Special Needs Final

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  1. When going over your clients health history you see that they marked "yes" for Rheumatic Heart Disease. You suspect that the client might have which cluster of signs/symptoms?
    Joint pain and subcutaneous nodules at the joints
  2. Does subendothelial myocardial infarction involve the rupture of the fibrous cap and arterial blockage?
    No
  3. Will necrotic tissue in the zone of infarction recover if blood flow is reestablished within 40 minutes?
    No
  4. Will tissue in the penumbra recover if blood flow is reestablished within 40 minutes?
    Yes
  5. Does angina respond to rest and nitroglycerin?
    Yes
  6. Does an MI infarction respond to rest and nitroglycerin?
    No
  7. You are seeing a new patient for the first time. What information should you gather?
    • Current medical status
    • Current vital signs
    • List of current medications
    • History of illness
  8. Your patient has a history of systemic hypertension and pulmonary edema. They complain that due to shortness of breath in a supine position, they are only able to sleep in their reclining chair. Other signs and symptoms include dyspnea, orthopnea, fatigue, cyanosis, and rales. They most likely have?
    Congestive Heart Failure: left ventricular failure
  9. Your patient with NO history of angina suddenly experiences intense chest pain during a dental office visit. You have followed the proper procedures for managing this emergency. What should be done immediately following activation of EMS?
    Administer oxygen and aspirin
  10. Atherosclerosis
    Can begin in childhood and is exacerbated by genetic and environmental factors
  11. As your young, healthy patient is walking with you back to your operatory you note they appear anxious. They self-report feeling suddenly light-headed and dizzy. What is your patient MOST likely experiencing
    Vasodepressor presyncope
  12. Your patient, who has a history of angina, is experiencing chest pain during a dental office visit. you have activated your office emergency team and halted dental treatment. You have assessed the patient is breathing with circulation. What should you do next?
    Administer sublingual nitroglycerin
  13. Your dental patient has a history of pulmonary semilunar valve stenosis and COPD. Currently, they present with shortness of breath, elevated systemic venous pressures, distended jugular veins and pitting edema in the lower extremities. They most likely have?
    Right ventricular failure
  14. Your patient, with no history of angina, suddenly experiences intense chest pain during a dental office visit. What should you do first?
    Terminate the dental procedure and activate the emergency medical systems
  15. Your patient is seated in your dental chair explaining that the reason they haven't been in for three years is due to their extreme fear of dental procedures. As you start to scale their teeth their eyes roll back in their head and they lose consciousness. What would most likely confirm that their syncopal even is related to psychogenic vasodepressor syncope?
    Their pulse has dropped from their base line of 76 to 52 beats per minute
  16. Can nitroglycerin effectively relieve the symptoms associated with stable angina?
    Yes
  17. Are renal disease and diabetes mellitus known causes of primary hypertension?
    No
  18. Is prinzmetal angina predictable and associated with the rupture of a fibrous plaque?
    No
  19. What is the most common medical emergency in the dental office?
    Transient loss of consciousness
  20. Which of the following is most LIKELY to put an individual at risk of syncope?
    • Mitral valve regurgitation
    • Mitral valve stenosis
    • Aortic valve stenosis
    • Rheumatic heart disease
  21. Which of the following patients can safely take nitroglycerin for anginal pain?
    • 62-year-old woman with history of emphysema and Cushing's 
    • 72-year-old man with history of erectile dysfunction and currently taking Viagra
    • 56-year-old man with history of Addison's disease and a blood pressure of 89/62
    • All can safely take nitroglycerine for anginal pain
  22. During an MI, do men most commonly experience nausea and referred back pain as primary symptoms?
    No
  23. The first stage in the pathogenesis of atherosclerosis involves?
    Endothelial dysfunction and LDL accummulation
  24. Which client is at high risk for postural hypotension?
    • Female, Age 16, high school cross-country runner, radial pulse of 52 bpm
    • Female, Age 74, history of diabetes and chronic sinus syncope
    • Male, age 49, history of hypertrophic cardiomyopathy and atrial fibrillation
    • Male, age 37, history of PTSD and anxiety
  25. What is the correct sequence for the CHAIN OF SURVIVAL in regards to cardiac arrest?
    Activation of EMS; early BLS/CPR; early defibrillation; effective advanced cardiac life support
  26. What should be used for the emergency treatment of delayed-onset, mild allergic skin reaction?
    Diphrenhydramine (Benadryl)
  27. Which statement is false regarding TB?
    • TB is spread by droplet transmission
    • A client with latent TB is asymptomatic
    • A client with latent TB is non-infectious
    • Once diagnosed, TB is typically treated with a 10-day course of antibiotics
  28. As this disease progresses, the patient demonstrates increased mucus production related to mucous gland hyperplasia. They exhibit a chronic, productive cough of 3 months duration for at least 2 consecutive years. The diagnosis is?
    Chronic obstructive bronchitis
  29. What is the correct definition of status asthmaticus?
    Bronchospams that persists despite the administration of 2 doses of bronchodilator
  30. Activation of the baroreceptor reflex due to a drop in blood volume during the non-progressive stage of shock is an example of?
    Neural compensation
  31. Intrinsic asthma
    • Is precipitated by non-allergic factors
    • Usually develops in adults older than 35
  32. As recommended by the CDC, dental patients with tuberculosis should only be treated if?
    • They are not in the coughing stage
    • They have been on anti-tuberculosis medications for at least 3 weeks
    • They have had 3 consecutive negative sputum smears on different days.
  33. What is NOT an effect of epinephrine administration?
    Decrease in systolic blood pressure
  34. Individuals with what kind of asthma have histories of allergies?
    Extrinsic
  35. Hyperventilating patients should be instructed to?
    Breathe into a paper bag
  36. Rapid breathing, precordial pain, muscle cramping, peripheral paresthesias, muscle tetany are noted in what?
    Hyperventilation
  37. Acute asthma is characterized by?
    • Respiratory smooth muscle spasm
    • Inflammation and edema of bronchial mucosa
    • Mucus hypersecretion
  38. What is an indication for use of a combination chest thrust/back blows (slaps)?
    Total airway obstruction in a conscious infant
  39. During irreversible stage of shock, are interventional therapies sufficient to save a person's life?
    No
  40. What is shock?
    A clinical syndrome resulting from inadequate tissue perfusion
  41. During progressive shock, do compensatory mechanisms become ineffective and fail to maintain cardiac output?
    Yes
  42. During nonprogressive shock, do homeostatic negative feedback mechanisms allow for successful compensation/
    Yes
  43. What is used by patients with asthma to PREVENT acute episodes of bronchospasm?
    Corticosteroid inhalers
  44. IgE antibodies are primarily involved in?
    Anaphylactic reactions
  45. Asthmatic patients, as a group, may be sensitive to what, contained in dental local anesthetic cartridges?
    Bisulfite preservative for the vasoconstrictor
  46. Urticaria and pruritus indicate?
    An allergic reaction
  47. The signs and symptoms (wheezing, breathlessness, cough, chest tightness) of this pathology may be triggered by allergens, exercise or dander
    Bronchial asthma
  48. Your adult client takes a prophylactic dose of penicillin just prior to treatment. While in the chair they exhibit rapid onset of respiratory distress and a drop in BP. Additionally, their skin demonstrates erythema, urticaria, and pruritus. What would NOT be indicated in this scenario?
    Retrieve the defibrillator from the front reception area
  49. What would contribute to an exacerbation of shock?
    • Bradykinin
    • Prostacyclin
    • Histamine
  50. Contact dermatitis would be an example of what?
    Cell-mediated hypersensitivity
  51. What are signs typically associated with active TB?
    • Chest pain
    • Coughing up blood or sputum
    • Weakness or fatigue
    • Night sweats
  52. Is distributive (vasogenic) shock related to factors that increase vascular tone?
    No
  53. Cardiogenic shock
    • Often caused by MI
    • only 15-20% of patients survive
  54. Hypovolemic shock
    • Most common form of shock
    • Caused by loss of blood volume
  55. Anaphylactic shock
    Due to the presence of inflammatory mediators in blood
  56. What questions should be asked of the patient with asthma during the medical history review?
    • When was your last acute asthma attack
    • What triggers your asthma
    • Have you been hospitalized for asthma
    • Do you have your inhaler with you today
  57. What is the most common cause of chronic obstructive bronchitis?
    Inhalation of cigarette smoke
  58. Can individuals with emphysema recover with smoking cessation and proper medical management?
    No
  59. What is pursed-lip expiration and weight loss a sign of?
    Emphysema
  60. Is nitrous oxide-oxygen sedation the choice in patients with severe emphysema?
    No
  61. What is the most common predisposing factor for hyperventilation?
    Acute anxiety
  62. An acute asthma attack is commonly treated with inhaled?
    Beta-2 agonist
  63. When an object enters the oropharynx of a patient seated in the supine position and it is still visible, you should do what?
    Move the chair into a more reclined position while the assistant picks up the intubation forceps
  64. Is Beclomethasone (Beclovent, Qvar) the most effective immediate management of acute episodes of asthma?
    No (false)
  65. Is nitrous oxide-oxygen sedation considered a respiratory depressant or bronchial irritant?
    Is it safe to use in managing anxious patients with asthma?
    • No it is not a depressant/irritant
    • Yes, it is safe to use in managing anxious patients with asthma
    • (true)
  66. Are tachypnea, diaphoresis, slow heart rate and use of accessory respiratory muscles signs of an acute asthma attack?
    No (false)
  67. Is prophylactic administration of aspirin advised for asthmatic patients with nasal polyps and pansinusitis?
    No (false)
  68. What is true regarding peptic ulcer disease?
    • Well defined break in the gastrointestinal mucosa greater than 3 mm in diameter
    • Presents as epigastric pain described as burning or gnawing
    • Bloody stools or black tarry stools indicate gastrointestinal hemorrhage
  69. is the primary causative agent of peptic ulcer disease a gram-positive, rod-shaped bacterium that is spread via droplet transmission?
    No
  70. What is the primary causative agent of peptic ulcer disease?
    • H. pylori
    • NSAIDs
  71. What is H. pylori and how is it transmitted?
    • Gram-negative, spiral shaped flagellated bacterium residing on the surface of the gastric epithelium
    • Can live in the stomach indefinitely, able to survive acidic environment
    • Transmitted via fecal-oral route
  72. Psuedomembranous colitis
    • Bacterial toxins lead to mucosal necrosis of the GI
    • Causative agent is C. difficile
    • Associated with high doses of antibiotics or long regimens, indicating a need for judicious administration of antibiotics by the medical and dental communities
  73. Is pseudomembranous colitis highly contagious?
    Yes, the causative agent survives well on environmental surfaces
  74. Your patient Hal is a large adult male. At the beginning of treatment you took an alginate impression of his dentition. What medication and what initial dose should be administered to your patient when he begins to experience a mild allergic skin reaction at the end of his appointment?
    50 mg oral Bendryl
  75. Acute asthma is characterized by?
    • Respiratory smooth muscle spasm
    • Inflammation and edema of bronchial mucosa
    • Mucus hypersecretion
  76. Your patient Jim presents with a history of semi-regular alcohol consumption and a recent diagnosis of peptic ulcer disease with NO presence of H. pylori. His only current medication is famotidine (Pepcid) prescribed to treat his condition. The dentist has performed her exam and recommended antibiotics to treat infection of #30. The patient states he has taken 4 ibuprofen (NSAID) 304 times daily for the past two weeks for pain, and would like to continue this until pain subsides. What are your potential concerns regarding this patient?
    • The patient's peptic ulcer medication famotidine (Pepcid) may lead to xerostomia
    • The patient's alcohol consumption and use of ibupofen  may result in gastrointestinal bleeding
  77. What describes type I diabetes?
    Deficit in insulin secretion
  78. Why should all health care providers be vaccinated against hepatitis B?
    • There is no treatment once infected
    • Chance of contracting HBV after accidental needle stick is about 40%
    • HBV may be carried in patient aerosolized secretions
  79. The primary therapeutic value of nitroglycerin is related to its ability to?
    Cause vasodilation
  80. You are seeing a recall patient that you have been providing routine hygiene care for during the last 2 years. You ask if there are any changes to her medical history and she replies "no." As you prepare to begin treatment you ask some additional questions. You inquire if the patient has been in the hospital since her last dental appointment 6 months ago. She replies "yes." With further questions you find out she was in the hospital 6 weeks ago after experiencing a 'mild' heart attack. What is your next course of action?
    Explain the need to reschedule this elective treatment until it has been at least 6 months after the myocardial infarction.
  81. Identify the PRIMARY steps in managing a syncope event in the proper order.
    • 1. Position patient supine with feet elevated
    • 2. Assess circulation, airway and breathing
    • 3. Administer oxygen
    • 4. Monitor patient vitals as they recover
    • 5. Slowly return patient to sitting position in the chair and attempt to determine the cause of the event
  82. List in order the steps in managing the following medical emergency. The patient is experiencing chest pain. There is no indication of heart problems listed on their medical history. They begin sweating, report pain in their arm and jaw and you notice pallor. The patient reports, "I will be fine in a minute, I think I have indigestion."
    • 1. Terminate treatment and place patient in a comfortable position
    • 2. Activate EMS
    • 3. Start oxygen and administer aspirin
    • 4. Monitor and record vitals
    • 5. Continue to monitor vitals until EMS arrives. Be prepared to begin CPR
  83. Do many medical conditions have similar characteristics?
    Yes
  84. Verbally reviewing the medical history with the patient prior to treatment allows the hygienist to identify areas of concern and potential emergencies?
    True
  85. Aspirin is a thrombolytic agent. Your patient is experiencing first time chest pain, and you suspect myocardial infarction. What is the proper dose and administration of aspirin for this patient?
    325 mg non-enteric coated, chewed and swallowed
  86. Chronic hyperglycemia seen in patients with diabetes leads to microvascular changes. What complications can be seen as a result of these changes?
    • Retinopathy
    • Accelerated atherosclerosis
    • Chronic kidney disease
    • Loss of tactile sensation
    • Peripheral vascular disease
    • Ulcers
    • Cataract
    • Glaucoma
    • Chronic infections
  87. What is the most common medical emergency complication of diabetes type I or II?
    Hypoglycemia
  88. Is cirrhosis of the liver only caused by excessive alcohol consumption?
    No
  89. In general, the cause for adult cardiac arrest is ventricular fibrillation. The cure is defibrillation. The best course of action for an unresponsive victim who is not breathing or only gasping is to?
    • Call 911 and get AED
    • Check pulse
    • Begin cycles of compressions and breaths
    • Attach AED upon arrival
  90. What are some signs or symptoms of myocardial infarction?
    • Pain described as heavy or crushing in the middle to upper sternum, can radiate to left arm, hand, epigastrium, shoulders
    • Shortness of breath, palpitations and nausea/vomiting
    • Cold sweat, weakness and faintness, dizziness
    • Back, neck and jaw pain
  91. If a patient has completely recovered from viral hepatitis are special drug or treatment planning modifications required?
    No
  92. If a patient has chronic active hepatitis, is consultation with a physician recommended for treatment planning?
    Yes
  93. If an adult is conscious and showing signs of airway obstruction, what is the proper order of steps to take?
    • Assess for airway obstruction
    • Perform abdominal thrusts
    • Call 911 if the patient becomes uncionscious
  94. What is the acceptable range for fasting blood glucose levels for a patient with diabetes?
    80-130 mg/dL
  95. Should a 2-hour postprandial blood glucose level of 200 mg/dL or higher be referred to a physician?
    Yes
  96. The signs and symptoms of this pathology may be triggered by allergens, exercise, or dander (wheezing, breathlessness, cough, chest tightness)?
    Bronchial asthma
  97. What are ways to prevent a diabetic emergency?
    • Advise the patient to take their insulin as usual
    • Advise the patient to monitor blood sugar levels at home
    • Have a blood glucose monitor available in the clinic
    • Maintain regular diet prior to appointment
    • Schedule morning appointments
    • Complete a thorough medical history with followup
  98. What is the most common contributing behavior to COPD?
    History of cigarette smoking
  99. COPD is a ___ respiratory disorder
    chronic
  100. During an emergency that requires CPR on an adult patient, which artery should be checked to assess for circulation?
    Carotid
  101. Where is H. pylori found and what is the concern with this?
    It may be found in dental plaque and can be a reservoir of infection along the digestive tract, leading to recurrence of peptic ulcers or difficulty in management
  102. What needs to be reviewed for a patient with peptic ulcer disease?
    Current medications AND antibiotics due to possible complications.
  103. CPR can be described as what?
    Emergency care performed to restore and maintain breathing and circulation and to provide oxygen and blood flow to the heart, brain and other vital organs.
  104. What is the most common cause of airway obstruction in an unresponsive patient?
    Tongue
  105. What is the best way to lift the tongue away from the back of the throat?
    Use the head tilt-chin lift if there is no apparent neck injury.
  106. For patients with Crohn's disease and ulcerative colitis, when should elective dental procedures be performed?
    During periods of remission
  107. Patients with Crohn's disease or ulcerative colitis have a tendency toward developing?
    Aphthous-like ulcers
  108. What oral conditions are potential complications of peptic ulcer disease?
    • Fungal infections with antibiotic use
    • Enamel erosion related to regurgitation of gastric secretions
    • Xerostomia with regular use of Pepcid
    • Vascular malformation of the lip
  109. What is the most common cause of cardiac arrest?
    Coronary artery disease
  110. A 52-year old man with diabetes II that is well controlled arrives for a 9 am appointment for extraction. He has taken his oral medication as usual. He was advised by a friend not to eat before having oral surgery. He is given an injection of lidocaine containing 1:100,000 epi to block the IA nerve. About 5 minutes after the injection he has the following symptoms: sweating, pallor, hunger, trembling, headache, dizziness and weakness. His pulse rate is 105 and BP 135/85. Symptoms do not improve after placed supine. What is the most probable condition?
    Hypoglycemia
  111. Signs and symptoms of pseudomembranous colitis
    • Fever
    • Diarrhea
    • Abdominal pain
  112. Signs of mild hypoglycemia include?
    • Confusion
    • Disorientation
    • Nausea
    • Irritability
    • Hunger
    • Weakness
    • Pallor
  113. When should there be concern/management of hypoglycemia?
    As soon as symptoms are noted
  114. Baseline data includes what?
    • Respiration
    • BP
    • Pulse
  115. Signs/symptoms of inflammatory bowel disease
    • Diarrhea
    • Nutritional deficiencies
    • Fluid imbalances
    • Fever
    • Weight loss
    • Tenderness over area of inflamed bowel
  116. What medication is most commonly used to treat diabetes type II?
    Glucophage (metformin)
  117. What medication is most commonly used to treat asthma?
    Albuterol
  118. What medication is most commonly used to treat myocardial infarction?
    Aspirin
  119. What medication is most commonly used to treat peptic ulcer disease?
    Omeprazole (Prilosec)
  120. What medication is most commonly used to treat anaphylactic shock?
    Epinephrine
  121. What medication is most commonly used to treat diabetes type I?
    Insulin injections (Humalog)
  122. What medication is most commonly used to treat angina?
    Nitroglycerine
  123. Which of the following is false regarding dental management concerns for the patient with hepatitis?
    • Patients with cirrhosis are at increased risk of esophageal varices
    • Patients with alcoholic liver disease should avoid the use of alcohol mouth rinses
    • Patients with cirrhosis and/or alcoholic liver disease are at increased risk of clot formation
    • Patients with cirrhosis and/or alcoholic liver disease are at increased risk of plaque and calculus formation
  124. For a conscious patient experiencing a hypoglycemic reaction, what is the indicated medical emergency management of this situation in a dental office?
    Position the patient upright and administer 3-4 oz of oral carbohydrates every 5-10 minutes until the patient recovers.
  125. What can be used to help manage almost any urgent medical emergency?
    Oxygen
  126. What are the 2 primary causes of peptic ulcer disease?
    • Regular use of NSAIDs
    • Infection by H. pylori bacteria
  127. A patient reports a history of angina on their medical history form. They are experiencing pain or pressure in the chest area during dental treatment. What is an appropriate management technique for this patient?
    Administer 1 tab or spray of sublingual nitroglycerin (a maximum of 3 tabs or sprays in 10 minutes)
  128. What is the proper order of steps for the management of anaphylactic shock?
    • Position patient in supine position with feet elevated
    • Assess circulation, airway and breathing
    • Activate EMS
    • Administer epinephrine
    • Administer oxygen
    • Monitor vitals
  129. What are signs/symptoms of acute viral hepatitis?
    • Jaundice
    • Pruritus
    • Myalgia
    • Lethargy
    • Arthralgia
    • Anorexia, nausea/vomiting
    • Abdominal pain
    • Fever
  130. What is one of the most important steps in managing a medical emergency?
    Establishing/maintaining an airway
  131. Oral complications of uncontrolled diabetes mellitus may include?
    • Xerostomia
    • Poor wound healing
    • Higher incidence of periodontal disease/gingivitis
    • Increased risk of caries
    • Oral abscesses, Lichen planus, candidiasis
  132. What A1c reading in a patient with diabetes indicates it is well controlled?
    Less than 7%
  133. The ___ the A1c, the higher the risk of developing complications related to diabetes?
    Higher
  134. Your patient is a 65-year-old woman with poorly controlled diabetes type I. She has active periodontal disease. What are appropriate components of her periodontal treatment plan?
    • Educate the patient regarding the correlation between poorly controlled diabetes and the impact on oral health
    • Reinforce the importance of good personal hygiene
  135. Occurs during pregnancy and can be an indicator for later development of diabetes type II.
    Gestational diabetes
  136. Destruction of pancreatic beta cells leading to insulin deficiency.
    Diabetes type I
  137. Characterized by insulin resistance and a progressive insulin secretory deficit.
    Diabetes type II
  138. Dependent on exogenous insulin.
    Diabetes type I
  139. Typically non-insulin dependent and insulin resistance develops later in life.
    Diabetes type II
  140. Strong correlation with obesity, diet and sedentary lifestyle.
    Diabetes type II
  141. Accounts for 10% of the cases of diabetes.
    Diabetes type I
  142. Tends to occur in young, lean individuals, with onset usually before age 30
    Diabetes type I
  143. Acetone (fruity, sweet) breath
    Diabetic ketoacidosis
  144. Hot, dry appearance of the skin
    Diabetic ketoacidosis
  145. Rapid onset of symptoms
    Hypoglycemia
  146. Slow onset of symptoms
    Diabetic ketoacidosis
  147. Sweaty, cold, wet appearance to skin
    Hypoglycemia
  148. Modes of action of epinephrine in treating anaphylactic shock
    • Alpha 1 receptors on vascular smooth muscle causing vasoconstriction
    • Beta 1 receptors on SA node of the heart increasing heart rate
    • Beta 2 receptors on bronchial smooth muscle causing bronchodilation
  149. When considering medical emergencies in the dental office, who is most likely to have some type of emergency event?
    It can happen to anyone at any time.
  150. What is the proper interval for rescue breaths for an adult?
    1 breath every 5-6 seconds.
  151. What condition can be caused by taking bisphosphonates, a common medication for osteoporosis patients?
    Osteonecrosis of the jaw
  152. Which of the following is NOT appropriate home care instruction for the parent of a young child?
    • Select a time for brushing and flossing when the child is very tired, as they will be too tired to object
    • The infant's mouth should be wiped daily with gauze prior to tooth eruption
    • Toddler's teeth should be brushed daily with water up until age 2
    • Children age 2-5, and some even older, do not have the manual dexterity to provide effective homecare
    • Appropriate levels of topical and systemic fluoride are beneficial in preventing tooth decay in children
  153. What are barriers to infant and toddler dental care?
    • Parent fear of the dentist
    • Parent lack of knowledge about prevention and understanding of how bacteria is transmitted
    • Cost of care and/or lack of insurance
    • Lack of transportation and/or parents cannot take time off work for appointments
  154. What are important factors to teach the patient with dentures?
    • Dentures need to be readjusted, repaired, relined and remade periodically
    • Dentures should be cleaned after each meal and oral mucosa should be gently brushed or massaged daily
    • Dentures need to be left out of the mouth overnight to provide "rest" for the oral tissues
  155. Is it safe to scale and polish during the first trimester of pregnancy?
    Yes
  156. During all trimesters of pregnancy, should only urgent care be provided?
    No (false)
  157. Which of the following statements is NOT true regarding Supine Hypotensive Pregnancy Syndrom?
    • It is caused by the compression of the aorta by the uterus in the pregnant patient
    • Signs and symptoms include bradycardia, sweating, nausea and weakness
    • It can result from lacing the pregnant client in the supine position for too long
  158. What are appropriate treatment plan modifications for the pregnant patient?
    • Educate the patient regarding rinsing with water after episodes of regurgitation to minimize enamel erosion
    • Implement dental hygiene care and education early in the pregnancy to optimize patient health and minimize oral infections
    • For pregnant patients with periodontitis, provide education regarding the link between periodontitis and preterm delivery and low birth weight babies
  159. Root surface caries is a major concern for the older adult patient. What are recommendations to reduce the risk for root surface cares?
    • Effective daily biofilm removal
    • Regularly scheduled maintenance procedures
    • Fluoride varnish application
  160. When providing care for an infant or toddler, what are key points of education regarding oral health to provide to the parent?
    • Babies and toddlers should never be put to bed with a bottle, unless it contains only water
    • Dental decay and gingivitis are transmissible from parent to child
    • Pacifiers should not be "cleaned" in the parent's mouth as bacteria is transmissible
  161. You have determined that an unresponsive child has an adequate pulse, but is not breathing or has very slow shallow breaths, and you should begin rescue breathing. What is the proper interval for rescue breaths for a pediatric patient?
    1 breath every 3 seconds resulting in visible chest rise
  162. Most pediatric medical emergencies in the dental environment are stress related (syncope, seizures, bronchospasm, hyperventilation). Emergencies associated with local anesthetic administration are much LESS likely to occur in a pediatric patient than with an adult patient.
    • The first statement is true
    • The second statement is false
  163. Female patients should all be screened for the possibility of pregnancy prior to taking radiographs, including girls of 12 and women over 50. Radiographic exposures of the pregnant patient are avoided unless they are required to diagnose and provide treatment
    Both statements are true
  164. Dementia is a progressive decline in cognitive function due to damage or disease in the brain beyond what is expected due to aging. patients with dementia exhibit deficits in memory, attention, language, and problem solving skills, which can lead to dependence on a caregiver for daily functioning
    Both statements are true
  165. Cardiac arrest in children is most often related to?
    Lack of adequate respiration
  166. If a child displays signs of poor perfusion (pallor, mottling, cyanosis) and pulse rate is less than ___ bpm, chest compression should be initiated.
    60
  167. What are some barriers to dental care for the geriatric patient?
    • Many live in a care facility or are confined to their home
    • They are often dependent on others for transportation
    • They often lack the finances or dental insurance to pay for services
    • Due to lack of formal education they may not understand the value of regular dental care
  168. Patients with dementia have high levels of oral disease because they are unable to adequately take care of their own oral hygiene. Caretakers typically have little to no training on management techniques for oral healthcare for patients with dementia.
    Both statements are true
  169. What is the main consideration for treating a patient with an implanted pacemaker?
    Electrical interference from dental devices such as ultrasonic scaling devices may interfere with the pacemaker.
  170. Is a pyogenic granuloma a benign tumor containing exudate and blood vessels with inflammatory cells?
    No
  171. Should memory lapses be exposed or confronted in order to clear up any patient confusion?
    No
  172. How should disruptive behavior and emotional outbursts be avoided?
    Not challenging the patient
  173. If disruptive behavior or physical attacks occur with dementia patients, what should you do?
    • Stay calm and composed
    • Seek the patient's caregiver
  174. When should dementia patient appointments be scheduled?
    During the time of day when they typically do their best, and ideally when the office is least busy
  175. What precautions should you make as a dental professional, to prevent a medical emergency relating to osteoporosis?
    Help the patient in and out of the dental chair to avoid falls
  176. When parents react towards the dental treatment of their child in a hysterical way, the child will most likely?
    Mirror their parents'behavior and become quite reactive
  177. What is not a potential denture-related oral change?
    Increased sensitivity to small objects in the mouth
  178. Oral treatment planning for older adults is based on what considerations?
    • Generally speaking, there is a higher degree of loss of attachment related to chronic periodontitis among older populations
    • The older adult population is at increased risk of chronic medical conditions and need for medications which contributes to oral disease
    • Older adults develop recurrent decay and root caries at a rate higher than younger adult populations
  179. What is the MOST common oral complication of pregnancy that is usually apparent by the second month?
    Pregnancy Gingivitis
  180. All of the following modifications to dental treatment are appropriate for the patient with cancer except...
    • shorter appointments to minimize patient fatigue
    • possible antibiotic prophylaxis
    • saliva substitute
    • fluoride varnish application
    • all of the answers are appropriate
  181. In a HEALTHY individual when the carotid baroreceptors are stimulated by stretch, external pressure or vigorous coughing, the result is?
    Produce systemic vasodilation
  182. Patients who undergo chemotherapy for acute leukemia are NOT at an increased risk for oral infections. All patients who undergo chemotherapy for cancer will experience oral complications that are directly related to chemotherapy drug activity.
    Both statements are false
  183. Hemophilia is a deficiency of what?
    serum proteins
  184. What ASA classification would be indicated for a patient with history of seizures that are well controlled by medication with no acute seizure within the past three months? There are no other significant medical history conditions.
    ASA II
  185. Patients with advanced HIV infections or AIDS may demonstrate all of the following lab values EXCEPT?

    A) decrease in CD4+ cells
    B) all answers are correct
    C) increased WBC count
    D) viral load of 500,000
    C) increased WBC count
    (this multiple choice question has been scrambled)
  186. Which of the following is NOT typically a sign or symptom of end-stage renal disease or chronic renal failure?

    A) Anemia
    B) Hypotension
    C) malnutrition
    D) hyperpigmentation of the skin
    B) Hypotension
    (this multiple choice question has been scrambled)
  187. What is the desired therapeutic INR range for a client taking Coumadin in order to prevent thromboembolism but minimize risk of excessive bleeding?
    2-3
  188. Which of the following is NOT an oral manifestation of HIV infection?

    A) Increased salivary flow
    B) Enlarged lymph nodes
    C) oral warts
    D) Kaposi's sarcoma
    A) Increased salivary flow
    (this multiple choice question has been scrambled)
  189. Your new patient Rhonda reports on her medical history that she chronically does not feel well, and she has not seen a physician or dentist in years. She experiences symptoms of weight loss, fever and malaise. She complains that her tongue has also been very "coated." Upon intra/extraoral exam, you note enlarged bilateral cervical and auricular lymph nodes. You also note her tongue is covered with white, curd-like plaques that wipe off. Lastly, you note a large red to purplish brown macule on the attached gingiva adjacent to #2-3. What do you suspect the two intraoral findings to be and what systemic condition do you suspect your patient is suffering from?
    • Pseudomembranous candidiasis
    • Kaposi sarcoma
    • HIV/AIDS
  190. After positioning the patient and quickly assessing circulation, airway, breathing, which of the following would be most important to do FIRST if your patient demonstrates signs of a stroke?

    A) Take the clients blood pressure
    B) Administer oxygen to the client
    C) Activate EMS
    D) Administer aspirin to the client
    C) Activate EMS
    (this multiple choice question has been scrambled)
  191. What pain medication is UNSAFE for a patient with hemophilia?
    Aspirin
  192. A patient with a history of seizures may have precipitating factors. The dental clinician's familiarity of these may help minimize the risk factors for the patient during treatment. Precipitating factors may include?
    • Sensory stimuli such as flashing lights, noises and peculiar odors
    • Depression
    • Anxiety and apprehension
  193. Side effects of HIV medications may include all of the following EXCEPT?

    A) Anemia
    B) Weakness and Fatigue
    C) Chest pain with inhalation
    D) Diarrhea
    C) Chest pain with inhalation
    (this multiple choice question has been scrambled)
  194. Before chemotherapy for the patient with cancer begins, patients should have all dental procedures, such as extractions, completed:
    At least one week prior to starting chemotherapy
  195. Which of these is NOT an effective way to speak with a patient who has suffered a stroke?

    A) Talk in a slower, less complex manner
    B) Raise your voice while talking
    C) Communicate at eye level
    D) Ask questions that can be answered with a yes or no
    B) Raise your voice while talking
    (this multiple choice question has been scrambled)
  196. Which of the following is NOT a recommended renoprotective strategy for slowing the progression of chronic kidney diseases?

    A) Glycemic control via dietary modifications and medications
    B) Lower lipids via dietary modifications and medications
    C) Increase of dietary protein intake
    D) Blood pressure control
    C) Increase of dietary protein intake
    (this multiple choice question has been scrambled)
  197. When should EMS be called if a patient is experiencing a seizure during dental care?
    If the seizure lasts 5 minutes
  198. Lupus is an autoimmune disease that mostly affects women?
    True
  199. Which of the following is NOT considered a major risk factor for a cerebrovascular accident?

    A) Atrial fibrillation
    B) Smoking
    C) Diabetes mellitus
    D) Hepatitis
    D) Hepatitis
    (this multiple choice question has been scrambled)
  200. Signs and symptoms of Lupus include what?
    • Butterfly rash across nose and cheeks, photosensitivity
    • Swollen joints, fatigue
    • Fever, weight loss
  201. (T/F) The client with a history of hemophilia is not at risk for hemorrhage after oral healthcare procedures. Most clients tolerate dental procedures well with medical management involving the administration of drugs to decrease bleeding or the infusion of platelets or plasma containing clotting factors.
    • The first statement is false
    • The second statement is true.
  202. What is the potential adverse effect of the seizure medication Dilantin (phenytoin)?
    Gingival hyperplasia
  203. The following are appropriate modifications of dental treatment for a patient with hemophilia EXCEPT:

    A) Use of aspirin or NSAIDs for pain control
    B) Possible medical consultation
    C) Use of a hemostatic agent as needed
    D) Patient education in thorough home care
    A) Use of aspirin or NSAIDs for pain control
    (this multiple choice question has been scrambled)
  204. What is the etiology of hemophilia?
    Genetic disorder
  205. (T/F) Management of a tonic-clonic seizure involves positioning the patient in the supine position with feel elevated, and administering oxygen and monitoring vitals for the postictal phase. During the ictal phase of a tonic-clonic seizure something soft like gauze or a towel should be placed in the mouth to prevent injury.
    • The first statement is true
    • The second statement is false
  206. Which if the following is a primary cause of chronic kidney disease?

    A) Smoking
    B) Hypotension
    C) Diabetes mellitus
    D) Pancreatitis
    C) Diabetes mellitus
    (this multiple choice question has been scrambled)
  207. If a patient with a history of seizures reports to you during treatment that they are beginning to experience their aura, what should you do?
    Remove instruments and obstructions away from the patient as they may be experiencing the beginning of a seizure.
  208. A(n) _____ consist of a solid mass of platelets and/or fibrin that forms locally in a vessel when the clotting mechanism is activated.
    Thrombus
  209. (T/F) Cancer can best be described as "a group of neoplastic diseases in which there is transformation of normal cells into malignant ones.
    True
  210. The clinical manifestations of this type of cerebrovascular accident features gradual onset of signs and symptoms; it also is frequently proceeded by transient ischemic attacks.
    Cerebral infarction
  211. (T/F) Absence seizures primarily occur in children and are characterized by a sudden blank stare and suppression of mental functions. A tonic-clonic seizure is the continuous or repetitive recurrence of seizure without recovery between attacks, and is life threatening
    • The first statement is true
    • The second statement is false
  212. Following a stroke or TIA, the patient must wait ____ before elective dental treatment.
    6 months
  213. (T/F) A medical consultation with the patient's physician is advised for the patient with lupus because complications of lupus can vary greatly, affecting multiple systems.
    True
  214. Blindness may be caused by which of the following?
    a. traumatic injury to the brain or eye
    b. age-related disorders
    c. congenital problems
    d. systemic diseases
    All of the above
  215. Which of the following communication techniques would NOT be appropriate when working with a patient with vision loss?

    A) Read the patient's paperwork aloud while protecting their privacy, and write in their repsonses
    B) Ask the patient if they would like assistance to the dental chair and guide them to the chair without pushing or pulling
    C) Speak loudly to the patient to make sure they hear you since they will be unable to use nonverbal communication.
    D) Ask the patient about the degree of visual function and what type of assistance they require
    C) Speak loudly to the patient to make sure they hear you since they will be unable to use nonverbal communication.
    (this multiple choice question has been scrambled)
  216. What modifications to care are appropriate for the patient with complete vision loss?
    a. describe each step of the dental procedure in detail prior to implementation
    b. allow the patient to feel scalers and explorers prior to use to familiarize them with the procedures
    c. interact with the patient's guide dog giving it positive feedback to ensure the animal is comfortable with you
    d. always verbalize to the patient prior to the use of power-driven instruments, compressed air or water
    e. demonstrate oral hygiene instructions in the patient's mouth allowing them to learn by feel
    • a
    • d
    • e
  217. What modifications to care are appropriate for the patient with partial vision loss?
    • Do not tilt patients with glaucoma back too far in the dental chair as this may increase pain and pressure in the eyes
    • Avoid glare of the dental light in the patient's eyes because sensitivity to light is common to many eye conditions
  218. Glaucoma
    • Change in eye pressure leading to peripheral vision loss,
    • Can cause total blindness
  219. Cataracts
    Clouding of the lens leading to loss of visual detail
  220. Vision loss related to stroke
    • Spatial distortions,
    • Dimness,
    • Loss of half the field of vision,
    • Double vision
  221. Retinitis pigmentosa
    • Vision decrease at night,
    • Loss of peripheral vision,
    • Blind spots,
    • Progresses to loss of central vision
  222. Macular degeneration
    Loss of central vision but not peripheral
  223. (T/F) It is easy to determine which patients have auditory challenges based on a review of current medications
    False
  224. (T/F) When providing dental hygiene care for a patient with a hearing aid, it should be turned off or removed during use of an ultrasonic scaler
    True
  225. Partial deafness may not be diagnosed or recognized by the patient. Which of the following is NOT a characteristic suggestive of hearing loss?
    a. Failure to respond to conversation
    b. Turning head to one side when listening
    c. Giving an answer unrelated to the question
    d. asking others to repeat what was said
    All are correct
  226. (T/F) For patients with partial hearing loss, it is important to speak clearly and eliminate background noises. When communicating with a patient who is a speech reader or who uses sign language, the speaker should exaggerate their works, but speak at a normal pace for best communication.
    • The first statement is true
    • The second statement is false
  227. Down syndrome
    Chromosomal abnormality
  228. Problems with social interactions, verbal and nonverbal communication
    Autism spectrum disorder
  229. Like attention and need affection for sense of security
    Down syndrome
  230. Compulsive behavior and atypical responses to environment
    Autism spectrum disorder
  231. Exact cause unknown, possibly related to genetics, viruses, chemicals or inadequate oxygenation at birth
    Autism spectrum disorder
  232. Sociable and cheerful with periods of stubborness
    Down syndrome
  233. Which if the following is NOT an oral finding related to Down syndrome?

    a. Mouthbreathing and tongue protrusion
    b. Angle's class III occlusion
    c. Microdontia and congenitally mission teeth
    d. increased periodontal infections
    All are true
  234. Which of the following are potential health problems significant to dental hygiene care for the patient with Down Syndrome?

    a. Obstructive airway problems related to macroglossia, increased secretions, respiratory infections or obesity
    b. Susceptibility to infections due to altered leukocyte function
    c. Congenital heart lesions that may require antibiotic premedication
    d. Pathologic brain changes later in life, similar to Alzheimer's disease
    All are correct
  235. For the patient with a developmental disorder, such as autism spectrum disorder, intellectual disorder or down syndrome, what modifications to dental care would NOT be appropriate?
    • Provide reinforcing rewards right after desired behavior is achieved
    • Conditioning of the patient prior o treatment by providing a plastic mouth mirror to practice with at home
    • Always orient the patient to the setting and equipment prior to use
    • Physically immobilize the patient that is uncooperative
    • Provide repetitive instruction in the form of "tell-show-do" utilizing patience and firmness
  236. What modifications to dental hygiene therapy would NOT be appropriate for the patient with schizophrenia?
    • Translate long-term goals into a series of realistic, short-term goals
    • Use a familiar, organized routine and create a restful atmosphere for dental visits
    • Use clear language and visual aids when providing homecare education
    • Orient the patient to reality when they express delusions or hallucinations
    • Set short appointments with frequent reminders of upcoming appointments
  237. What is NOT a potential oral consideration of depression?

    A) Loss of taste perception leading to increased intake of cariogenic foods
    B) Xerostomia related to the use of antidepressant medications
    C) Lack of general health habits and lack of oral care increasing risk of various oral infections
    D) All are potential oral considerations
    D) All are potential oral considerations
    (this multiple choice question has been scrambled)
  238. Which of the following is NOT an appropriate modification to dental care for the patient with bipolar disorder?

    A) Carefully review medications for potential oral complications
    B) Provide a comfortable, uncluttered environment
    C) Use simple, direct instructions and a positive attitude when providing oral hygiene education
    D) Recommend a longer interval between maintenance appointments because it will be difficult for the patient to come in regularly
    D) Recommend a longer interval between maintenance appointments because it will be difficult for the patient to come in regularly
    (this multiple choice question has been scrambled)
  239. Anorexia nervosa is characterized by all of the following except?

    A) Voluntary, severe restriction of food which may lead to life-threatening weight loss
    B) Intense fear of gaining weight even though underweight
    C) Affects only young women
    D) Perceptual disturbances relative to body image
    C) Affects only young women
    (this multiple choice question has been scrambled)
  240. (T/F) Bulimeia nervosa is a compulsive disorder characterized by recurrent episodes of uncontrolled binge eating. Patients with bulimia nervosa are typically underweight and always use purging to control their weight.
    • The first statement is true
    • The second statement is false
  241. Which if the following is NOT an oral complication of eating disorders?

    A. Trauma to soft palate
    B. Perimylosis
    C. Hypersensitive teeth
    D. Xerostomia
    E. Candida albicans
    E. Candida albicans
    (this multiple choice question has been scrambled)
  242. Which of the following would NOT be an appropriate modification to dental care for the patient with PTSD?

    A) Provide a soothing environment utilizing headphones, blanket, or other comfort devices as needed
    B) Get as close as possible to your patient during treatment and OHI so they know you are engaged in their care
    C) Minimize stress and potential triggers for anxiety
    D) Use caution with nitrous-oxide/oxygen sedation
    B) Get as close as possible to your patient during treatment and OHI so they know you are engaged in their care
    (this multiple choice question has been scrambled)
  243. Thorazine is used for?
    Schizophrenia
  244. Fluoxetine (Prozac) is used to treat?
    Depression
  245. Lithium is used to treat?
    Bipolar disorder
  246. Disulfiram (Antabuse) is used to treat?
    Alcoholism
  247. Which of the following factors does NOT increase an individual's risk for alcoholism?

    A) Genetics (family history)
    B) Cultural influences and beliefs
    C) All could potentially increase risk for alcoholism
    D) Schizophrenia
    C) All could potentially increase risk for alcoholism
    (this multiple choice question has been scrambled)
  248. All of the following are signs associated with alcoholism EXCEPT:

    A. Tremor of hands, tongue and eyelids
    B. Red, baggy eyes; puffy facial features
    C. yellowish skin
    D. Spider petechiae on the nose
    E. Fruity breath
    E. Fruity breath
    (this multiple choice question has been scrambled)
  249. Which of the following is NOT a potential complication of chronic alcohol abuse?

    A. brain damage
    B. liver failure
    C. Increased immune response/hypersensitivity reactions
    D. squamous cell carcinoma of the oral cavity
    E. malnutrition
    C. Increased immune response/hypersensitivity reactions
    (this multiple choice question has been scrambled)
  250. Which non-prescription street drug(s) act as a stimulant with the following acute effects? 
    A feeling of increased energy and mental alertness.
    Increased heart rate, respirations and metabolic activity
    • Cocaine
    • Methamphetamine
  251. Common oral manifestations of substance abuse may include all of the following EXCEPT:

    A. Chipped, fractured or eroded teeth
    B. Perforation of the palate
    C. Moderate to severe gingival inflammation
    D. Rampant carious lesions
    E. Excessive saliva production
    E. Excessive saliva production
    (this multiple choice question has been scrambled)
  252. Chronic long-term use of inhaled cannabis can cause all of the following EXCEPT:

    A. Increased periodontal infections
    B. Leukoplakia
    C. Decreased risk of premalignant oral changes due to beneficial pharmacologic properties
    D. Chronic bronchitis
    C. Decreased risk of premalignant oral changes due to beneficial pharmacologic properties
    (this multiple choice question has been scrambled)
  253. Generally people who abuse drugs and/or alcohol have increased risk of poor oral health and many serious medical complications. Dental care treatment planning considerations should include which of the following?

    a. Nutritional counseling to decrease risk of protein and vitamin deficiencies
    b. Use of alcohol free oral hygiene products and pre-procedural rinses
    c. Careful consideration of prescribing narcotic pain control
    d. Postponing all dental treatment until the patient has undergone appropriate rehabilitation therapy
    e. May need medical consultation for the patient with chronic, long-term substance abuse
    • a
    • b
    • c
    • e
  254. Which of the following modification to dental hygiene care would NOT be appropriate for the patient with a chronic substance abuse disorder?

    A. Always using an ultrasonic scaler for scaling and debridement due to increased efficiency of biofilm removal
    B. Explain procedures, speak and move slowly, and be cautious about invasion of personal space
    C. Consultation with patient's physician regarding need for antibiotic premedication
    D. Avoiding the use of local anesthetic with epinephrine in patients abusing stimulants such as cocaine
    E. Caution with or avoidance of nitrous-oxide/oxygen sedation
    A. Always using an ultrasonic scaler for scaling and debridement due to increased efficiency of biofilm removal
    (this multiple choice question has been scrambled)

Card Set Information

Author:
reccarynn
ID:
315026
Filename:
Special Needs Final
Updated:
2016-03-13 20:43:12
Tags:
DH139 LCC Nichols Special
Folders:

Description:
Cards are based on quiz questions from winter 2016, DH 139, Special Needs
Show Answers:

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