chapter 1,2,3 review question
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Apr 3, 2024
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Self-Study Review – Chapter 1 1.The best strategy for preventing medical emergencies in dental practice settings is keeping a medical emergency kit readily available because quick action is needed to save a life.
a.Both the statement and reason are correct and related.
b.Both the statement and reason are correct, but NOT related.
c.The statement is correct, but the reason is NOT.
d.The statement is NOT correct, but the reason is correct.
e.NEITHER the statement NOR the reason is correct.
2.
One of the best ways to anticipate a potential emergency when reviewing the medical history is to:
a.complete follow-up questions for all “yes” responses.
b.obtain a medical clearance for each client.
c.ask the client if he or she thinks an emergency is possible at the appointment.
d.verify information with the supervising dentist.
3.Clients may fail to provide complete medical history information as a result of all of the following reasons EXCEPT ONE. Which is the EXCEPTION?
a.Client does not understand question.
b.Feelings of invasion of privacy.
c.Client had assistance completing the form.
d.Client may skip questions.
4.Determining cardiac risk based on the client’s ability to perform daily activity describes:
a.cardiac equivalents.
b.functional capacity.
c.ASA risk classification.
d.vital signs.
5.A client presents with a medical history of obesity, smoking, diabetes, and hypertension. He is currently participating in weight loss and walking programs. What ASA classification does this client represent?
a.I
b.II
c.III
d.IV’
BP is most accurate if taken when the client is:
a.seated in a supine position.
b.seated in an upright position.
c.rested.
d.standing.
7.The ADA Council on Scientific Affairs recommends that BP be measured at the initial appointment. If the BP reading is within the normal limits, the client does not have hypertension.
a.Both statements are true.
b.Both statements are false.
c.The first statement is true, and the second statement is false.
d.The first statement is false, and the second statement is true.
8.A 12-year-old boy presents with a BP of 118/84 mm Hg, right arm, representing stage 2 hypertension. Treatment should be delayed until the BP is better controlled.
a.Both statements are true.
b.Both statements are false.
c.The first statement is true, and the second statement is false.
d.The first statement is false, and the second statement is true.
9.Your client presents with a BP of 148/86 mm Hg, right arm, sitting. Treatment considerations for this client include (circle all that apply):
a.performing routine dental or dental hygiene procedures.
b.delaying treatment until the BP is better controlled.
c.referring the client to a physician for a medical evaluation.
d.using a stress-reduction protocol during dental and dental hygiene procedures.
10.Your client presents with a BP of 165/100 mm Hg, right arm, sitting. Treatment considerations for this client include all of the following EXCEPT one. Which is the EXCEPTION?
a.Performing routine dental or dental hygiene procedures.
b.Delaying treatment until the BP is better controlled.
c.Referring the client to a physician for a medical evaluation.
d.Using a stress-reduction protocol during dental and dental hygiene procedures.
All of the following are true for a fast, irregular pulse EXCEPT one. Which one is the EXCEPTION?
a.The client is in excellent physical condition.
b.A potential medical emergency can occur.
c.A sign of cardiovascular instability.
d.High risk for cardiac arrest.
12.A client who presents with a pulse rate over 100 bpm and an irregular rhythm should be referred to a physician for medical evaluation because he may have bradycardia.
a.Both the statement and reason are correct and related.
b.Both the statement and reason are correct, but NOT related.
c.The statement is correct, but the reason is NOT.
d.The statement is NOT correct, but the reason is correct.
e.NEITHER the statement NOR the reason is correct.
13.During an emergency, the pulse should be taken from which artery?
a.Brachial
b.Carotid
c.Femoral
d.Radial
Normal respiration rate for adults is:
a.10–18 breaths per minute.
b.14–20 breaths per minute.
c.16–22 breaths per minute.
d.18–24 breaths per minute.
15.When evaluating respiration, the clinician should observe:
a.rate of respiration.
b.depth of respiration.
c.presence of sounds.
d.all of the above.
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16.An ultrasonic device to debride teeth can safely be used in a client with compromised respiration. Suction devices will eliminate aerosols and reduce the potential for contamination.
a.Both statements are true.
b.Both statements are false.
c.The first statement is true, and the second statement is false.
d.The first statement is false, and the second statement is true.
17.Normal body temperature ranges from:
a.95.8°F to 98.58°F.
b.95.8°F to 99.58°F.
c.96.8°F to 99.58°F.
d.97.8°F to 100.58°F.
18.Treatment considerations for a 10-year-old boy who presents with a body temperature of 100.5°F include all of the following EXCEPT one. Which one is the EXCEPTION?
a.Postponing treatment
b.Referral to a physician to identify the type of infection or illness
c.Asking the client to rinse with mouthwash before providing treatment
d.Identifying any temporary causes of elevated temperature
1.Define the following terms: BP, systolic pressure, diastolic pressure, pulse, respiration, functional capacity, and METs.
2.Why should all questions on the medical history form be answered?
3.What guidelines should be used when considering oral treatment for a client who presents with a BP of 180/100 mm Hg, right arm?
4.The majority of individuals taking antihypertensive medication continue to have
insufficient BP control. What is the clinical relevance of this finding?
5.According to the latest guidelines on screening for hypertension, at what age should the BP be measured in a dental office?
6.Describe the technique for taking the pulse during an emergency.
7.What information related to “quality” is needed before determining a client’s respiration status?
8.What is the risk of treating a client with an elevated body temperature?
Review Answers
1.Blood pressure (BP)—the pressure in the arteries when the heart beats and the pressure when the heart rests
Systolic BP—the pressure in the arteries when the heart beats
Diastolic BP—the pressure in arteries when the heart rests or between beats
Pulse—the heart rate or a reflection of the heartbeat
Respiration—the inhalation and exhalation of air
Functional capacity—the ability to complete various physical activities; a measure of cardiac risk assessment
Metabolic equivalents (METs)—a measure of the ability to perform common daily tasks
2.All questions on the medical history form should be answered to help predict potential medical emergencies.
3.Recheck BP after 5 minutes when client has rested; if still elevated, inform client of readings; refer for medical evaluation if dental procedure is stressful or if anesthesia is required; provide routine treatment; consider using a stress-
reduction protocol during oral health treatment; and keep appointments short.
4.Failure to adhere to antihypertensive therapy and lifestyle changes are factors that contribute to insufficient BP control.
5.BP should be measured routinely after age 3.
6.Palpate the carotid artery found in the middle of the neck along the sternocleidomastoid muscle.
7.Presence of sounds or noises, and depth of respirations.
8.Disease or infection transmission.
Case A
Mr. Farnsworth, a 48-year-old man, presents for a dental examination and restorative appointment. Before performing the examination, vital signs are measured. His pulse is 72 bpm, respiration is 16 breaths per minute, and BP measures 126/86 mm Hg, right arm. His height is 5′8” and weight is 200 lbs.
1.What category of BP does Mr. Farnsworth’s reading rate?
2.What health recommendations should be made on the basis of Mr. Farnsworth’s vital signs?
3.What dental considerations should be made when considering oral treatment for this client with his BP values?
Mr. Farnsworth returns for a dental hygiene appointment 1 year later. Upon updating the medical history, the clinician learns that this client had a myocardial infarction approximately 4 months ago. He is currently taking aspirin 81 mg and Norvasc daily, but he left his medication at home and cannot recall the dosage. Vital signs at this appointment are pulse 80 bpm, respiration 18 breaths per minute, temperature 97.8°F, and BP 145/88 mm Hg, right arm. When questioned about functional capacity, Mr. Farnsworth reports that he has difficulty climbing stairs, cannot dance or play tennis without shortness of breath, and has difficulty walking the dog more than a few blocks.
4.What category of BP does Mr. Farnsworth’s reading rate now?
5.Which ASA classification does this client represent?
6.Based on the client’s vital signs and METs, what treatment considerations should be made?
Answeres
1.Prehypertension
2.Lifestyle modifications including weight management and BP control
3.Routine dental treatment can be provided; remeasure BP at continuing care appointments as a screening strategy for hypertension
4.Mr. Farnsworth presents with stage 1 hypertension
5.Mr. Farnsworth presents with ASA classification IV.
6.Postpone elective treatment, such as a dental hygiene appointment, until his condition has improved and medical consultation verifies that he has moved to the ASA III category.
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Chapter 2 Self-Study Review
1.Screening questions on the medical history form concerning active TB are recommended by the:
a.Centers for Disease Prevention and Health Promotion.
b.Centers for Disease Control and Prevention.
c.National Institutes of Health.
d.National Center for Health and Disease Prevention.
2.Symptoms of active TB include all of the following EXCEPT one. Which is the EXCEPTION?
a.Persistent cough for > 3 weeks
b.Cough that produces blood
c.Unexplained weight gain
d.Flu-like symptoms
3.Mr. Cheng presents with a history of coughing up blood for 3 weeks. He had seen a physician, but does not know his diagnosis. What resource would you use to determine if this client was diagnosed with TB?
a.Centers for Disease Control and Prevention
b.National Institutes of Health
c.State agency for infectious diseases
d.Local public health department
4.A positive Mantoux skin test without symptoms indicates that the client is:
a.infected with the TB bacillus, but not contagious to others.
b.infected with the TB bacillus and has active disease.
c.infected with the TB bacillus and is contagious to others.
d.infected with the TB bacillus and immunocompromised.
5.Blood in the sputum of an individual infected with TB represents aerosols have infected and damaged blood vessels in the lungs. The client should be isolated and dental hygiene treatment should be postponed.
a.Both statements are true.
b.Both statements are false.
c.The first statement is true, and the second statement is false.
d.The first statement is false, and the second statement is true.
6.All of the populations are at a high risk of contracting TB EXCEPT one. Which one is the EXCEPTION?
a.People infected with HIV
b.Immigrants from third world countries
c.People with malignancies
d.People who are immunocompromised with diabetes mellitus
7. Redness is not a sign of a positive Mantoux skin test. Induration at the skin test site is a sign of a positive test.
a.Both statements are true.
b.Both statements are false.
c.The first statement is true, and the second statement is false.
d.The first statement is false, and the second statement is true.
8.A client diagnosed with active TB taking appropriate medications, should not be treated by a dental provider for 6 months because this level of drug therapy is needed to ensure that the disease is not resistant to the antimicrobial agents and that the client is no longer contagious.
a.Both the statement and reason are correct and related.
b.Both the statement and reason are correct, but NOT related.
c.The statement is correct, but the reason is NOT.
d.The statement is NOT correct, but the reason is correct.
e.NEITHER the statement NOR the reason is correct.
9.An office staff worker who has a positive Mantoux skin test and no symptoms of active TB disease is:
a.not contagious and can continue working.
b.not contagious, but cannot work for 3 weeks.
c.is contagious and cannot work for 3 weeks.
d.is contagious and may not work until the disease is controlled.
Chapter 3
Self-Study Review
1.From the following list, identify the four reasons for gingival bleeding during toothbrushing.
a.
Poor plaque control
b.Periodontal therapy
c.Orthodontic treatment
d.
Daily use of aspirin therapy
e.
Trauma
f.Blood dyscrasia
g.Fluoride therapy
h.Root caries
2.Xerostomia is a common finding associated with the aging process. This condition often results in an increase in caries.
a.Both statements are true.
b.Both statements are false.
c.The first statement is true, and the second statement is false.
d.The first statement is false, and the second statement is true.
3.A client presents with exposed root surfaces in the maxillary right posterior sextant. This finding most likely represents:
a.a past history of periodontal surgery.
b.evidence of dental decay.
c.a need for oral health education.
d.fear of dental treatment.
4.It is safe to use a rubber cup and polishing agent in areas that are decalcified because plaque removal will promote remineralization of the enamel.
a.Both the statement and reason are correct and related.
b.Both the statement and reason are correct, but NOT related.
c.The statement is correct, but the reason is NOT.
d.The statement is NOT correct, but the reason is correct.
e.NEITHER the statement NOR the reason is correct.
5.From the following list, identify the clinical findings associated with orthodontia.
a
.Enamel demineralization
b.Tooth sensitivity
c.TMJ dysfunction
d.External root resorption
e.Root caries
f
.Bruxism
g.Gingival recession
h.Xerostomia
Self-Study Review
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6.The most common emergency in the dental office is:
a.airway blockage.
b.hypertension.
c.hyperventilation.
d.syncope.
7.All of the following techniques may be used to reduce stress during oral health treatment EXCEPT one. Which one is the EXCEPTION?
a.Distraction
b.Antianxiety medication
c.Postpone the procedure
d.Conscious analgesia
8.Should a client experience syncope:
a.place in an upright position with the head between his/her knees.
b.lower the chair back and place the client in a supine position.
c.place the client in the Trendelenburg position.
d.raise the chair so the client’s head is higher than the heart.
9.Facial pallor, nausea, and disorientation are signs of which type of syncope?
a.Pre-syncope
b.Syncope
c.Syncope just before loss of consciousness
d.Post-syncope
10.The client most likely to experience hyperventilation during an oral health appointment is the:
a.child.
b.teenager or young adult.
c.mature adult.
d.older adult.
11.A prominent masseter muscle usually indicates:
a.bruxism.
b.ear infection.
c.neoplasia.
d.previous orthodontia.
12.What is the term that refers to the client’s reason for his/her dental or dental hygiene visit?
a.Dental problem
b.Chief complaint
c.Unsatisfied need
d.Motivational influence