Title: Chapter 37: Test Generator Questions
Course: DEH 2821 Medically-Compromised Patient

Q: Pain perception relates to which of the following?
- In the brain it is interpreted as pain
- Highly variable between individuals with intact nervous systems
- Combination of the interpretation and the response to the pain message
- Accounts for the variability seen between patients
- Influenced by age, fatigue, emotional state, and learned behaviors
A: In the brain it is interpreted as pain

Q: It is not important to match the pain control method to the patient's treatment needs and medical status. All pain management techniques are more effective when utilized before the patient experiences pain.
- Both statements are true
- Both statements are false
- The first statement is true and the second statement is false
- The first statement is false and the second statement is true
A: The first statement is false and the second statement is true

Q: Mr. Jones is a new patient to your dental practice. He has very sensitive teeth and grips the chair when you start to put the mirror in his mouth. You put the instruments down and talk calmly with Mr. Jones for a few minutes before you start the scaling. By building a trust relationship, you let him feel in control without the use of pharmacologic techniques. Which of the five pain control mechanisms best describes the technique you utilized?
- Remove the painful stimulus
- Block the pathway of the pain message
- Raise the pain reaction threshold
- Depress the central nervous system
- Psychosedation methods (iatrosedation)
A: Psychosedation methods (iatrosedation)

Q: Which of the following medications is the drug of choice for dental pain?
- Ibuprofen
- Acetyl salicylic acid
- St. John's wort
- Morphine sulfate
- Acyclovir
A: Ibuprofen

Q: The diminution or elimination of pain in the patient experiencing conscious sedation is called:
- local anesthesia
- psychosedation
- topical anesthetic
- analgesia
- general anesthesia
A: analgesia

Q: Case Study 1
Mr. Jones is a 50-year-old male periodontal patient. He has been alternating scaling and root planing appointments every 3 months with your office and the periodontist. He has nitrous oxide sedation at each visit and says that it is the only way a hygienist can touch him. He suffers from stress-induced bronchial asthma and severe allergies. When you asked to review the medical history with him, he said that he had no changes other than an eye surgery last month.

Reference: Ref 37-1

Open and read the attached case to answer the following question. Which of the following is the best reason to justify the use of nitrous oxide sedation?
- The analgesic effect is most pronounced on the root surfaces of the teeth
- To help reduce his strong gag reflex
- To help prevent his stress-induced bronchial asthma
- To help prevent a heart attack
- To help prevent a stroke
A: To help prevent his stress-induced bronchial asthma

Q: Case Study 1
Mr. Jones is a 50-year-old male periodontal patient. He has been alternating scaling and root planing appointments every 3 months with your office and the periodontist. He has nitrous oxide sedation at each visit and says that it is the only way a hygienist can touch him. He suffers from stress-induced bronchial asthma and severe allergies. When you asked to review the medical history with him, he said that he had no changes other than an eye surgery last month.

Reference: Ref 37-1

Open and read the attached case to answer the following question. Mr. Jones's recent eye surgery a month ago required the use of Perfluoropropane and sulfur hexafluoride. Would nitrous oxide be contraindicated for this appointment?
- No, there is no problem since it was a month ago
- Yes, you need to wait 6 months after eye surgery
- Yes, you need to wait 8 weeks after use of Perfluoropropane
- Yes, you need to wait 8 weeks after use of sulfur hexafluoride
- Yes, you should never again use nitrous as vision damage could result
A: Yes, you need to wait 8 weeks after use of Perfluoropropane

Q: Case Study 1
Mr. Jones is a 50-year-old male periodontal patient. He has been alternating scaling and root planing appointments every 3 months with your office and the periodontist. He has nitrous oxide sedation at each visit and says that it is the only way a hygienist can touch him. He suffers from stress-induced bronchial asthma and severe allergies. When you asked to review the medical history with him, he said that he had no changes other than an eye surgery last month.

Reference: Ref 37-1

Open and read the attached case to answer the following question. You will start Mr. Jones on a 20% concentration. How soon could you assess this initial dose?
- 0 to 1 minute
- 1 to 2 minutes
- 2 to 3 minutes
- 3 to 4 minutes
- 4 to 5 minutes
A: 1 to 2 minutes

Q: Case Study 1
Mr. Jones is a 50-year-old male periodontal patient. He has been alternating scaling and root planing appointments every 3 months with your office and the periodontist. He has nitrous oxide sedation at each visit and says that it is the only way a hygienist can touch him. He suffers from stress-induced bronchial asthma and severe allergies. When you asked to review the medical history with him, he said that he had no changes other than an eye surgery last month.

Reference: Ref 37-1

Open and read the attached case to answer the following question. It is indicated in Mr. Jones's record that the concentration he needs is 35%. What percentage of patients fit into this dose requirement?
- 30%
- 40%
- 50%
- 60%
- 70%
A: 70%

Q: Case Study 1
Mr. Jones is a 50-year-old male periodontal patient. He has been alternating scaling and root planing appointments every 3 months with your office and the periodontist. He has nitrous oxide sedation at each visit and says that it is the only way a hygienist can touch him. He suffers from stress-induced bronchial asthma and severe allergies. When you asked to review the medical history with him, he said that he had no changes other than an eye surgery last month.

Reference: Ref 37-1

Open and read the attached case to answer the following question. You have just finished scaling Mr. Jones's teeth. You get up, take off your gloves, and rinse your hands off. The receptionist is waving at you to come up to the front desk. One of your morning patients is on the phone and wants to ask you a question. What should you do?
- Go to the phone since Mr. Jones has nitrous a lot and is okay
- Turn up the oxygen and then go to the phone to answer the question
- Stay in the room with Mr. Jones and tell the receptionist to take a message
- Pull the receptionist into the room to stand there while you go to the phone
- Ignore the receptionist until you are done with your patient
A: Stay in the room with Mr. Jones and tell the receptionist to take a message

Q: Case Study 1
Mr. Jones is a 50-year-old male periodontal patient. He has been alternating scaling and root planing appointments every 3 months with your office and the periodontist. He has nitrous oxide sedation at each visit and says that it is the only way a hygienist can touch him. He suffers from stress-induced bronchial asthma and severe allergies. When you asked to review the medical history with him, he said that he had no changes other than an eye surgery last month.

Reference: Ref 37-1

Open and read the attached case to answer the following question. Mr. Jones takes his mask off immediately when you finish scaling and says he has to use the restroom. When he stands up he complains of a headache and faints. What is the cause of his syncope?
- Inadequate oxygen in the alveoli
- Blood loss from your root planing appointment
- He simply got up too fast
- Postural hypotension
A: Inadequate oxygen in the alveoli

Q: Dental local anesthetic drugs can be divided chemically into two major groups, esters and amides. Except for topicals, all currently used anesthetic agents are amides.
- Both statements are true
- Both statements are false
- The first statement is true and the second statement is false
- The first statement is false and the second statement is true
A: Both statements are true

Q: What is the purpose of the vasoconstrictor in a local anesthetic cartridge?
- To increase the rate of metabolism
- To increase the duration of the anesthetic effect
- To decrease the depth and profoundness of the anesthetic
- To decrease the sensitivity to the anesthetic
- To prevent the risk of hemostasis
A: To increase the duration of the anesthetic effect

Q: All of the following are criteria for drug selection of local anesthetics except one. Which one is the exception?
- Duration of anesthesia required
- Medical status of the patient
- Preference of the dentist
- Potential for prolonged discomfort after treatment
- Potential for self-inflicted injury before anesthetic wears off
A: Preference of the dentist

Q: Mr. Jones is scheduled for scaling and root planing on the maxillary right quadrant. He currently has 4-mm pockets and very inflamed tissue. It appears as though he has an abscess on tooth #3. What effect would his dental conditions have on the use and effect of local anesthetics?
- Local anesthetic is not required for scaling and root planing
- An Oraquix dispenser is best in pockets for more profound anesthesia
- Increase the dose as inflamed tissue has a low pH, which inhibits anesthetic
- Try to use topical anesthetic since the pockets are only 4 mm deep
- Send the patient for a medical consultation prior to anesthetic use
A: Increase the dose as inflamed tissue has a low pH, which inhibits anesthetic

Q: Which of the following statements is true with respect to the gauge of the needle?
- They are ranked from largest to smallest, 25, 27, and 30 gauges
- The gauge of the needle refers to the length
- The 40-mm needle is used for most injections
- The 30-gauge needles are stiffer and deflect less as they penetrate
- The smaller-gauge needles provide easier and more accurate aspiration
A: They are ranked from largest to smallest, 25, 27, and 30 gauges

Q: Mr. Smith was in the office for scaling and root planing yesterday. The mandibular left quadrant was anesthetized with an amide anesthetic. He just called the office to complain that he cannot open his mouth very easily and his jaw is sore. What is the most common cause of this condition?
- Hematoma
- Paresthesia
- Epithelial desquamation
- Trismus
- Psychogenic reaction
A: Trismus

Q: Which of the following topical anesthetics is the most widely used topical agent and has the potential to cause an allergic reaction?
- Lidocaine
- Lidocaine hydrochloride
- Benzocaine
- Tetracaine hydrochloride
- Dyclone
A: Benzocaine