Mixed Deck — All CHS Topics Flashcards

A postmenopausal woman on hormone replacement therapy (HRT) is noted to have new-onset hypertension. Which component of HRT is primarily implicated?

Answer: Oral estrogens increasing hepatic angiotensinogen production

Oral estrogens stimulate hepatic angiotensinogen synthesis, increasing angiotensin II levels and causing sodium retention and hypertension; transdermal estrogen avoids first-pass hepatic effect.

In essential hypertension, increased sympathetic nervous system activity contributes to elevated blood pressure primarily through which mechanism?

Answer: Increased renal sodium retention and peripheral vasoconstriction

Sympathetic overactivity raises blood pressure by increasing peripheral vascular resistance through vasoconstriction and promoting renal sodium and water retention via beta-adrenergic stimulation of renin release.

A 58-year-old woman has office BP of 158/96 mmHg but normal ABPM (average 122/78 mmHg). This pattern is best described as:

Answer: White-coat hypertension

White-coat hypertension is characterized by elevated office BP with normal out-of-office (ABPM or home) readings.

Masked hypertension is defined as:

Answer: Normal office BP with elevated out-of-office (ABPM or home) BP

Masked hypertension occurs when office BP is normal but out-of-office measurements reveal true hypertension, carrying significant cardiovascular risk.

What are the five process groups in CHS project management?

Answer: Initiating, Planning, Executing, Monitoring & Controlling, Closing

The five groups cover the lifecycle: Initiating, Planning, Executing, Monitoring & Controlling, and Closing.

According to NFPA 99, which class of hyperbaric chamber is defined as a chamber intended for use by one patient who is not accompanied by a medical attendant?

Answer: Class B

NFPA 99 defines Class B chambers as single-occupancy units designed for one patient without an inside attendant, which is the standard monoplace configuration.

A patient reports that they feel fine and questions why they need regular BP monitoring if they are asymptomatic. Which educational approach best addresses this?

Answer: Explain that hypertension causes silent end-organ damage that symptoms do not predict

Hypertension causes progressive kidney, heart, and vascular damage without producing symptoms until advanced stages, making monitoring essential.

Which of the following best describes the purpose of an infection control risk assessment (ICRA) in a hyperbaric facility?

Answer: Identify and mitigate risks of healthcare-associated infections during construction or renovation

An ICRA is a multidisciplinary risk assessment used to identify infection risks introduced by construction, renovation, or maintenance activities in healthcare settings.

A CHS professional who fails to renew their credential but continues to represent themselves as certified is engaging in:

Answer: Fraudulent misrepresentation of credentialed status

Representing oneself as credentialed after expiration is dishonest and may constitute fraud, exposing the individual to disciplinary and legal consequences.

Which of the following patients represents an ABSOLUTE contraindication to hyperbaric oxygen therapy?

Answer: A patient with untreated pneumothorax

Untreated pneumothorax is an absolute contraindication because hyperbaric pressure can cause the pneumothorax to expand during decompression, leading to tension pneumothorax.

HBO2 therapy for idiopathic sudden sensorineural hearing loss (ISSNHL) produces the best outcomes when initiated within what timeframe?

Answer: Within 3 months of onset

Evidence supports initiating HBO2 for ISSNHL within 3 months of onset, with the greatest benefit seen in the first 2 weeks.

Which finding on 24-hour ambulatory blood pressure monitoring is most associated with increased cardiovascular risk in elderly hypertensive patients?

Answer: Non-dipping pattern (nocturnal BP fall <10%)

A non-dipping nocturnal BP pattern (fall <10% during sleep) is independently associated with increased left ventricular hypertrophy, proteinuria, and cardiovascular events in elderly patients.

What is the significance of the UHMS (Undersea and Hyperbaric Medical Society) approved indications list for patient safety?

Answer: It defines evidence-based conditions for which HBO has demonstrated safety and efficacy

The UHMS approved indications list defines evidence-based conditions where HBO has proven safe and effective, protecting patients from unnecessary or harmful treatments.

What does an 'intention-to-treat' (ITT) analysis in a hypertension RCT ensure?

Answer: All randomized patients are analyzed in their original groups regardless of adherence or dropout

ITT analysis preserves the benefits of randomization and provides a conservative, real-world estimate of treatment effectiveness by including all randomized participants.

A pregnant patient with suspected severe CO poisoning presents to the hyperbaric facility. The correct approach is:

Answer: Proceed with HBO2 because maternal and fetal benefits outweigh theoretical risks

Severe CO poisoning in pregnancy carries high fetal mortality risk, making HBO2 strongly indicated — benefits far outweigh theoretical fetal risks.

What is peer review in CHS Pharmacology & Medication Management?

Answer: Quality evaluation by qualified colleagues for improvement

Peer review provides objective assessment by qualified professionals to identify improvements and ensure accountability.

How long should a patient rest in a seated position before a blood pressure measurement is taken?

Answer: 5 minutes

AHA/ACC guidelines recommend at least 5 minutes of quiet rest before measurement to allow cardiovascular stabilization.

Which of the following wound types treated in a hyperbaric unit poses the greatest risk for gas gangrene (clostridial myonecrosis) transmission to staff?

Answer: Crush injuries with necrotic muscle tissue

Crush injuries with necrotic, anaerobic tissue provide the environment required for Clostridium perfringens proliferation and potential gas gangrene, requiring vigilant wound management.

The mnemonic VENTID is used in hyperbaric medicine to identify warning signs of:

Answer: Central nervous system oxygen toxicity

VENTID (Vision, Ears, Nausea, Twitching, Irritability, Dizziness) describes the prodromal signs of CNS oxygen toxicity preceding potential seizure.

Under the minimum necessary standard of HIPAA, a hyperbaric facility sharing records with a wound care nurse coordinator should:

Answer: Provide only the information relevant and necessary for the coordinated care purpose

HIPAA's minimum necessary standard requires that only the information needed for the specific care coordination purpose be shared, not the entire medical record.