements using a known reference gas Correct answer.
  4. only after the electrode membrane is replaced

Explanation

Electrodes drift and the membrane and electrolyte solution degrade, so a two-point calibration against a known gas is performed before each measurement session. Monthly service and membrane changes do not substitute for calibration at the point of use.

Question 3Evaluation and Assessment

Why is otoscopy performed before a patient's hyperbaric treatment?

  1. To record middle ear pressure in millimeters of mercury
  2. To check that the tympanic membrane is intact and that nothing blocks equalization Correct answer.
  3. To measure hearing acuity before pressurization
  4. To check for excess cerumen that the technologist will remove with suction

Explanation

Otoscopy confirms that the tympanic membrane can be seen and is intact and identifies effusion, perforation, or obstruction that would make pressure equalization difficult or unsafe. Findings guide coaching, decongestant timing, or postponement of the dive.

Question 4Evaluation and Assessment

Measuring blood glucose before treatment is most important for which patient?

  1. A patient with claustrophobia
  2. A patient taking a diuretic
  3. A patient with insulin-dependent diabetes Correct answer.
  4. A patient receiving treatment for a chronic radiation wound

Explanation

Fasting, altered insulin sensitivity and the stress of treatment can produce hypo- or hyperglycemia in diabetic patients, so glucose is checked before treatment and periodically thereafter. Confusion arising during a treatment in these patients must be evaluated with a glucose measurement.

Question 5Evaluation and Assessment

A periwound transcutaneous oxygen measurement of 22 mmHg obtained at sea level while the patient breathes room air indicates:

  1. an artifact caused by improper electrode temperature
  2. normal tissue oxygenation for that location
  3. severely reduced tissue oxygenation Correct answer.
  4. a value that cannot be interpreted without an in-chamber reading

Explanation

On room air at sea level, periwound values below roughly 30 mmHg reflect markedly impaired perfusion and predict poor healing. Values in the 30-40 mmHg range are borderline, and higher values are normal.

Question 6Evaluation and Assessment

During descent a patient reports increasing ear pain and cannot equalize. What is the most appropriate immediate action?

  1. Stop the descent, coach equalization, and if pain persists ascend slightly and reassess Correct answer.
  2. Continue the descent but at a slower rate so the patient has more time to equalize
  3. Have the patient remove the oxygen mask and breathe room air
  4. Increase the descent rate so the painful period is shortened

Explanation

Descent must be halted as soon as equalization fails so the pressure differential is not increased across the tympanic membrane. Coaching techniques and a slight ascent relieve the gradient; if pain persists the treatment is aborted or postponed rather than forced.

Question 7Evaluation and Assessment

Why is pulse oximetry of limited value for judging the adequacy of hyperbaric oxygen therapy?

  1. Saturation is already near 100% before treatment, so the reading cannot show the added dissolved oxygen Correct answer.
  2. Pulse oximeters are not approved for use in any hyperbaric chamber and must be replaced by blood gas sampling
  3. Hemoglobin cannot bind oxygen under increased ambient pressure
  4. Oximeters measure arterial oxygen tension rather than saturation

Explanation

Hemoglobin is essentially fully saturated on normobaric oxygen, so the additional oxygen carried in hyperbaric therapy is dissolved in plasma and does not appear as a saturation change. Oximetry remains useful for detecting hypoxemia, not for quantifying the hyperbaric effect.

Question 8Evaluation and Assessment

Which method is most practical for measuring blood pressure in an unresponsive patient inside a monoplace chamber?

  1. Palpation of the radial pulse during compression only
  2. A Doppler probe or chamber-compatible automated cuff Correct answer.
  3. A standard mercury sphygmomanometer operated inside the chamber
  4. An arterial line routed through the chamber hull

Explanation

The patient in a monoplace chamber cannot be reached to operate a manual device, so Doppler ultrasound over the brachial artery or a chamber-rated oscillometric monitor is used to obtain intermittent readings. Mercury devices are not permitted and arterial lines are not routed through the hull for routine treatment.

Question 9Evaluation and Assessment

Which assessment finding during treatment most suggests a pneumothorax?

  1. Bilateral fine crackles at the lung bases that clear after a deep breath
  2. Dullness to percussion at both lung bases
  3. A dry cough that begins after thirty minutes of oxygen breathing
  4. Sudden one-sided chest pain, dyspnea, and absent breath sounds on that side Correct answer.

Explanation

Unilateral pleuritic pain, dyspnea and diminished or absent breath sounds on the affected side are the classic bedside findings of pneumothorax and demand immediate evaluation and decompression of the chamber if tension develops. Bilateral or symmetric findings point elsewhere.

Question 10Evaluation and Assessment

Which symptom is a classic early warning sign of central nervous system oxygen toxicity?

  1. Bradycardia with hypertension
  2. Perioral or facial muscle twitching Correct answer.
  3. Productive cough with pink sputum
  4. Loss of deep tendon reflexes

Explanation

Twitching of the lips, face or eyelids, along with visual disturbance, tinnitus, nausea, irritability and dizziness, precedes a generalized seizure and requires the attending to be notified immediately. Recognizing these early signs allows the exposure to be interrupted before convulsion occurs.

Question 11Evaluation and Assessment

Which patient characteristic most justifies increasing the frequency of vital sign checks during treatment?

  1. A stable wound that has not changed in two weeks
  2. A completed course of twenty treatments
  3. A history of well-controlled hypertension
  4. Recent hemodynamic instability or vasopressor dependence Correct answer.

Explanation

Patients who are hemodynamically unstable or on vasoactive infusions can change rapidly under pressure and are monitored more often, sometimes continuously. Stable outpatients on a routine course are monitored at standard intervals.

Question 12Evaluation and Assessment

Which practice most improves the reliability of serial wound measurements?

  1. Using the same method and anatomical landmarks at every assessment Correct answer.
  2. Measuring only the wound depth with a cotton swab
  3. Having a different clinician measure the wound at each visit
  4. Estimating size from memory between visits

Explanation

Consistency of technique, reference landmarks, and measurement tool reduces inter-assessment variability so that apparent change reflects real healing. Serial photographs taken at a fixed distance and angle support the same goal.

Question 13Evaluation and Assessment

A patient's periwound transcutaneous oxygen value is 20 mmHg on room air at sea level and rises to 175 mmHg while breathing 100% oxygen at 2.4 ATA in the chamber. How should this response be interpreted?

  1. A response that guarantees the wound will heal without adjunctive therapy or surgery
  2. An artifact, because a rise of this magnitude cannot occur during a single treatment
  3. A favorable response, but a value indicating only moderate healing potential Correct answer.
  4. A failure of oxygen delivery, since in-chamber values should always exceed 250 mmHg

Explanation

The rise from 20 to 175 mmHg demonstrates that the tissue can be oxygenated when a hyperbaric gradient is applied, but in-chamber values in the 100-200 mmHg range carry a guarded prognosis compared with values above roughly 200 mmHg. The test therefore supports, but does not guarantee, a healing response.

Question 14Evaluation and Assessment

Which pre-treatment pulmonary finding most increases the risk of pulmonary oxygen toxicity during a prolonged course of hyperbaric oxygen?

  1. A history of well-controlled asthma with normal spirometry
  2. A reduced diffusing capacity for carbon monoxide Correct answer.
  3. A vital capacity at 95% of predicted
  4. A productive cough from chronic bronchitis that has resolved

Explanation

A reduced diffusing capacity indicates impaired gas exchange and limited pulmonary reserve, which raises susceptibility to oxygen toxicity and often prompts reduced exposure and closer monitoring. Normal spirometry or a resolved cough does not carry the same risk.

Question 15Evaluation and Assessment

A diver surfaces and within minutes develops confusion, one-sided weakness, and blurred vision. What is the priority action?

  1. Obtain a CT scan of the head before any treatment is started
  2. Treat as arterial gas embolism and arrange urgent recompression Correct answer.
  3. Observe for six hours to see whether the symptoms resolve spontaneously
  4. Give oral fluids and reassess in the chamber waiting area

Explanation

Acute neurological deficits appearing within minutes of surfacing are treated as arterial gas embolism until proven otherwise, and recompression must not be delayed for imaging. Transport and oxygen first aid proceed simultaneously with arranging the chamber.

Question 16Evaluation and Assessment

Which measure best reduces the likelihood of a claustrophobic reaction during a patient's first monoplace treatment?

  1. Routine pre-treatment sedation for every patient with no history of anxiety
  2. Keeping the chamber interior unlit to reduce visual stimulation
  3. A pre-treatment orientation with a chamber tour and intercom check Correct answer.
  4. Limiting the pre-treatment explanation so the patient is not frightened

Explanation

Familiarity with the chamber, the intercom and the treatment sequence reduces anticipatory anxiety and gives the patient a sense of control. Sedation is reserved for selected patients after medical review, and sensory deprivation in a dark chamber tends to worsen anxiety.

Question 17Evaluation and Assessment

A patient begins to shiver during a monoplace treatment in cold chamber gas. Why should this be addressed?

  1. Shivering is an early sign of an impending oxygen toxicity seizure
  2. Shivering prevents the chamber from reaching the prescribed treatment pressure
  3. Shivering raises oxygen consumption and discomfort and can compromise the treatment Correct answer.
  4. Shivering has no physiological consequence during hyperbaric exposure

Explanation

Shivering increases metabolic rate and oxygen demand, causes distress and vasoconstriction that may reduce wound perfusion, and can lead to hypothermia over a long exposure. Warming the gas and covering the patient address the cause.

Question 18Evaluation and Assessment

Thirty minutes into a treatment a diabetic patient becomes confused and diaphoretic. Which assessment most reliably distinguishes hypoglycemia from central nervous system oxygen toxicity?

  1. The trend in the patient's heart rate
  2. A measured blood glucose value Correct answer.
  3. The patient's blood pressure
  4. The presence of perioral tingling

Explanation

Confusion and diaphoresis occur in both hypoglycemia and early CNS oxygen toxicity, so an objective capillary glucose measurement is the fastest way to separate them. The result determines whether glucose is given, oxygen exposure is interrupted, or both.

Question 19Evaluation and Assessment

Which approach is best for documenting a patient's wound-related pain across a course of treatments?

  1. Relying on the clinician's overall impression of how comfortable the patient appears
  2. Using the same validated 0-10 numeric rating scale at each assessment Correct answer.
  3. Recording only whether pain is present or absent at each visit
  4. Asking the patient to describe pain only when it worsens

Explanation

A consistent validated scale produces comparable numbers over time and allows response to treatment to be tracked objectively. Descriptors and clinician impressions add context but cannot substitute for a repeated standardized score.

Question 20Evaluation and Assessment

Which assessment findings suggest dehydration that should be corrected before elective treatment?

  1. Dry mucous membranes, poor skin turgor, and dark concentrated urine Correct answer.
  2. A weight gain of 0.5 kg since the previous visit
  3. Warm, dry skin with good skin turgor
  4. Moist mucous membranes and clear, pale urine

Explanation

Dry membranes, reduced skin turgor and dark concentrated urine indicate volume depletion, which impairs perfusion and raises the risk of decompression illness in diving patients. Hydration is corrected before elective treatment.

Question 21Evaluation and Assessment

Which otoscopic finding after treatment is most consistent with middle ear barotrauma?

  1. A pearly, translucent membrane with a visible light reflex
  2. Hemotympanum or a middle ear effusion behind an intact membrane Correct answer.
  3. A membrane that moves normally with a Valsalva maneuver
  4. A small amount of cerumen in the external canal

Explanation

Blood in the middle ear or a serous effusion after a dive indicates that the eustachian tube failed to equalize and the mucosa was injured by the pressure gradient. Normal translucency and normal mobility indicate an uninjured ear.

Question 22Evaluation and Assessment

What is the most important assessment for a patient with an implanted cardiac pacemaker who is scheduled for hyperbaric oxygen therapy?

  1. Whether the generator can be switched off for the duration of the treatment
  2. Whether the patient can perform a Valsalva maneuver to equalize middle ear pressure
  3. Whether the device is pressure-rated and appropriately programmed Correct answer.
  4. Whether the patient has ever experienced palpitations

Explanation

The device must be confirmed as suitable for hyperbaric exposure and its programmed mode and rate verified, because pressure and oxygen can affect some generators and leads. Deactivating the device is not a routine step and backup pacing is planned when indicated.

Question 23Evaluation and Assessment

Which set of findings during a prolonged treatment best indicates early pulmonary oxygen toxicity?

  1. Wheezing that resolves with a bronchodilator
  2. Sudden hemoptysis with pleuritic chest pain
  3. Fever with purulent sputum production
  4. Substernal burning, chest tightness, and a dry cough Correct answer.

Explanation

Pulmonary oxygen toxicity begins as tracheobronchial irritation with substernal burning, chest tightness and a nonproductive cough before any radiographic or blood gas abnormality appears. Reducing the oxygen exposure at this stage prevents progression.

Question 24Evaluation and Assessment

A patient being treated for decompression illness has a documented baseline neurological examination. Which change on reassessment most clearly indicates deterioration?

  1. New numbness or weakness in a limb that was normal at baseline Correct answer.
  2. A decrease in heart rate of eight beats per minute
  3. Resolution of a headache after the first oxygen period
  4. Improved grip strength in the previously weak hand

Explanation

Serial examinations are compared against the documented baseline, and a deficit appearing in a previously unaffected area indicates progression or incomplete resolution. This finding is reported so treatment can be extended or repeated.

Question 25Evaluation and Assessment

Which assessment is most appropriate immediately after a patient completes a hyperbaric treatment?

  1. A chest radiograph for every patient as a routine screen
  2. Repeat vital signs and a focused check for new ear pain or chest discomfort Correct answer.
  3. Blood cultures to detect bacteremia
  4. Immediate repeat transcutaneous oximetry to confirm the treatment worked

Explanation

Post-treatment assessment repeats vital signs and screens for complications such as middle ear barotrauma, chest symptoms, or neurological change, and documents the patient's condition against the pre-treatment baseline. Additional testing is driven by findings rather than performed routinely.

Question 26Evaluation and Assessment

Which finding in a diabetic foot wound most strongly suggests a spreading soft-tissue infection that requires urgent medical evaluation?

  1. A moist, granulating wound bed
  2. Erythema spreading beyond the wound edge Correct answer.
  3. Tenderness confined to the wound margin
  4. Dry eschar with no surrounding redness

Explanation

Erythema that extends beyond the wound margin suggests cellulitis or a deeper spreading infection and warrants prompt medical escalation. Stable eschar, a moist granulating bed, and pain limited to the wound edge are common in wounds without spreading infection.

Question 27Evaluation and Assessment

A patient being evaluated for hyperbaric oxygen therapy for a nonhealing leg ulcer has an ankle-brachial index of 0.35. How should this finding be interpreted?

  1. Normal arterial inflow, so hyperbaric therapy may proceed
  2. Severe arterial disease; assess for revascularization Correct answer.
  3. Mild arterial disease, so no additional workup is needed
  4. Venous disease, so compression therapy is the priority

Explanation

An ankle-brachial index of 0.35 indicates severe arterial insufficiency, which usually requires vascular evaluation for revascularization before or alongside wound therapy. Hyperbaric oxygen cannot correct inadequate arterial inflow.

Question 28Evaluation and Assessment

When serial transcutaneous oxygen measurements are obtained to evaluate a wound, which practice best ensures the values can be compared over time?

  1. Measuring after the patient has exercised
  2. Using a new electrode membrane for every measurement
  3. Placing the electrode at a different site each session
  4. Fixed electrode temperature and fixed site Correct answer.

Explanation

Transcutaneous oxygen values depend strongly on electrode temperature and measurement site, so both must be kept constant for serial values to be comparable. Changing site, activity, or membrane conditions introduces variability unrelated to healing.

Question 29Evaluation and Assessment

For a patient with diabetes receiving hyperbaric oxygen therapy, when should blood glucose be checked?

  1. Only after the final treatment in the course
  2. Once weekly at the wound clinic visit
  3. Only when the patient reports symptoms
  4. Before, during, and after treatment Correct answer.

Explanation

Glucose should be measured before treatment and at intervals during and after treatment because chamber exposure and fasting can cause hypo- or hyperglycemia. Symptom-driven or weekly checks can miss dangerous excursions.

Question 30Evaluation and Assessment

Which pre-treatment assessment best indicates that a patient will be able to equalize middle ear pressure during descent?

  1. A history of seasonal allergic rhinitis
  2. Resting oxygen saturation above 95 percent
  3. A positive Romberg test on examination
  4. Ability to perform a Valsalva maneuver Correct answer.

Explanation

The ability to perform a Valsalva or gentle ear-clearing maneuver demonstrates that the patient can actively open the eustachian tube. Balance testing, oxygenation, and allergy history do not directly test equalization.

Question 31Evaluation and Assessment

A patient reports pain over the cheek and forehead during chamber descent, along with a bloody nasal discharge. Which problem is most likely?

  1. Dental barotrauma
  2. Pulmonary barotrauma
  3. Paranasal sinus barotrauma Correct answer.
  4. Middle ear barotrauma

Explanation

Facial pain over the sinuses with bloody nasal discharge during compression is characteristic of sinus barotrauma. Middle ear barotrauma causes ear pain and hearing fullness, while dental and pulmonary barotrauma present differently.

Question 32Evaluation and Assessment

Which dental condition most increases the risk of tooth squeeze during hyperbaric treatment?

  1. A well-seated amalgam restoration
  2. Recent professional dental cleaning
  3. A porcelain veneer on a front tooth
  4. An incomplete root canal with gas Correct answer.

Explanation

Tooth squeeze occurs when gas trapped in a poorly filled root canal or beneath a restoration cannot equalize during pressure change. Well-seated restorations and routine cleaning do not trap gas.

Question 33Evaluation and Assessment

A patient who has completed several weeks of hyperbaric oxygen therapy reports blurred distance vision. Which explanation is most likely?

  1. Acute glaucoma requiring surgery
  2. Irreversible damage to the retina
  3. Transient myopia from oxygen Correct answer.
  4. Optic neuritis from barotrauma

Explanation

Prolonged hyperbaric oxygen exposure commonly causes a reversible myopic shift that resolves after therapy ends. It is not retinal destruction, acute glaucoma, or optic neuritis.

Question 34Evaluation and Assessment

Which measurement is most important for confirming adequate ventilation of a multiplace chamber during treatment?

  1. Carbon dioxide concentration Correct answer.
  2. Chamber humidity
  3. Chamber sound level
  4. Chamber door seal pressure

Explanation

Adequate ventilation is confirmed by keeping chamber carbon dioxide concentration low through continuous or intermittent flushing. Humidity, noise, and door seal pressure do not reflect ventilation adequacy.

Question 35Evaluation and Assessment

Before treating a patient who has a cuffed tracheostomy tube, which assessment is most important?

  1. Removing the tube for the duration of treatment
  2. Measuring the tube's outer diameter
  3. Checking cuff pressure and air leak Correct answer.
  4. Deflating the cuff completely before descent

Explanation

Cuff pressure must be within the recommended range and the tube must not leak, because gas volume in the cuff changes with pressure and an overinflated cuff can injure the trachea. Removing the tube or fully deflating the cuff risks loss of the airway.

Question 36Evaluation and Assessment

Which tool is used to document a patient's level of consciousness in a standardized way?

  1. The Glasgow Coma Scale Correct answer.
  2. The Braden Scale
  3. The Apgar Score
  4. The Visual Analog Scale

Explanation

The Glasgow Coma Scale standardizes assessment of eye, verbal, and motor responses. The Braden Scale assesses pressure injury risk, the visual analog scale measures pain, and the Apgar score assesses newborns.

Question 37Evaluation and Assessment

Which laboratory value best reflects recent nutritional status relevant to wound healing?

  1. Serum sodium
  2. Serum creatinine
  3. Serum bilirubin
  4. Serum prealbumin Correct answer.

Explanation

Prealbumin has a short half-life and reflects recent protein-calorie status better than longer-lived markers such as albumin. Sodium, bilirubin, and creatinine reflect electrolyte, hepatic, and renal status rather than nutrition.

Question 38Evaluation and Assessment

Which test is used to confirm carbon monoxide exposure?

  1. Troponin level
  2. Serum lactate level
  3. Carboxyhemoglobin level Correct answer.
  4. D-dimer level

Explanation

Carboxyhemoglobin measurement directly quantifies carbon monoxide bound to hemoglobin. Lactate may be elevated but is nonspecific, and troponin and D-dimer assess different processes.

Question 39Evaluation and Assessment

Which medication in a patient's history most increases the risk of pulmonary oxygen toxicity during a prolonged course of hyperbaric oxygen therapy?

  1. Metformin
  2. Bleomycin Correct answer.
  3. Atorvastatin
  4. Levothyroxine

Explanation

Bleomycin is associated with increased pulmonary oxygen toxicity and warrants caution or dose adjustment in hyperbaric oxygen therapy. Metformin, atorvastatin, and levothyroxine are not associated with this risk.

Question 40Evaluation and Assessment

Which set of findings is most useful for assessing perfusion of a skin flap after hyperbaric treatment?

  1. Flap size, patient weight, and urine output
  2. Flap color, refill, and temperature Correct answer.
  3. Patient's pain score and appetite
  4. Serum potassium and chloride levels

Explanation

Flap color, capillary refill, and temperature are bedside indicators of flap perfusion. Size, weight, urine output, pain, appetite, and electrolytes do not directly assess flap circulation.

Question 41Evaluation and Assessment

A patient has a generalized seizure during hyperbaric treatment. After the seizure stops, which assessment is the priority?

  1. Deep tendon reflexes
  2. Wound size and drainage
  3. Visual acuity
  4. Airway, breathing, and glucose Correct answer.

Explanation

Postictal assessment focuses on airway patency, breathing, and blood glucose because hypoxia and hypoglycemia can cause or worsen seizures. Wound, reflex, and vision checks are secondary.

Question 42Evaluation and Assessment

Which outcome measure best reflects the success of hyperbaric oxygen therapy for a diabetic foot ulcer?

  1. Complete wound closure during follow-up Correct answer.
  2. Patient's satisfaction with the chamber
  3. Number of treatments attended
  4. Change in resting heart rate

Explanation

The clinically meaningful endpoint for a diabetic foot ulcer is complete wound closure within a defined follow-up period. Attendance, satisfaction, and heart rate do not measure ulcer healing.

Question 43Evaluation and Assessment

Which test is most appropriate for evaluating the response of sudden sensorineural hearing loss to hyperbaric oxygen therapy?

  1. Pure-tone audiometry Correct answer.
  2. Tympanometry
  3. Otoacoustic emissions only
  4. Vestibular caloric testing

Explanation

Pure-tone audiometry quantifies hearing thresholds and is the standard measure of response in sudden sensorineural hearing loss. Tympanometry assesses middle ear function, caloric testing assesses vestibular function, and otoacoustic emissions alone do not quantify hearing level.

Question 44Evaluation and Assessment

A treatment is terminated early because the patient develops chest pain. Which documentation element is most essential?

  1. The chamber's maintenance log for the day
  2. Symptoms, vital signs, and provider notification Correct answer.
  3. Only the total minutes the patient spent in the chamber
  4. The patient's current insurance information

Explanation

Documentation of an unplanned termination must capture the symptoms, vital signs, actions taken, and notification of the responsible provider so the clinical event can be reconstructed and followed up. Time alone, insurance data, and maintenance logs do not document the clinical event.

Question 45Evaluation and Assessment

Which imaging study is generally preferred for detecting osteomyelitis in a diabetic foot?

  1. Ultrasound of the soft tissues
  2. Magnetic resonance imaging Correct answer.
  3. Plain radiography of the foot
  4. Computed tomography of the foot

Explanation

Magnetic resonance imaging has high sensitivity and specificity for bone marrow involvement in osteomyelitis. Plain films are often obtained first but are less sensitive early, CT is better for cortical bone, and ultrasound assesses soft tissue.

Question 46Evaluation and Assessment

Which method is used to estimate the percentage of total body surface area burned in an adult?

  1. The rule of nines Correct answer.
  2. The Glasgow Coma Scale
  3. The Mallampati score
  4. The Braden Scale

Explanation

The rule of nines assigns percentages to body regions and is widely used to estimate burn surface area in adults. The Glasgow Coma Scale assesses consciousness, the Braden Scale assesses pressure injury risk, and the Mallampati score assesses the airway.

Question 47Evaluation and Assessment

Which laboratory marker is most useful for monitoring the response of an infection to treatment?

  1. Alkaline phosphatase
  2. Serum calcium
  3. Hemoglobin A1c
  4. C-reactive protein Correct answer.

Explanation

C-reactive protein rises with acute inflammation and falls as infection responds to treatment. Calcium, hemoglobin A1c, and alkaline phosphatase do not track acute infection.

Question 48Evaluation and Assessment

During a treatment, a patient's oxygen saturation falls and the oxygen analyzer reading decreases while the patient remains awake. Which assessment is most appropriate?

  1. Reduce the treatment time by half
  2. Check the oxygen supply for a fault Correct answer.
  3. Increase the chamber pressure immediately
  4. Assume the patient is anxious and continue

Explanation

A simultaneous fall in saturation and in the measured oxygen concentration points to a delivery or supply problem, so the equipment should be checked first. Increasing pressure, assuming anxiety, or shortening the treatment does not address the cause.

Question 49Evaluation and Assessment

A patient scheduled for elective hyperbaric therapy reports new nasal congestion and ear fullness. Which action is most appropriate?

  1. Postpone and reassess after symptoms resolve Correct answer.
  2. Give a sedative and begin treatment
  3. Proceed with treatment and use a higher pressure
  4. Proceed but skip the descent phase

Explanation

New congestion and ear fullness suggest eustachian tube dysfunction, which raises the risk of barotrauma; elective treatment should be postponed and the patient reassessed. Proceeding, skipping descent, or sedating does not address the risk.

Question 50Evaluation and Assessment

Which assessment best evaluates the response of mandibular osteoradionecrosis to a course of hyperbaric oxygen therapy?

  1. Recording the patient's dietary preferences
  2. Pain, mucosal healing, and bone imaging Correct answer.
  3. Measuring the patient's grip strength
  4. Counting the total number of treatments delivered

Explanation

Response in osteoradionecrosis is judged by clinical improvement, including pain and mucosal healing, together with imaging evidence of bone change. Treatment count, grip strength, and diet preferences are not measures of bone response.