Test Bank For Dental Hygiene Theory And Practice 4th edition By Michele Leonardi Darby

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Dental Hygiene Theory And Practice 4th edition By Michele Leonardi Darby

 

Chapter 01: The Dental Hygiene Profession

Darby & Walsh: Dental Hygiene: Theory and Practice, 4th Edition

 

MULTIPLE CHOICE

 

  1. What is the discipline of dental hygiene?
a. The study of teeth and their supporting structures
b. Brushing and flossing one’s teeth and rinsing with an antimicrobial mouth rinse twice a day, morning and night
c. The study of preventive oral healthcare, including the management of behavior to prevent oral disease and promote health
d. The study of those procedures that dental hygienists provide to clients

 

 

ANS:  C

The study of teeth and their supporting structures. This answer is wrong because the discipline of dental hygiene covers much more information than the study of teeth and supporting structures. Dental hygiene focuses on the preventive measures that the teeth and supporting structures must receive, in addition to other oral healthcare steps that must be taken to promote one’s health.

Brushing and flossing one’s teeth and rinsing with an antimicrobial mouth rinse twice a day, morning and night. This answer is wrong because this statement describes only one procedure within the discipline of dental hygiene. Dental hygiene is a much larger and general field of study than this simple preventive action.

The study of preventive oral healthcare including the management of behavior to prevent oral disease and promote health. This answer is correct because this is the direct definition of dental hygiene. The definition can be broken down into smaller, specified divisions to further develop the discipline of dental hygiene.

The study of those procedures that dental hygienists provide to clients. This answer is wrong because dental hygienists play many interrelated roles, such as clinician, educator, administrator or manager, advocate, and researcher. Although each of these roles is created to assist in dental hygiene, the discipline is not centered on the actions and procedures of the dental hygienist.

 

REF:   What is Dental Hygiene? | 1

 

  1. Who is the professional dental hygienist?
a. A licensed preventive oral health professional who has graduated from a Commission on Dental Accreditation, accredited, entry level dental hygiene program
b. A licensed person who has learned on the job via a preceptorship program, such as the Alabama Dental Hygienists Program
c. A dentist who has graduated from a Commission on Dental Accreditation, accredited, dental school program
d. A person who has graduated from a Commission on Dental Accreditation, accredited, dental assisting program

 

 

ANS:  A

A licensed preventive oral health professional who has graduated from a Commission on Dental Accreditation, accredited, entry level dental hygiene program. This answer is correct because to be eligible as a professional dental hygienist, the person must have graduated from an accredited dental hygiene program.

A licensed person who has learned on the job via a preceptorship program, such as the Alabama Dental Hygienists Program. This answer is wrong because a dental hygienist cannot learn on the job to become a professional. Rather, they must pass written examinations and graduate from an accredited dental hygiene program.

A dentist who has graduated from a Commission on Dental Accreditation, accredited, dental school program. This answer is wrong because a dentist has a higher degree than a dental hygienist and therefore, generally, works above a dental hygienist. It is not necessary for a dental hygienist to receive an education from a dental school.

A person who has graduated from a Commission on Dental Accreditation, accredited, dental assisting program. This answer is wrong because a person graduating from an accredited dental assisting program would only be licensed as a dental assistant.

 

REF:   Who Is the Dental Hygienist? | 1

 

  1. All of these services are provided by the majority of dental hygienists in the clinical setting except one. Which one is the exception?
a. Perform periodontal maintenance care.
b. Implement interventions to direct a person back to oral wellness.
c. Provide fluoride varnish treatment.
d. Place and remove restorations.

 

 

ANS:  D

Perform periodontal maintenance care. This is a service provided in the clinical setting. The clinical setting allows for application of preventive and therapeutic agents related to periodontal disease. For example: subgingival sustained-release delivery systems containing chlorhexidine.

Implement interventions to direct a person back to oral wellness. This is a service provided in the clinical setting. The main goal of a dental hygienist is to prevent oral disease and promote health. Therefore, if the state of an individual’s oral health changes, the dental hygienist (within the scope of the clinical setting) can provide some degree of intervention to direct the individual back to oral wellness.

Provide fluoride varnish treatment. This is a service provided in the clinical setting. The clinical setting allows for application of preventive and therapeutic agents related to dental caries. Fluoride varnish treatments prolong fluoride exposure on the tooth surface for safe and effective caries control.

Place and remove restorations. This service is not provided by the majority of dental hygienists in the clinical setting. Only a few dental hygienists have the certification to place restorations, while many others do not. Also, the removal of restorations is not a given action of a dental hygienist in the clinical setting.

 

REF:   Clinician | 3

 

  1. Which of the following is a key behavior within the dental hygiene process of care?
a. Observation
b. Diagnosis
c. Communication skills
d. Client care

 

 

ANS:  B

Observation. This answer is wrong because dental hygienists must go further than simply observing the client. The hygienist must assess the client by thoroughly collecting data.

Diagnosis. This answer is correct because identifying the diagnosis is the focal point for establishing goals in the dental hygiene care plan. The client’s dental hygiene needs are determined so that specific interventions can be implemented.

Communication skills. This answer is wrong because the communication skills are not a key behavior and are not necessary to complete the dental hygiene process.

Client care. This answer is wrong because client care is not one of the steps in dental hygiene care. However, proper client care is the goal being achieved through the key behaviors.

 

REF:   What Is the Dental Hygiene Process of Care? | 1

 

  1. Which of the following is not an environmental factor that the dental hygienist takes into account in the Human Needs Model?
a. Age
b. Attitudes
c. Lifestyles
d. Weight

 

 

ANS:  D

Age. This answer is an environmental factor that must be taken into account because age plays a large role in the development of an individual’s oral health.

Attitudes. This answer is an environmental factor that must be taken into account because it can have an effect on the dental hygiene process.

Lifestyles. This answer is an environmental factor that must be taken into account because an individual’s oral health can be affected by lifestyle choices.

Weight. This answer is not an environmental factor that must be taken into account because an individual’s weight does not affect their oral health. The diet choices that go along with a person’s particular weight may affect oral health, but the overall weight of an individual does not.

 

REF:   What Is the Dental Hygiene Process of Care? | 1

 

  1. Which of the following is not one of the seven roles of a dental hygienist?
a. Clinician
b. Public Health
c. Interpreter
d. Researcher

 

 

ANS:  C

The seven roles of a dental hygienist are clinician, public health, researcher, educator,

administrator, and entrepreneur.

 

REF:   Chapter One, Table 1-1 Seven Roles of the Dental Hygienist | 4

 

  1. What is a paradigm?
a. A widely accepted worldview of a discipline that shapes the knowledge of its practitioners, educators, administrators, and researchers
b. Decision-making skills that are used worldwide
c. A school of thought within a discipline
d. A widely accepted worldview of a discipline that shapes the direction and methods of its practitioners, educators, administrators, and researchers

 

 

ANS:  D

A widely accepted worldview of a discipline that shapes the knowledge of its practitioners, educators, administrators, and researchers. This answer is incorrect because a paradigm does not shape the knowledge but shapes the direction and methods of practitioners, etc.

Decision-making skills that are used worldwide. This answer is incorrect because a paradigm does not focus on decision-making skills that are accepted worldwide.

A school of thought within a discipline. This answer is incorrect because it is the definition of a conceptual model.

A widely accepted worldview of a discipline that shapes the direction and methods of its practitioners, educators, administrators, and researchers. This answer is correct because practitioners, educators, administrators, and researchers all accept this paradigm or worldview of discipline in major concepts selected for study and statements about major statements that define them in a global matter.

 

REF:   Dental Hygiene’s Paradigm | 5

 

  1. Which of the following is not one of the four major concepts of paradigm for the dental hygiene discipline?
a. Client
b. Health and oral health
c. Environment
d. Nutrition

 

 

ANS:  D

Client. This answer is a major concept of paradigm because the client is the recipient of dental hygiene care.

Health and oral health. This answer is a major concept of paradigm because the discipline of dental hygiene exists to promote oral health, which influences overall health.

Environment. This answer is a major concept of paradigm because factors other than dental hygiene actions affect the client’s attainment of optimal oral health.

Nutrition. This answer is not a major concept of paradigm because nutrition does not identify the phenomena central to the discipline of dental hygiene in an abstract global manner.

 

REF:   BOX 1-3: Four Major Concepts of the Dental Hygiene Paradigm | 6

 

  1. The importance of a conceptual model is to provide philosophic and practical perspectives about dental hygiene’s paradigm concepts. Dental hygiene’s paradigm is operationalized via the Human Needs Conceptual Model.
a. Both statements are true.
b. The first statement is true, and the second statement is false.
c. The first statement is false, and the second statement is true.
d. Both statements are false.

 

 

ANS:  A

Both statements are true. Conceptual models do provide philosophic and practical perspectives about dental hygiene’s paradigm concepts; however, the models can explain dental hygiene from different perspectives as well. Also, the Human Needs Conceptual Model defines the paradigm concepts.

The first statement is true; the second statement is false. Both statements are true.

The first statement is false; the second statement is true. Both statements are true.

Both statements are false. Both statements are true.

 

REF:   Conceptual Models | 6

 

  1. What occurs when individuals with differing strengths and areas of expertise work together as equal partners to achieve better outcomes than each would achieve working alone?
a. Implementation
b. Collaboration
c. Determination
d. Concentration

 

 

ANS:  B

Implementation. This answer is incorrect because by definition implementation is the act of putting something into effect. Implementing something can be done individually.

Collaboration. This answer is correct and is demonstrated in the Collaborative Practice Model, which assumes that dentists and dental hygienists work together as colleagues.

Determination. This answer is incorrect because determination does not require partners of differing strengths. Determination can be achieved individually by staying focused on the task at hand.

Concentration. This answer is incorrect because concentration is just maintaining a strong focus on the task at hand. Collaboration can be done more efficiently if the partners are concentrated but is not required.

 

REF:   Collaborative Practice Model | 6

 

  1. What is the collaborative practice conceptual model?
a. Dentist and dental hygienist work together as colleagues, each offering professional expertise for the goal of providing optimum oral healthcare to the public
b. Model describing the best methods of dentist and dental hygienist to work as a team
c. Model showing how collaboration produces better work
d. Dental hygienists and other healthcare professionals work together as colleagues, each offering professional expertise for the goal of providing optimum oral healthcare to the public

 

 

ANS:  A

Dentist and dental hygienists work together as colleagues, each offering professional expertise for the goal of providing optimum oral healthcare to the public.

Model describing the best methods of dentist and dental hygienist to work as a team. This answer is incorrect because the focus and main goal of the model is to provide optimum oral healthcare to the public, not to learn to work as a team.

Model showing how collaboration produces better work. This answer is incorrect because the model focuses on providing optimum oral healthcare to the public. Collaboration between a dentist and dental hygienist is just an assisting factor to reach optimum oral healthcare.

Dental hygienists and other healthcare professionals work together as colleagues, each offering professional expertise for the goal of providing optimum oral healthcare to the public. This answer is incorrect because the collaboration must be between a dentist and a dental hygienist. This plays a key role in establishing a co-therapist relationship within the Collaborative Practice Conceptual Model.

 

REF:   Collaborative Practice Model | 6-7

 

  1. Which is not one of the five interrelated roles of a professional dental hygienist?
a. Educator
b. Manager
c. Researcher
d. Clients

 

 

ANS:  D

Educator. This is one of the five interrelated roles of a professional dental hygienist. An educator explains concepts regarding oral health and disease, and their relationship to general health; demonstrates oral self-care procedures; determines client understanding; motivates behavior change; reinforces learning or desired behavior; and evaluates the client’s progress in learning.

Manager. This is one of the five interrelated roles of a professional dental hygienist. A manager’s position is to guide and direct the work of others. They do this by planning, making decisions, organizing, staffing, directing, and controlling.

Researcher. This is one of the five interrelated roles of a professional dental hygienist. A researcher tests the assumptions of clinical practice.

Clients. This is not one of the five interrelated roles of a professional dental hygienist. The client is the individual receiving oral healthcare from the dental hygienist.

 

REF:   Roles | 2-5

 

  1. According to the Occupational Model, the dental hygienist:
a. uses a process of care to assess needs, diagnose dental hygiene problems, and plan, implement, evaluate, and document dental hygiene care.
b. works together with the dentist, each offering professional expertise for the goal of providing optimum oral healthcare to the public.
c. is a dental auxiliary who implements treatment plans and carries out isolated duties as directed by the supervising dentist.
d. explains dental hygiene from different perspectives.

 

 

ANS:  C

The Occupational Model5 presents the concept of dental hygiene actions as technically based. According to this model the dental hygienist is a dental auxiliary who implements treatment plans and carries out isolated duties as directed by the supervising dentist.

 

REF:   Chapter One, Conceptual Models | 6

 

  1. Which of the following is not a setting for a dental hygiene researcher?
a. Clinical practice
b. Research institutions
c. Hospitals
d. Oral healthcare industry
e. Public school programs

 

 

ANS:  C

Clinical practice. This is a setting for a dental hygiene researcher because researchers are testing assumptions from clinical practices. Researchers may go to the clinical practice to assess the area of study.

Research institutions. This is a setting for a dental hygiene researcher because this is a place where research is the prime goal and source of employment. Researchers gather together here and are able to collaborate with one another if necessary.

Hospitals. This is not a setting for a dental hygiene researcher because a hospital is not primarily focused on oral healthcare, rather it is focused on the overall health of an individual. A researcher would not have the information or materials needed to do their studies.

Oral healthcare industry. This is a setting for a dental hygiene researcher because the oral healthcare industry is the field that they are studying or researching. By working within the oral healthcare industry, the researchers can make evidence-based decisions.

Public school programs. This is a setting for a dental hygiene researcher because this is a place where the researcher can transmit current concepts of health promotion and disease prevention to individuals and groups, and evaluate the educational outcomes.

 

REF:   Researcher | 3

 

  1. The three responsibilities of the dental hygiene clinician are:
a. preventive, therapeutic, educational.
b. manager, educator, researcher.
c. planner, organization of appointments, billing.
d. communicator, planner, researcher.

 

 

ANS:  A

Preventive, therapeutic, educational. This answer is correct because a dental hygiene clinician is expected to fulfill these areas. Preventive methods are created to promote health and prevent oral disease. Therapeutic methods are created to arrest or control oral disease. Educational methods are created to reinforce learning, evaluate understanding, demonstrate self-care techniques, determine ability to perform desired behavior, and explain oral disease and health concepts.

Manager, educator, researcher. This answer is incorrect because these are not responsibilities; instead they are roles that can be played by dental hygienists based on the degree of education.

Planner, organization of appointments, billing. This answer is incorrect because these are the responsibilities of an administrator or manager.

Communicator, planner, researcher. This answer is incorrect because these are the responsibilities of a researcher.

 

REF:   BOX 1-2: Responsibilities of the Dental Hygiene Clinician | 3

 

  1. What is an administrator or manager not doing when referring to dental hygiene?
a. Planning
b. Staffing
c. Financial work
d. Directing

 

 

ANS:  C

Planning. This is done by an administrator to acknowledge priorities and decide on appropriate continuing care intervals and self-care measures.

Staffing. This is done by an administrator to create a knowledgeable and stable staff, and to determine the line of authority and responsibilities of each co-worker.

Financial work. This is not done by an administrator because financial work does not relate to the job of an administrator, which is to guide and direct the work of others.

Directing. This is done by an administrator while managing a professional educational program and possibly serving as a dean for various schools.

 

REF:   Administrator | 5

 

  1. When considering the key roles of a dental hygienist, what does the client advocate most refer to?
a. A dental hygienist who is working with the state legislature to change the dental practice act
b. Dental hygienist’s role in protecting and supporting clients’ rights and well-being
c. A person whose official position is to guide and direct the work of others
d. A dental hygiene educator who is employed as a full-time faculty member

 

 

ANS:  B

A dental hygienist who is working with the state legislature to change the dental practice act. This answer is incorrect because it does not directly relate to the client.

Dental hygienist’s role in protecting and supporting clients’ rights and well-being. This is correct because the definition directly links to the client’s best interests.

A person whose official position is to guide and direct the work of others. This is incorrect because this is the key role of an administrator or manager.

A dental hygiene educator who is employed as a full-time faculty member. This is incorrect because this is a role of an educator.

 

REF:   What Is the Dental Hygiene Process of Care? | 1-2

 

  1. A dental hygienist keeps up-to-date with the rapidly changing art and science of dental hygiene by doing all of the following, except one. Which one is the exception?
a. Discussing updated techniques with other dental hygienists
b. Making evidence-based decisions
c. Using multiple research skills
d. Practicing at least part-time as a dental hygienist

 

 

ANS:  A

Discussing updated techniques with other dental hygienists. This is not done to stay up-to-date with the art and science of dental hygiene. Although discussing with other dental hygienists will draw conversation to new changes, further research and analyzing must be done to fully understand the rapid changes in the art and science of dental hygiene.

Making evidence-based decisions. This is done to stay up-to-date with the art and science of dental hygiene. By looking in-depth at scientific evidence, client preferences or values, clinical client circumstances, and experiences and judgment, dental hygienists can draw conclusions and remain up-to-date in the discipline of dental hygiene.

Using multiple research skills. This is done to stay up-to-date with the art and science of dental hygiene. Multiple research skills should be used to find relevant evidence and critical appraisal skills to rapidly evaluate and sort out what is valid and useful.

Practicing at least part-time as a dental hygienist. This is done to stay up-to-date with the art and science of dental hygiene. By staying involved in the discipline of dental hygiene, more and more information can be learned. There are many different roles that a professional can play as a dental hygienist; any of these roles will keep a dental hygienist up-to-date with the rapid changes.

 

REF:   Researcher | 3

 

  1. What is accreditation?
a. The process of explaining the concepts of oral health and their relationship to general health
b. The process of guiding and directing of the work of others so that they can become certified
c. The process of researching a specific topic and analyzing it
d. A formal, voluntary nongovernmental process that establishes a minimum set of national standards that promotes and ensures quality in education

 

 

ANS:  D

The process of explaining the concepts of oral health and their relationship to general health. This answer is incorrect because this statement is explaining the role of an educator.

The process of guiding and directing of the work of others so that they can become certified. This answer is incorrect because guiding and directing the work of others is a role played by an administrator.

The process of researching a specific topic and analyzing it. This answer is incorrect because this process is performed by a dental hygienist researcher.

A formal, voluntary nongovernmental process that establishes a minimum set of national standards that promotes and ensures quality in education. This answer is correct because accreditation is given to institutions or programs to ensure that the education being taught is proper and accurate.

 

REF:   Accreditation | 8

 

  1. What professional organization promotes the profession of dental hygiene globally?
a. ADHA
b. NDHA
c. CDHA
d. IFDH

 

 

ANS:  D

ADHA. This answer is incorrect because the professional organization is limited to the United States.

NDHA. This answer is incorrect because the professional organization specifically focuses on minority professionals.

CDHA. This answer is incorrect because the professional organization is limited to Canada.

IFDH. This answer is correct because the professional organization includes several countries and focuses on worldwide issues of dental hygiene.

 

REF:   International Federation of Dental Hygienists | 9-10

 

  1. What is the one most important reason why state dental practice laws were established?
a. To regulate the practice of dental hygiene and dentistry
b. To regulate the amount of education one must have to practice dentistry
c. To ensure the best overall service to the general public
d. To protect the health and welfare of the public

 

 

ANS:  A

To regulate the practice of dental hygiene and dentistry. This answer is correct because regulating the practice will ensure all criteria are met and education is fulfilled properly. The practice will be able to run smoothly in each state, ensuring beneficial service to the public.

To regulate the amount of education one must have to practice dentistry. This answer is incorrect because the amount of education one must have to practice dentistry is similar for all states so that relocating can be more easily accomplished.

To ensure the best overall service to the general public. This answer is incorrect because it is not the most important reason. If the practice of dental hygiene and dentistry is regulated, the best overall service will be given to the general public.

To protect the health and welfare of the public. This answer is incorrect because it is not the most important reason. If the practice of dental hygiene and dentistry is regulated, the health and welfare of the public will be protected.

 

REF:   Practice Acts and Licensure | 8

 

  1. Which one of these is most descriptive of licensure?
a. The process of becoming a dentist or dental hygienist
b. The process of graduating from an accredited dental hygiene program and then practicing dental hygiene
c. The process by which a government agency certifies that individuals are minimally qualified to practice within its jurisdiction
d. All of the above

 

 

ANS:  C

The process of becoming a dentist or dental hygienist. This answer is incorrect because the description of licensure is very broad and undetailed.

The process of graduating from an accredited dental hygiene program and then practicing dental hygiene. This answer is incorrect because licensure does not require oneself to immediately begin practicing dental hygiene. This statement is also not the most descriptive.

The process by which a government agency certifies that individuals are minimally qualified to practice within its jurisdiction. This answer is correct because the description is full and gives a complete idea of licensure.

All of the above. This answer is incorrect because each statement is not equally descriptive so they cannot all be the most descriptive of licensure.

 

REF:   Practice Acts and Licensure | 8

 

  1. The Canadian Dental Hygienist’s Association (CDHA) Board’s actions are directed toward attaining:
a. Direct access to dental hygiene care
b. Recognition by the Canadian public
c. Supportive public policy and a strong national voice
d. All of the above

 

 

ANS:  D

The CDHA Board’s actions are directed toward attaining specific measurable outcomes, including the following: direct access to dental hygiene care, recognition by the Canadian public, supportive public policy and a strong national voice, interprofessional practice, professional identity and professional standards, knowledge and research, business success and workplace well-being, and leadership development.

 

REF:   Chapter One, Professional Dental Hygiene Organizations | 9

 

  1. The dental hygienist must be _____ in the jurisdiction in which they practice.
a. licensed
b. certified
c. accredited
d. educated

 

 

ANS:  A

Licensed. This answer is correct because licensing examinations are created in each jurisdiction and must be passed by dental hygienists to receive a license to practice.

Certified. This answer is incorrect because certifications are usually voluntary. Licenses are required to become a professional while certifications usually are not.

Accredited. This answer is incorrect because accreditation can only be given to an institution or program, not an individual such as a dental hygienist.

Educated. This answer is incorrect because dental hygienists must pass certain written examinations to practice in the jurisdiction. A simple education does not meet the standard.

 

REF:   Practice Acts and Licensure | 8

Chapter 03: Evidence-Based Decision Making

Darby & Walsh: Dental Hygiene: Theory and Practice, 4th Edition

 

MULTIPLE CHOICE

 

  1. Which of the following components define evidence-based practice?
a. Clinical judgment and expertise
b. Client values/preferences
c. Scientific research
d. Both a and c
e. Options a, b, and c

 

 

ANS:  E

Clinical judgment and expertise, client values/preferences, and scientific research are all components of an evidence-based practice.

 

REF:   What is Evidence-Based Decision-Making? | 34

 

  1. The purpose of evidence-based decision-making (EBDM) is to:
a. emphasize new research findings.
b. close the gap between research and practice.
c. defer to clients’ wishes.
d. use expert opinions.
e. do none of the above.

 

 

ANS:  B

The purpose of EBDM is to close the gap between research and practice. Emphasizing new research findings, deferring to clients’ wishes, and use of expert opinions are not part of the stated purpose of EBDM.

 

REF:   Competencies | 34

 

  1. Being a good consumer of research literature means you:
a. understand what you are reading.
b. can identify the level of evidence.
c. know how much confidence you can put into the findings.
d. Both a and c are correct.
e. Options a, b, and c are correct.

 

 

ANS:  E

Being a good consumer of research literature means you understand what you are reading, can identify the level of evidence, and know how much confidence you can put into the findings.

 

REF:   Competencies | 34

 

  1. Which of the following distinguishes EBDM from traditional decision making?
a. Client preferences or values
b. Clinical circumstances
c. Clinician’s experience and judgment
d. Scientific evidence
e. All of the above

 

 

ANS:  D

The use of scientific evidence distinguishes EBDM from traditional decision making. Client preferences or values, clinical circumstances, and the clinician’s experience and judgment are part of both traditional decision-making and EBDM.

 

REF:   Competencies | 34

 

  1. Which of the following can generate questions in practice?
a. Client care issues
b. Client clinical condition
c. Clinical problems
d. Clinician’s interest
e. All of the above

 

 

ANS:  E

Client care issues, the client’s clinical condition, clinical problems, and the clinician’s interest can all generate questions in practice.

 

REF:   Principals of Evidence-Based Decision-Making | 34

 

  1. Which of the following is a true statement?
a. Evidence alone does not tell practitioners what to do.
b. All evidence is equal on the hierarchy.
c. The number of studies increase as you move up the hierarchy.
d. The clinical relevance of studies decreases as you move up the hierarchy.
e. None of the above are true statements.

 

 

ANS:  A

Evidence alone does not tell practitioners what to do is a true statement. All of the other statements are incorrect.

 

REF:   Principals of Evidence-Based Decision-Making | 34

 

  1. Primary research includes all of the following except:
a. experimental studies.
b. observational studies.
c. systematic reviews.
d. case control studies.
e. cohort studies.

 

 

ANS:  C

Primary research includes experimental studies, observational studies, case control studies, and cohort studies, but it does not include systematic reviews.

 

REF:   Evidence Sources and Levels of Evidence | 34-35

 

  1. Characteristics of experimental studies include:
a. testing cause and effect.
b. describing already existing conditions.
c. testing potentially harmful substances.
d. both b and c.
e. options a, b, and c.

 

 

ANS:  A

Characteristics of an experimental study include testing cause and effect. Describing already existing conditions and testing potentially harmful substances are characteristics of observational research.

 

REF:   Evidence Sources and Levels of Evidence | 34-35

 

  1. Characteristics of secondary research include the following except:
a. filtered, preappraised research.
b. meta-analyses.
c. systematic reviews.
d. case reports.
e. research on already conducted research.

 

 

ANS:  D

Secondary research includes filtered, preappraised research, meta-analyses, systematic reviews, and research on already conducted research. Case reports are characteristic of primary research.

 

REF:   Evidence Sources and Levels of Evidence | 35

 

  1. Characteristics of nonexperimental research include:
a. making observations between exposures and diseases.
b. ability to conduct studies prospectively.
c. ability to conduct studies retrospectively.
d. both a and c.
e. options a, b, and c.

 

 

ANS:  E

Characteristics of nonexperimental research include making observations between exposures and diseases, the ability to conduct studies prospectively, and the ability to conduct studies retrospectively.

 

REF:   Figure 3-2: Hierarchy of Research Designs and Levels of Scientific Evidence | 35

 

  1. Which of the following are considered Level 1 evidence?
a. RCTs, systematic reviews, case reports
b. Systematic reviews, meta-analyses, cohort studies
c. RCTs, systematic reviews, meta-analyses
d. RCTs, cohort studies, case control studies
e. Case series, case control studies, RCTs

 

 

ANS:  C

RCTs, systematic reviews, and meta-analyses are considered Level 1 evidence. The remaining choices are mixtures of the levels of evidence.

 

REF:   Figure 3-2: Hierarchy of Research Designs and Levels of Scientific Evidence | 35

 

  1. The AHA Guidelines on Prevention of Infective Endocarditis changed most recently because of:
a. more people dying from dental procedures.
b. quality of evidence.
c. dental professionals not following the guidelines.
d. client compliance.
e. a change in medications available.

 

 

ANS:  B

The AHA Guidelines on Prevention of Infective Endocarditis changed most recently because of the quality of evidence. The remaining statements were not stated reasons for the change.

 

REF:   Evidence Sources and Levels of Evidence | 36

 

  1. Which of the following organizations is solely dedicated to producing systematic reviews?
a. American Academy of Pediatric Dentistry
b. American Academy of Periodontology
c. American Dental Association
d. Centers for Disease Control and Prevention
e. Cochrane Collaboration

 

 

ANS:  E

The sole purpose of the Cochrane Collaboration is to produce systematic reviews. Systematic reviews are not the sole purpose of the American Academy of Pediatric Dentistry, American Academy of Periodontology, American Dental Association, or the Centers for Disease Control and Prevention.

 

REF:   Evidence Sources and Levels of Evidence | 36

 

  1. EBDM is now possible due primarily to which factor(s)?
a. Scientific databases
b. Computer access
c. Information explosion
d. Both a and b
e. Both a and c

 

 

ANS:  D

EBDM is now possible due primarily to scientific databases and computer access. The explosion of information is a reason why EBDM is needed, but not a factor in making it possible.

 

REF:   EBDM Process and Skills: A Practical Application | 37

 

  1. The first step in the EBDM process is:
a. finding the best evidence.
b. applying the results to client care.
c. asking a good clinical question.
d. evaluating the results.
e. critically appraising the evidence.

 

 

ANS:  C

The first step in the EBDM process is asking a good clinical question. Finding the best evidence is the second step; applying the results to client care is the fourth step; evaluating the results is the fifth step; critically appraising the evidence is the third step.

 

REF:   Step 1. Asking Good Questions: The PICO Process | 37

 

  1. The second step in the EBDM process is:
a. finding the best evidence.
b. applying the results to client care.
c. asking a good clinical question.
d. evaluating the results.
e. critically appraising the evidence.

 

 

ANS:  A

The second step in the EBDM process is finding the best evidence. Applying the results to client care is the fourth step; asking a good clinical question is the first step; evaluating the results is the fifth step; critically appraising the evidence is the third step.

 

REF:   Step 2. Conduct an Efficient Computerized Search | 37

 

  1. Select the PICO component that is either missing or incomplete from this question: For a client with attachment and bone loss due to periodontal disease, will antimicrobial therapy (minocycline HCI) with scaling and root planning, as compared to antimicrobial therapy alone, be more effective?
a. P (present and complete: client with attachment and bone loss due to periodontal disease)
b. I (present and complete: antimicrobial therapy [minocycline HCI] with scaling and root planning)
c. C (present and complete: antimicrobial therapy alone)
d. O (incomplete, more effective in doing what should be specified [e.g., more effective in stopping the progression of attachment loss])
e. No component is missing/incomplete

 

 

ANS:  D

The “O” component of the PICO is incomplete: More effective in doing what should be specified (e.g., more effective in stopping the progression of attachment loss). The remaining components of the PICO are complete.

 

REF:   Step 1. Asking Good Questions: The PICO Process | 37

 

  1. Which two PICO components provide the primary searching terms?
a. Problem and outcome (primary focus is on the intervention treatment and comparison treatment)
b. Intervention and comparison
c. Intervention and outcome (partially correct; intervention needs to be compared with the comparison treatment to determine which might be more effective and appropriate)
d. Comparison and outcome (partially correct; comparison needs to be compared with the intervention treatment to determine which might be more effective and appropriate)
e. None of the above

 

 

ANS:  B

Intervention and comparison are the two PICO components that provide the primary searching terms. The other choices are incorrect.

 

REF:   Step 2. Conduct an Efficient Computerized Search | 38

 

  1. Which of the following describes a clinical practice guideline?
a. Secondary evidence
b. Incorporates scientific evidence from SRs and MAs
c. A panel of experts makes specific recommendations
d. Intended to translate the research into practical applications
e. All of the above

 

 

ANS:  E

Secondary evidence, incorporates scientific evidence from SRs and MAs, a panel of experts makes specific recommendations, and intended to translate the research into practical applications all describe clinical practice guidelines.

 

REF:   Evidence Sources and Levels of Evidence | 36

 

  1. Which of the key critical analysis questions should be answered first so that your time is used most efficiently?
a. What are the results?
b. Are the results of the study valid?
c. Will the results help in caring for my client?
d. Why was the study conducted?
e. Was statistical significance found in analyzing the data?

 

 

ANS:  B

Whether or not the results of the study are valid should be determined first. If the study is not valid (i.e., if the methods and manner in which the study was conducted are not correct), then the results do not matter. There may be a good reason for conducting the study; however, if the methods and manner in which the study was conducted are not valid, then the purpose will not be met. If the study is not valid (i.e., if the methods and manner in which the study was conducted are not correct), then the data obtained may be biased and inappropriate to analyze. Also, statistical significance does not imply clinical relevance.

 

REF:   Step 3. Critically Appraise the Evidence for Its Validity and Usefulness (Clinical Applicability) | 40

 

  1. Critical analysis requires that you understand:
a. research design and level of evidence.
b. statistical and clinical significance.
c. formulating a PICO question.
d. both a and b.
e. both b and c.

 

 

ANS:  D

Critical analysis requires that you understand research design and level of evidence and statistical and clinical significance. The PICO question directs the search.

 

REF:   Step 3. Critically Appraise the Evidence for Its Validity and Usefulness (Clinical Applicability) | 40

 

  1. Which of the PubMed clinical queries options finds citations such as systematic reviews, meta-analyses, reviews of clinical trials, and consensus development conferences?
a. Clinical study categories: Therapy and Narrow scope
b. Clinical study categories: Therapy and Broad scope
c. Systemic reviews
d. Medical genetics searches
e. Both a and b

 

 

ANS:  C

Systematic reviews find citations such as systematic reviews, meta-analyses, reviews of clinical trials, and consensus development conferences.

 

REF:   Step 2. Conduct an Efficient Computerized Search | 38

 

  1. Benefits of using PubMed include:
a. the clinical queries feature.
b. using evidence-based filters to retrieve articles.
c. searching electronically across hundreds of journals at the same time.
d. finding relevant clinical evidence when it’s needed.
e. all of the above.

 

 

ANS:  E

The benefits of using PubMed include the clinical queries feature, using evidence-based filters to retrieve articles, searching electronically across hundreds of journals at the same time, and finding relevant clinical evidence when it’s needed.

 

REF:   Step 2. Conduct an Efficient Computerized Search | 37-38

 

MATCHING

 

Put the levels of evidence order of their ability to demonstrate causality and limit bias, with answer 1 as the highest level and 5 as the lowest level.

a. Case control study
b. Cohort study
c. Systematic review
d. Randomized controlled trial
e. Case report

 

 

  1. 1

 

  1. 2

 

  1. 3

 

  1. 4

 

  1. 5

 

  1. ANS:  C

REF:   Figure 3-2: Hierarchy of Research Designs and Levels of Scientific Evidence | 35

 

  1. ANS:  D

REF:   Figure 3-2: Hierarchy of Research Designs and Levels of Scientific Evidence | 35

 

  1. ANS:  B

REF:   Figure 3-2: Hierarchy of Research Designs and Levels of Scientific Evidence | 35

 

  1. ANS:  A

REF:   Figure 3-2: Hierarchy of Research Designs and Levels of Scientific Evidence | 35

 

  1. ANS:  E

REF:   Figure 3-2: Hierarchy of Research Designs and Levels of Scientific Evidence | 35

 

Match the PICO component with its definition.

a. P
b. I
c. C
d. O

 

 

  1. What you plan to do

 

  1. Main concern or chief complaint

 

  1. Measurable result

 

  1. Alternative

 

  1. ANS:  B                    REF:   Step 1. Asking Good Questions: The PICO Process | 37

 

  1. ANS:  A                    REF:   Step 1. Asking Good Questions: The PICO Process | 37

 

  1. ANS:  C                    REF:   Step 1. Asking Good Questions: The PICO Process | 37

 

  1. ANS:  D                    REF:   Step 1. Asking Good Questions: The PICO Process | 37Chapter 11: Ergonomics

    Darby & Walsh: Dental Hygiene: Theory and Practice, 4th Edition

     

    MULTIPLE CHOICE

     

    1. Sharp instruments are essential to the elimination of fatigue and stress on the clinician’s hand, wrist, arm, and shoulders, which cause repetitive stress injuries (RSIs). Dull instruments that deviate from their original design cause the clinician to apply additional force, resulting in increased lateral pressure, excess stroke repetitions, and a tightened grasp.
    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.

     

     

    ANS:  A

    Sharp instruments minimize the amount of lateral pressure used by the clinician, the tightness of the grasp, and the number of working strokes needed. Dull instruments that deviate from their original design will ultimately promote unsound ergonomic motions by the clinician during treatment.

     

    REF:   Hand Instrument Cutting Edge Sharpness | 148

     

    1. One environmental factor to consider to reduce the occurrence of repetitive stress injuries is the temperature of the workplace; this is because a cold room temperature is related to less-relaxed, less-flexible muscles and tendons.
    a. Both the statement and the reason are correct, and they are related.
    b. Both the statement and the reason are correct, but they are 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

     

     

    ANS:  A

    Muscles and tendons must be warm for maximum comfort and flexibility when working, and to reduce muscle and tendon injury.

     

    REF:   Environmental Factors | 144

     

    1. What is the foremost risk factor for carpal tunnel syndrome (CTS)?
    a. Holding instruments too tightly
    b. Repetition
    c. Use of vibrating instruments
    d. Cold room temperatures

     

     

    ANS:  B

    Although all the choices are risk factors for CTS, repetition and continued motion are the leading risk factors.

     

    REF:   Risk Factors | 153

     

    1. Which nerve is affected when carpal tunnel syndrome is evident?
    a. Ulnar nerve
    b. Radial nerve
    c. Median nerve
    d. Nerves from the brachial plexus

     

     

    ANS:  C

    The median nerve is located in the carpal tunnel between the carpal bones of the wrist and the transverse carpal ligament. Repetitive motions and forces to the wrist cause tendon inflammation and swelling within the carpal tunnel, causing pressure on the median nerve.

     

    REF:   Carpal Tunnel Syndrome | 151

     

    1. Which is a common symptom of thoracic outlet compression?
    a. Numbness and tingling in the fingertips
    b. Neck and shoulder muscle spasms
    c. Warm extremities
    d. Prominent or enhanced radial pulse

     

     

    ANS:  B

    Thoracic outlet compression is a repetitive stress injury resulting in compression of the brachial artery and plexus nerve trunk at the thoracic outlet. This compression occurs at the neck.

     

    REF:   Symtoms | 155

     

    1. Which nerve is affected when Guyon’s canal syndrome is evident?
    a. Ulnar nerve
    b. Radial nerve
    c. Median nerve
    d. Nerves from the brachial plexus

     

     

    ANS:  A

    The ulnar nerve becomes entrapped in a tunnel formed by the pisiform and hamate bones and the ligaments that connect them.

     

    REF:   Guyon’s Canal Syndrome | 156

     

    TRUE/FALSE

     

    1. The fulcrum finger must remain locked during instrument activation.

     

    ANS:  T

    A locked fulcrum allows the clinician to pivot on and gain strength from the fulcrum finger.

     

    REF:   Fulcrum and Hand Stabalizations | 147

     

    1. Digital motion is an acceptable hand movement during treatment instrument activation.

     

    ANS:  F

    Digital motion increases hand muscle fatigue, along with causing decreased instrument power and stability.

     

    REF:   Wrist Motion During Instrument Activation | 147

     

    SHORT ANSWER

     

    1. Name the two symptoms of de Quervain’s syndrome.

     

    ANS:

    Symptoms include aching and weakness of the thumb along the base, and pain migrating into the forearm.

     

    REF:   De Quervain’s Syndrome | 157

     

    1. List three chairside preventive measures to minimize the occurrence of carpal tunnel syndrome.

     

    ANS:

    Maintain a neutral elbow position during procedures, alter instrument grasps, and avoid repetitive crossing of arms across the chest.

     

    REF:   Chairside Preventive Measures | 153

     

    1. What causes the shoulder injury trapezius myalgia?

     

    ANS:

    Trapezius myalgia is caused by static loading in the shoulder or stabilizing muscles over a long period of time.

     

    REF:   Risk Factors | 158

     

    1. List three chairside preventive measures to reduce the incidence of lumbar joint dysfunction.

     

    ANS:

    Avoid twisting the back and spine, properly support body weight, and modify equipment placement to avoid twisting to reach.

     

    REF:   Chairside Preventive Measures | 159

     

    MATCHING

     

    Match the categories of motion with the proper classification.

    a. Movement of fingers, wrist, and arms
    b. Movement of fingers only
    c. Movement of the entire arm and shoulder
    d. Movement of fingers and wrist
    e. Movement of arm and twisting of body

     

     

    1. Class I

     

    1. Class II

     

    1. Class III

     

    1. Class IV

     

    1. Class V

     

    1. ANS:  B                    REF:   Table 11-2: Five Categories of Motion | 147

     

    1. ANS:  D                    REF:   Table 11-2: Five Categories of Motion | 147

     

    1. ANS:  A                    REF:   Table 11-2: Five Categories of Motion | 147

     

    1. ANS:  C                    REF:   Table 11-2: Five Categories of Motion | 147

     

    1. ANS:  E                    REF:   Table 11-2: Five Categories of Motion | 147

     

    Match the exercise that will improve the function of the associated body part.

    a. Sit-ups
    b. Hyperextension
    c. Neck isometric
    d. Rubber ball squeeze
    e. Doorway stretch
    f. Suspension from a bar

     

     

    1. Lumbar spine

     

    1. Abdominal muscles and lumbar spine

     

    1. Lower back

     

    1. Upper and lower back

     

    1. Cervical spine and neck

     

    1. Hand and fingers

     

    1. ANS:  B                    REF:   Box 11-1: Strengthening Exercises | 152

     

    1. ANS:  A                    REF:   Box 11-1: Strengthening Exercises | 152

     

    1. ANS:  F                    REF:   Box 11-1: Strengthening Exercises | 152

     

    1. ANS:  E                    REF:   Box 11-1: Strengthening Exercises | 152

     

    1. ANS:  C                    REF:   Box 11-1: Strengthening Exercises | 152

     

    1. ANS:  D                    REF:   Box 11-1: Strengthening Exercises | 152Chapter 21: Dental Hygiene Diagnosis

      Darby & Walsh: Dental Hygiene: Theory and Practice, 4th Edition

       

      MULTIPLE CHOICE

       

      1. A diagnosis is an identification of a condition, problem, or situation based on the analysis of its cause and defining characteristics. The dental hygienist diagnoses client conditions within the scope of dental hygiene to prevent oral disease, minimize the risk of oral disease, and promote wellness.
      a. Both statements are true.
      b. Both statements are false.
      c. The first statement is true, and the second is false.
      d. The first statement is false, andthe second is true.

       

       

      ANS:  A

      The diagnostic process is generic but can be applied to specific disciplines; a diagnosis becomes discipline specific when it is applied to the practice of that discipline.

       

      REF:   361

       

      1. The term dental hygiene diagnosis is found in each of the following EXCEPT one. Which one is the EXCEPTION?
      a. The American Dental Education Association’s (ADEA) Competencies for Entry into Dental Hygiene
      b. The American Dental Hygienists’ Association’s (ADHA) Code of Ethics and Standards for Clinical Dental Hygiene Practice
      c. The Commission on Dental Accreditation’s (CODA) Standards for Dental Hygiene Education Programs
      d. The Health Insurance Portability and Accountability Act (HIPAA)

       

       

      ANS:  D

      HIPAA rules concern the privacy of client health information. Miller introduced the concept of the dental hygiene diagnosis to describe the expression of dental hygiene judgment and decision making in 1982. The dental hygiene profession has accepted diagnosis as part of the dental hygienist’s role.

       

      REF:   361

       

      1. Using the dental hygiene human needs conceptual model to define the dental hygiene diagnosis as identifying human need deficits defines the scope and domain of dental hygiene practice broadly and clarifies the role of the dental hygienist professionally and legally for other healthcare providers, the public, and legislators. Doing so clearly distinguishes a dental hygiene diagnosis from a dental diagnosis.
      a. Both statements are true.
      b. Both statements are false.
      c. The first statement is true, and the second is false.
      d. The first statement is false, and the second is true.

       

       

      ANS:  A

      A dental hygiene diagnosis is a clinical decision made by a dental hygienist that identifies an actual or potential human need deficit that the dental hygienist is educated and licensed to treat and/or to refer for care. The dental hygiene diagnosis requires analysis of all available assessment data and the use of critical decision-making skills to reach conclusions about the client’s dental hygiene care needs.

       

      REF:   361

       

      1. Which of the following is the first phase of the concept of diagnosis within the dental hygiene process?
      a. Implementation
      b. Evaluation
      c. Assessment
      d. Planning
      e. Documentation

       

       

      ANS:  C

      Assessment is the first phase, followed by diagnosis, planning, implementation, documentation, and evaluation. The dental hygiene diagnosis requires analysis of all available assessment data and the use of critical decision-making skills to reach conclusions about the client’s dental hygiene care needs. After the assessment phase of the dental hygiene process, the diagnostic process begins. In making a dental hygiene diagnosis the dental hygienist works within the scope of dental hygiene practice.

       

      REF:   361

       

      1. Each of the following is an example of how a dental hygienist historically was cautioned to not diagnose but to identify dental problems and then communicate the observations EXCEPT one. Which one is the EXCEPTION?
      a. “Mr. Jones has suspicious areas on teeth 14, 19, and 32.”
      b. “Ms. Smith has signs of gingival and periodontal disease around teeth 22 to 26.”
      c. “Ms. Taylor, the periodontal probing depths of 5 to 7 mm, mobility of 2, and bleeding around the lower front teeth suggest moderate periodontitis; however, the final diagnosis must be confirmed by your dentist.”
      d. “Mr. Thomas, there appears to be a radiolucent area at the apex of tooth 8.”

       

       

      ANS:  C

      If state law permits preliminary diagnostic services provided by the dental hygienist, the dental hygienist could provide the clinical information as written. The remaining observations are neither dental nor dental hygiene diagnoses and create confusion for the client.

       

      REF:   361-362

       

      1. Which of the following is the term used to describe when a dental hygienist identifies oral disease and refers to a dentist for a definitive diagnosis?
      a. Assessment
      b. Preliminary diagnosis
      c. Planning
      d. Evaluation

       

       

      ANS:  B

      When a dental hygienist identifies oral disease, such as gingivitis or early periodontitis, this is called a preliminary diagnosis, which must be referred to a dentist for a definitive diagnosis and treatment or for possible delegation by the dentist back to the dental hygienist for nonsurgical periodontal care.

       

      REF:   362

       

      1. Which of the following is a characteristic of a dental hygiene diagnosis rather than a dental diagnosis?
      a. Identifies a specific oral disease
      b. Identifies conditions or problems for which the dentist directs the primary treatment
      c. Often deals with the client’s perceptions, beliefs, attitudes, and motivations regarding his or her own oral status
      d. Remains the same for as long as the disease is present

       

       

      ANS:  C

      Dental diagnoses identify diseases or conditions for which the dentist directs or provides the primary treatment; dental hygiene diagnoses identify unmet human needs that can be met by dental hygienists within the scope of dental hygiene practice. Thus, the dental hygiene diagnosis correlate to “Identifies a specific oral disease” is “Identifies an unmet human need.” The dental hygiene diagnosis correlate to “Identifies conditions or problems for which the dentist directs the primary treatment” is “Identifies conditions or problems within the scope of dental hygiene practice.” The dental hygiene diagnosis correlate to “Remains the same for as long as the disease is present” is “May change as the client’s responses and behaviors change.”

       

      REF:   362

       

      1. Dental diagnoses identify diseases or conditions for which the dentist directs or provides the primary treatment. Dental hygiene diagnoses identify unmet human needs that can be met by dental hygienists within the scope of dental hygiene practice.
      a. Both statements are true.
      b. Both statements are false.
      c. The first statement is true, and the second is false.
      d. The first statement is false, and the second is true.

       

       

      ANS:  A

      Legal, professional, and social responsibilities require clear distinctions between a dental hygiene diagnosis and a dental diagnosis. Diagnostic decision making and therapeutic care fall within precise legal and professional boundaries. Both types of diagnoses serve different purposes as related to the professional’s scope of practice.

       

      REF:   362

       

      1. How many “Dental Hygiene Diagnostic Classifications” currently exist?
      a. Four
      b. Six
      c. Eight
      d. Ten

       

       

      ANS:  C

      Currently, a classification of eight possible diagnoses creates a standardized language for identifying client oral health conditions amenable to dental hygiene care. This classification, based on eight human needs, is designed to work synergistically with the diagnosis of the dentist and other healthcare professionals.

       

      REF:   362

       

      1. The dental hygiene diagnostic classification uses descriptors that focus on the client’s human needs, because this emphasizes the client as an integrated human being rather than as a disease entity.
      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.

       

       

      ANS:  A

      The diagnostic classification allows dental hygienists to focus on client needs and to communicate this information to the client and other health professionals.

       

      REF:   362

       

      1. Each of the following is one of the human needs found in the “Dental Hygiene Diagnostic Classifications” EXCEPT one. Which one is the EXCEPTION?
      a. Conceptualization and Problem Solving
      b. Skin and Mucous Membrane Integrity of Head and Neck
      c. Wholesome Facial Image
      d. Ideal Oral Care
      e. Freedom from Head and Neck Pain

       

       

      ANS:  D

      Ideal Oral Care is not one of the human needs found. The eight are: Protection for Health Risks, Freedom from Fear and Stress, Wholesome Facial Image, Biologically Sound and Functional Dentition, Skin and Mucous Membrane Integrity of Head and Neck, Freedom from Head and Neck Pain, Conceptualization and Problem Solving, and Responsibility for Oral Health.

       

      REF:   362-365

       

      1. Which of the following is the first step of the “Dental Hygiene Diagnostic Process”?
      a. Prioritizing the dental hygiene diagnoses
      b. Identifying unmet human needs related to dental hygiene problems
      c. Synthesizing, analyzing, and interpreting client data
      d. Formulating and validating the dental hygiene diagnosis

       

       

      ANS:  C

      The correct sequence is: Synthesizing, analyzing, and interpreting client data; Identifying unmet human needs related to dental hygiene problems; Formulating and validating the dental hygiene diagnosis; and Prioritizing the dental hygiene diagnoses.

       

      REF:   362

       

      1. Dental hygiene diagnoses focus on professional care and allow dental hygienists to assess and manage client conditions within their scope of practice. After diagnosis, goals are developed in conjunction with the client interventions then are implemented, documented, and evaluated along with other relevant information.
      a. Both statements are true.
      b. Both statements are false.
      c. The first statement is true, and the second is false.
      d. The first statement is false, and the second is true.

       

       

      ANS:  A

      Client goals—the desired outcome of care—clarify what the client needs to do to promote, maintain, or achieve oral health and wellness. Planning care is contingent on the dental hygiene diagnosis.

       

      REF:   362

       

      1. Dental hygienists begin data synthesis, analysis, and interpretation during which of the following phases of the dental hygiene process?
      a. Planning
      b. Implementation
      c. Documentation
      d. Assessment
      e. Evaluation

       

       

      ANS:  D

      The dental hygienist looks for significant clusters of data that signal the presence of an actual or potential unmet human need, formulates a diagnosis, and develops a care plan.

       

      REF:   362

       

      1. The need for antibiotic premedication would be a “Sign and Symptom” of which of the following “Dental Hygiene Diagnostic Classifications”?
      a. Responsibility for Oral Health
      b. Protection from Health Risks
      c. Conceptualization and Problem Solving
      d. Skin and Mucous Membrane Integrity

       

       

      ANS:  B

      “Signs and Symptoms” of “Protection from Health Risks” includes: Evidence on health history for immediate referral to, or consultation with, a physician regarding uncontrolled diseases (e.g., signs of cardiac problem, signs of uncontrolled diabetes, or abnormal vital signs); Evidence of need for antibiotic premedication; Evidence that client is at risk for oral injury (e.g., plays a contact sport without an athletic mouth protector or has impaired eyesight, tremor, or limited dexterity); Evidence that client is at risk for oral or systemic disease; and Evidence that client is in a life-threatening situation.

       

      REF:   363-365

       

      1. The use of nitrous oxide–oxygen (N2O-O2) analgesia is an example of an “Educational, Preventive, and Therapeutic Intervention” for which of the following “Dental Hygiene Diagnostic Classifications”?
      a. Responsibility for Oral Health
      b. Freedom from Fear and Stress
      c. Protection from Health Risks
      d. Conceptualization and Problem Solving
      e. Freedom from Head and Neck Pain

       

       

      ANS:  B

      “Educational, Preventive, and Therapeutic Interventions” for “Freedom from Fear and Stress” includes: Provide reassurance; Use desensitizing agents; Perform instrumentation techniques with care; Use a topical or local anesthetic agent, and/or nitrous oxide–oxygen (N2O-O2) analgesia; Use behavior management strategies.

       

      REF:   363-365

       

      1. Which of the following is a one of the “Causes” for which the “Dental Hygiene Diagnostic Classification” of “Freedom from Head and Neck Pain” was created?
      a. Nonadherence or noncompliance
      b. Temporomandibular joint (TMJ) discomfort
      c. Halitosis
      d. Lack of financial resources

       

       

      ANS:  B

      The “Causes” for which “Freedom from Head and Neck Pain” was created include: Temporomandibular joint (TMJ) discomfort; Oral surgery, dental procedure, dental hygiene procedure; Untreated dental disease; and Inadequate access to care or lack of regular dental care. “Nonadherence or noncompliance” and “Lack of Financial Resources” are two of the “Causes” for “Responsibility for Oral Health.” Halitosis is one of the “Causes” for “Wholesome Facial Image.”

       

      REF:   363-365

       

      1. The dental hygienist can compare observed data with an accepted standard. Appropriate standards include normative values for the client’s age and oral status.
      a. Both statements are true.
      b. Both statements are false.
      c. The first statement is true, and the second is false.
      d. The first statement is false, and the second is true.

       

       

      ANS:  A

      For example, a child’s gingival architecture may be normal given the child’s developmental level but may be considered abnormal at another age. Similarly, a blood pressure of 130/90 mm Hg may be within the expected range for an individual with hypertension under the control of a physician, but abnormal for a person not under a physician’s care.

       

      REF:   366

       

      1. A dental hygiene diagnoses should rely on a single definitive sign or symptom, because gathering complete data to support a recognizable pattern prevents the dental hygienist from formulating an incorrect diagnosis.
      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.

       

       

      ANS:  D

      Dental hygiene diagnoses always should be based on a cluster of significant information rather than on a single sign or symptom. There is a danger of arriving at a dental hygiene diagnosis from a single factor. For example, cultural differences may mean that what is perceived as a deficit in one culture may not be perceived as a deficit in another culture.

       

      REF:   366

       

      1. Which of the following should be used by the dental hygienist to determine whether the identified client condition requires a dental diagnosis, a dental hygiene diagnosis, or a medical diagnosis?
      a. Any college biology textbook
      b. Any college chemistry textbook
      c. Critical thinking
      d. The Physicians’ Desk Reference
      e. The website for the dental hygiene program of graduation

       

       

      ANS:  C

      The dental hygienist distinguishes between oral health conditions that only a dentist is qualified to treat (dental diagnosis), which requires a dental referral, and oral health conditions that require dental hygiene care (dental hygiene diagnosis). Here, critical thinking determines whether the identified condition requires a dental diagnosis, a dental hygiene diagnosis, or a medical diagnosis. While the other choices may provide useful information, critical thinking is necessary to provide the answer.

       

      REF:   366

       

      1. Clients also may present information during the assessment indicating that they are at risk for developing an unmet human need. No client will ever present without an unmet human need.
      a. Both statements are true.
      b. Both statements are false.
      c. The first statement is true, and the second is false.
      d. The first statement is false, and the second is true.

       

       

      ANS:  C

      An example of a situation where assessment may indicate that a client is at risk for developing an unmet need would occur when a dental hygienist records that a client has signs of possible uncontrolled diabetes mellitus, but a hemoglobin A1C test has not been done for the past 6 months. At times a client may present with no unmet human needs. This situation is an opportunity for the dental hygienist to identify the client’s protective factors, build on these strengths for greater levels of oral wellness, and reinforce oral health promotion interventions to maintain and augment wellness.

       

      REF:   368

       

      1. Which of the four possible conclusions after analyzing client assessment data would lead a dental hygienist to “Plan, implement, and evaluate dental hygiene care”?
      a. No unmet human needs related to dental hygiene care
      b. Possible unmet human needs related to an oral health problem
      c. Actual or potential unmet human needs related to dental hygiene care (dental hygiene diagnosis)
      d. Actual or potential unmet human needs requiring a diagnosis by another healthcare professional

       

       

      ANS:  C

      If the action requires a diagnosis, the dental hygienist formulates, validates, and prioritizes dental hygiene diagnoses before care. More than one unmet human need may be found, and multiple dental hygiene diagnoses may be identified.

       

      REF:   368

       

      1. Which of the following is the correct dental hygiene action if the conclusion by the dental hygienist after analyzing client assessment data indicates “Possible unmet human needs related to an oral health problem”?
      a. Initiate oral health promotion strategies to achieve higher levels of oral and systemic wellness.
      b. Reinforce client’s oral health beliefs and behavior.
      c. Collect more assessment data to validate suspected problem, which may require a dental hygiene diagnosis, a dental diagnosis, or a medical diagnosis.
      d. Consult with and refer to appropriate healthcare professional; work collaboratively to solve problem.

       

       

      ANS:  C

      Formulation of the dental hygiene diagnosis is based on the identification of the client’s human needs as supported by the assessment data.

       

      REF:   368

       

      1. A diagnostic statement links the client’s problem and its cause, guides the selection of interventions, and facilitates the definition of expected outcomes to evaluate the
      a. quality of patient home care.
      b. efficacy of care.
      c. disruption of plaque biofilm.
      d. nature of the putative periodontal pathogens that are present.

       

       

      ANS:  B

      The diagnostic statement has three components: (1) Unmet human need: oral health condition or potential (at-risk) health problem amenable to dental hygiene intervention, (2) Cause: probable cause or risk factors for the actual or potential deficit, and (3) Signs and symptoms.

       

      REF:   368-369

       

      1. A 45-minute appointment for oral prophylaxis, bitewing radiographs, fluoride application, and 6-month continued care is an appropriate standard for dental hygiene care, because the diagnostic statement provides a focus on specific client unmet needs.
      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.

       

       

      ANS:  D

      The diagnostic statement provides a focus on specific client unmet needs so that the routine approach, characteristic of traditional dental hygiene care, is no longer an appropriate standard.

       

      REF:   369

       

      1. Each diagnosis has a cluster of defining characteristics that must be observed during client assessment. What are the defining characteristics?
      a. The signs and symptoms that must be evident for the diagnostic label to be used correctly
      b. The matrix or framework for the disease
      c. The differentiation between what is considered normal variation and pathology
      d. The vital signs, including: height, weight, and blood pressure

       

       

      ANS:  A

      The signs and symptoms are predictors for judging the presence of an unmet human need related to an oral health condition or a potential problem. The client’s signs and symptoms enable the dental hygienist to focus on the true problem and to eliminate others.

       

      REF:   369

       

      1. A diagnosis should be accompanied by noting the
      a. objective signs observed by the dental hygienist and the subjective symptoms reported by the client.
      b. objective symptoms observed by the dental hygienist and the subjective signs reported by the client.
      c. objective signs observed by the dental hygienist and the objective symptoms reported by the client.
      d. subjective signs observed by the dental hygienist and the subjective symptoms reported by the client.

       

       

      ANS:  A

      Objective signs are observed by the professional, and subjective symptoms are reported by the client.

       

      REF:   369

       

      1. Potential health problems may not require specification of the cause, and in these situations the defining characteristics are the
      a. symptoms reported by the patient.
      b. observed risk factors.
      c. defining characteristics found in an authoritative textbook.
      d. inferences drawn based on previous experiences.

       

       

      ANS:  B

      A dental hygiene diagnosis regarding an at-risk problem is written with its presenting risk factors as the defining characteristics.

       

      REF:   370

       

      1. Each of the following is an example of a poor dental hygiene diagnosis EXCEPT one. Which one is the EXCEPTION?
      a. Inadequate self-care related to laziness
      b. Moderate, localized aggressive periodontitis
      c. Unmet need for responsibility for oral health related to a lack of manual dexterity and self-care, as evidenced by a plaque index score of 3 and an inability to grasp a toothbrush
      d. Generalized gingival bleeding and attachment levels of 5–8 mm

       

       

      ANS:  C

      Inadequate self-care related to laziness is an example of emotionalism expressed in the diagnosis. Moderate, localized aggressive periodontitis is an example of a dental diagnosis instead of a dental hygiene diagnosis. Generalized gingival bleeding and attachment levels of 5–8 mm is an example of identifying signs and symptoms as the client problem.

       

      REF:   370

       

      1. Dental hygiene diagnosis is not an attempt to move into the domain of the dentist. Dental hygiene diagnosis is a vehicle for distinguishing roles professionally and legally.
      a. Both statements are true.
      b. Both statements are false.
      c. The first statement is true, and the second is false.
      d. The first statement is false, and the second is true.

       

       

      ANS:  A

      Dental hygiene diagnoses facilitate the development of professional autonomy and accountability by focusing on phenomena within the scope of dental hygiene practice and by providing a language for communication. By identifying the client’s unmet human needs that can be fulfilled through dental hygiene care, the dental hygiene diagnosis clarifies the role of the dental hygienist and allows for a defined scope and domain of dental hygiene practice.

       

      REF:   371

      Chapter 31: Chemotherapy for the Control of Periodontal Disease

      Darby & Walsh: Dental Hygiene: Theory and Practice, 4th Edition

       

      MULTIPLE CHOICE

       

      1. The FDA ensures the safety and efficacy of prescription drugs and over-the-counter products that make therapeutic claims. The ADA seal of acceptance aims to assist the public and oral health professionals by identifying products that are of benefit to the oral health of consumers.
      a. Both statements are true.
      b. Both statements are false.
      c. The first statement is true, and the second is false.
      d. The second statement is true, and the first is false.

       

       

      ANS:  C

      The FDA ensures the safety and efficacy of prescription drugs and over-the-counter products that make therapeutic claims. The ADA seal of acceptance is granted to those products that demonstrate therapeutic efficacy in accordance with published criteria. The CDA Seal of recognition aims to assist the public and oral health professionals by identifying products that are of benefit to the oral health of consumers and by helping them to make informed choices about such products.

       

      REF:   551-552

       

      1. Which of the following active ingredients in oral chemotherapeutics alter the structure and/or metabolic activity of bacteria?
      a. An antiseptic agent
      b. Antibiotics
      c. A modifying agent
      d. An antiadhesive

       

       

      ANS:  C

      Modifying agents alter the structure and/or metabolic activity of bacteria. Antiseptic agents usually broad spectrum; kill or prevent propagation of plaque microorganisms. Antibiotics, broad or narrow spectrum, inhibit or kill specific or groups of bacteria or modulate host inflammatory response. Antiadhesives are products that interfere with the ability of bacteria to attach to the acquired pellicle.

       

      REF:   553

       

      1. What is one of the most common self-applied oral chemotherapeutic that has both therapeutic and cosmetic effects?
      a. Dentifrice
      b. Fluoride
      c. Mouth rinse
      d. Mouth lozenges

       

       

      ANS:  A

      One of the most common self-applied delivery modes is dentifrice. Commonly known as toothpaste, dentifrice is available mostly as paste or gel. It is a vehicle for the local delivery of active ingredients. Dentifrice can have both therapeutic and cosmetic effects. From a therapeutic standpoint, the anticariogenic agent fluoride is the most well-established active ingredient found in dentifrices. Oral rinses are available for both cosmetic and therapeutic use.

       

      REF:   553

       

      1. Which of the following ingredients is included in many formulations of oral rinses to emulsify the antimicrobial ingredients within the rinse?
      a. Water
      b. Alcohol
      c. Cleansing agents
      d. Flavoring ingredients
      e. Sodium

       

       

      ANS:  B

      Alcohol (10% to 30% by volume) is included in many formulations to emulsify the antimicrobial ingredients within the rinse. It has some antiseptic properties, although this influence is not considered to make an important contribution to overall efficacy.

       

      REF:   553

       

      1. Alcohol containing rinses are contraindicated in which of the following individuals?
      a. Clients with xerostomia
      b. Recovering alcoholics
      c. Clients on sodium-restricted diets
      d. Both A and B
      e. All of the above

       

       

      ANS:  B

      Alcohol-containing oral rinses may be contraindicated for some individuals with other conditions (e.g., recovering alcoholics) and for individuals taking certain antibiotics, in whom gastrointestinal upset may occur. Alcohol in oral rinses has also been implicated with xerostomia, but this relationship remains unsubstantiated. Xerostomic individuals do not appear to have an increased sensitivity to alcohol-containing rinses. Some mouth rinses also contain substantial amounts of sodium, which can result in sodium absorption through the oral mucosa during rinsing. People on sodium-restricted diets should be aware that some brands of mouthwash may be significant sources of sodium. These clients should consult their physicians about the potential impact of such mouthwashes.

       

      REF:   554

       

      1. What mouth rinse(s) is/are traditionally recommended for clients being treated with head and neck radiation and who have mucositis?
      a. Sterile water
      b. Baking soda in water
      c. Normal saline rinse
      d. All of the above

       

       

      ANS:  D

      It has been traditionally recommended that clients being treated with head and neck radiation and who have mucositis should use bland oral rinses such as sterile water, baking soda in water, or normal saline rinse due to oral sensitivities.

       

      REF:   554

       

      1. A preprocedural rinse has the potential to reduce the amount of available microorganisms by
      a. approximately 50%.
      b. approximately 80%.
      c. less than 90%.
      d. more than 90%.

       

       

      ANS:  D

      A preprocedural rinse has the potential to significantly reduce the amount of available microorganisms by more than 90%; thus this practice is recommended by the Centers for Disease Control and Prevention in the United States.

       

      REF:   554

       

      1. When the professional delivery of subgingival irrigation is indicated, it is recommended as a monotherapy. Moderate pressure is required, because low force has not been shown to penetrate the pocket adequately.
      a. Both statements are true.
      b. Both statements are false.
      c. The first statement is true, and the second is false.
      d. The first statement is false, and the second is true.

       

       

      ANS:  B

      When the professional delivery of subgingival irrigation is indicated, it is not recommended as a monotherapy; it should instead be used in conjunction with periodontal debridement. It is also necessary to irrigate the tooth circumferentially, because the lateral dispersion of chemotherapeutics via a cannula is minimal. However, only minimal pressure is required, because low force has been shown to penetrate the pocket adequately.

       

      REF:   555

       

      1. Controlled-release drug delivery results in 1000 times the concentration of the drug within the GCF at the diseased site, but only one hundredth of the systemic dose reaches the rest of the body.
      a. Both statements are true.
      b. Both statements are false.
      c. The first statement is true, and the second is false.
      d. The first statement is false, and the second is true.

       

       

      ANS:  A

      Controlled-release drug delivery results in 1000 times the concentration of the drug within the GCF at the diseased site, but only one hundredth of the systemic dose reaches the rest of the body.

       

      REF:   555

       

      1. Which local delivery product remains effective against predominant periodontal pathogens for more than 20 days?
      a. PerioChip
      b. Atridox
      c. Arestin
      d. Elyzol

       

       

      ANS:  C

      Arestin well exceeds MIC levels within hours, and it remains effective against predominant periodontal pathogens for more than 20 days while it is slowly resorbed. PerioChip maintains an average GCF concentration of 125 mg/mL of chlorhexidine over a 7- to 10-day period. Atridox provides the controlled release of doxycycline for 7 days. Elyzol reaches its peak concentration in the GCF 4 hours after administration, and it maintains levels of more than 100 mg/mL for the first 8 hours. The product maintains concentrations exceeding the MIC for anaerobic pathogens susceptible to metronidazole (1.0 g/mL) for approximately 36 hours.

       

      REF:   556-557

       

      1. Systematic review of controlled release products found that scaling and root planing alone produce pocket depth and CAL improvement in the range of 2.5 mm, controlled release drugs added improvements in the range of 0.25 to 0.5 mm.
      a. Both statements are true.
      b. Both statements are false.
      c. The first statement is true, and the second is false.
      d. The first statement is false, and the second is true.

       

       

      ANS:  D

      A systematic review of controlled-release products found that, overall, adjunctive local antibiotics within controlled release drug-delivery systems have a positive impact on pocket depths and CALs. Although scaling and root planing alone produce pocket-depth and CAL improvements in the range of 1.5 mm, controlled-release drugs added improvements in the range of 0.25 to 0.5 mm. Although this is statistically significant, the dental hygienist must weigh the clinical relevance of these findings in practice situations.

       

      REF:   557

       

      1. Systematic reviews to evaluate the adjunctive benefits of systemic antibiotics concluded all of the following EXCEPT one provided a benefit over scaling and root planing alone. What is the exception?
      a. Amoxicillin
      b. Penicillin
      c. Metronidazole
      d. Subantimicrobial dose of doxycycline

       

       

      ANS:  B

      Recently systematic reviews have been conducted to evaluate the adjunctive benefits of systemic antibiotics; it was concluded that amoxicillin or a combination of amoxicillin and metronidazole, metronidazole alone, or a subantimicrobial dose of doxycycline all provided a benefit over scaling and root planing alone.

       

      REF:   558

       

      1. Which of the following host modulation therapies has shown positive outcomes in regard to alveolar bone preservation?
      a. Probiotics
      b. Vaccines
      c. Some NSAIDs
      d. Subantimicrobial antibiotics

       

       

      ANS:  C

      Some NSAIDs have shown positive outcomes, particularly with regard to alveolar bone preservation. Studies examining subantimicrobial doses of doxycycline have demonstrated improved periodontal outcomes as compared with scaling and root planing therapy alone. Other more novel approaches to modulating the host response include probiotics and vaccines, but research involving oral applications is in its infancy.

       

      REF:   559

       

      1. Which of the following is considered the “gold standard” oral rinse formulation for plaque and gingivitis reduction?
      a. Chlorhexidine
      b. Colgate Total
      c. Listerine Zero
      d. Viadent
      e. Cepacol

       

       

      ANS:  A

      Chlorhexidine gluconate (CHG) is considered to be the “gold standard” that provides a benchmark for measurement in studies examining the efficacy of other oral-rinse formulations for plaque and gingivitis reduction.

       

      REF:   559

       

      1. Which of the following products is available with varying research support to substantiate their primary use as an anticaries agent?
      a. Echinacea
      b. Goldenseal
      c. Povidone–iodine
      d. Xylitol
      e. Probiotics

       

       

      ANS:  D

      Xylitol is primarily used as an anticaries agent. Povidone–iodine is used as a professionally applied irrigant (10%), for home irrigation (0.1%), or as an oral rinse (1.0%), and it has a wide spectrum of efficacy. Probiotics are live microorganisms that have health benefits for the host; they can confer an effect by being antimicrobial to pathogens, modulating the host response, or exerting a competitive exclusion mechanism. Active ingredients including echinacea, goldenseal, povidone–iodine, xylitol, host proteins (lysozyme, lactoferrin, and lactoperoxidase), and probiotics have been used in oral health products and have varying research support to substantiate their use.

       

      REF:   561

       

      1. Dental hygienists have no legal or ethical obligation to be aware of the current literature surrounding personal and professional chemotherapeutic interventions. Making use of systematic reviews and professional guidelines is helpful for professional responsibility.
      a. Both statements are true.
      b. Both statements are false.
      c. The first statement is true, and the second is false.
      d. The first statement is false, and the second is true.

       

       

      ANS:  D

      Dental hygienists have a legal and ethical obligation to be aware of the current literature surrounding personal and professional chemotherapeutic interventions. Making use of systematic reviews and professional guidelines is helpful for this professional responsibility.

       

      REF:   561

       

      1. The success of local drug-delivery systems for treating periodontal infections is dependent on the ability of these systems to deliver the antimicrobial agents to the disease site at the minimum inhibitory concentration for a sufficient duration of time. Substantivity is the ability of an active ingredient to bond with oral tissues, thus allowing the ingredient to be retained in the oral cavity and to be continually released while maintaining its potency.
      a. Both statements are true.
      b. Both statements are false.
      c. The first statement is true, and the second is false.
      d. The first statement is false, and the second is true.

       

       

      ANS:  A

      The success of local drug-delivery systems for treating periodontal infections is dependent on the ability of these systems to deliver the antimicrobial agents to the disease site at the minimum inhibitory concentration for a sufficient duration of time. Substantivity is the ability of an active ingredient to bond with oral tissues, thus allowing the ingredient to be retained in the oral cavity and to be continually released while maintaining its potency.

       

      REF:   562

       

      MATCHING

       

      Match the following product with the active ingredient.

      a. Minocycline hydrochloride (1 mg)
      b. 25% metronidazole benzoate
      c. 2.5 mg of chlorhexidine D-gluconate
      d. 10% doxycycline hyclate

       

       

      1. PerioChip

       

      1. Arestin

       

      1. Atridox

       

      1. Elyzol

       

      1. ANS:  C                    REF:   555-557

       

      1. ANS:  A                    REF:   555-557

       

      1. ANS:  D                    REF:   555-557

       

      1. ANS:  B                    REF:   555-557

       

      Match the following brand names to mechanism of action. Multiple answers may be appropriate.

      a. Colgate 100
      b. Amosan
      c. Listerine
      d. Crest Pro-Health
      e. Hydrogen peroxide
      f. Colgate Total Plax
      g. Scope
      h. Cepacol
      i. Essential oils

       

       

      1. Antimicrobial as a result of the release of oxygen

       

      1. Destroy microorganisms by interacting with the bacterial cell membrane and causing it to become permeable and loose its content

       

      1. Disrupts the cytoplasmic membrane of the cell

       

      1. Destroy microorganisms by compromising the cell membrane and inhibiting enzyme activity.

       

      1. ANS:  B                    REF:   559-560

       

      1. ANS:  A                    REF:   559-560

       

      1. ANS:  F                    REF:   559-560

       

      1. ANS:  C                    REF:   559-560Chapter 41: Nitrous Oxide–Oxygen Analgesia

        Darby & Walsh: Dental Hygiene: Theory and Practice, 4th Edition

         

        MULTIPLE CHOICE

         

        1. Which delivery method includes administration of nitrous oxide–oxygen analgesia?
        a. Local
        b. General
        c. Inhalation
        d. Intravenous

         

         

        ANS:  C

        Delivery of nitrous oxide–oxygen analgesia is an inhalation method of conscious sedation. Local anesthesia produces loss of sensation without inducing a loss of consciousness. General anesthesia produces unconsciousness and it is often administered intravenously.

         

        REF:   768

         

        1. All are indications for the use of nitrous oxide–oxygen (N2O-O2) analgesia EXCEPT one. Which one is the EXCEPTION?
        a. Anesthetizing specific area
        b. Relaxation for mild apprehension
        c. Pain control for slightly painful procedures
        d. Pain control for moderately painful procedures

         

         

        ANS:  A

        All are indications for the use of nitrous oxide–oxygen (N2O-O2) analgesia EXCEPT for anesthetizing a specific area; the use of a local anesthetic is for anesthetizing a specific area. All are indications for the use of nitrous oxide–oxygen (N2O-O2) analgesia: Relaxation for mild apprehension; and pain control for slightly and moderately painful procedures.

         

        REF:   768

         

        1. Which term refers to nitrous oxide–oxygen (N2O-O2) analgesia acting on the central nervous system in such a way that pain impulses are not relayed to the cerebral cortex?
        a. Psychosedation
        b. Relative analgesia
        c. Conscious sedation
        d. Inhalation sedation

         

         

        ANS:  A

        Psychosedation refers to nitrous oxide–oxygen (N2O-O2) analgesia acting on the central nervous system in such a way that pain impulses are not relayed to the cerebral cortex. Relative analgesia refers to the state of sedation produced. Conscious sedation refers to the fact that the client is awake and able to respond to verbal commands during the administration of N2O-O2. Inhalation sedation refers to the fact that gases are inhaled through the nose.

         

        REF:   768

         

        1. Which term does NOT describe nitrous oxide?
        a. Tasteless
        b. Colorless
        c. Sweet-smelling
        d. Pleasant tasting

         

         

        ANS:  D

        Pleasant tasting does NOT accurately describe nitrous oxide as it is tasteless. Nitrous oxide is also described as colorless and sweet-smelling.

         

        REF:   768

         

        1. Nitrous oxide is stored as a liquid and vapor in equilibrium in a blue-colored cylinder because as a relative analgesia, the client’s mood and pain reaction threshold are altered.
        a. Both the statement and the 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.

         

         

        ANS:  B

        Both the statement and reason are correct but NOT related. Nitrous oxide is stored as a liquid and vapor in equilibrium in a blue-colored cylinder. Nitrous oxide–oxygen is a relative analgesia that will alter the client’s mood and pain reaction threshold. Choices A, C, D, and E do not accurately describe the statement and reason.

         

        REF:   768

         

        1. Which factor accounts for the rapid onset and recovery from the analgesic effects of nitrous oxide–oxygen (N2O-O2) sedation?
        a. Inhalation delivery
        b. Blood-gas solubility
        c. Combination with hemoglobin
        d. Competition with carbon dioxide

         

         

        ANS:  B

        The blood-gas solubility of nitrous oxide–oxygen (N2O-O2) accounts for the rapid onset and recovery from the analgesic effects. The inhalation delivery of nitrous oxide–oxygen (N2O-O2) is not related to the rapid onset and recovery from the analgesic effects. The nitrous-oxide gas does not combine with the hemoglobin molecule in the blood and it does not compete with carbon dioxide for combination with the hemoglobin molecule.

         

        REF:   768

         

        1. Which psi reading reflects a full tank of oxygen?
        a. 500
        b. 750
        c. 1000
        d. 2100

         

         

        ANS:  D

        The gauge reading of 2100 psi indicates a full tank of oxygen. Choices A, B, and C do not accurately answer the question.

         

        REF:   768

         

        1. Which BEST explains the physiology of nitrous-oxide?
        a. Modifies pain receptors
        b. Alters nerve ending receptors
        c. Stimulates the Cerebral cortex
        d. Depresses the central nervous system

         

         

        ANS:  D

        Nitrous-oxide depressed the central nervous system. It does NOT modify or alter the pain receptors in any way. It does NOT stimulate the cerebral cortex of the brain.

         

        REF:   769-770

         

        1. Nitrous oxide can block pain perception because it can NOT cause a different interpretation of nerve impulses.
        a. Both the statement and the 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.

         

         

        ANS:  E

        Neither the statement NOR the reason is correct. Nitrous oxide does NOT block pain perception because it can cause a different interpretation of nerve impulses. Choices A, B, C, and D do not accurately define the statement.

         

        REF:   770

         

        1. The nitrous oxide molecule enters the blood through the lungs. It eventually exits unchanged through the lungs.
        a. Both statements are true.
        b. Both statements are false.
        c. The first statement is true; the second statement is false.
        d. The first statement is false; the second statement is true.

         

         

        ANS:  A

        Both statements are true. The nitrous oxide molecule enters the blood through the lungs. It eventually exits unchanged through the lungs. Choices B, C, and D do not accurately define the statements.

         

        REF:   770

         

        1. For a client receiving dental hygiene care, at which stage of anesthesia is it necessary to turn the nitrous oxide off and increase the oxygen to 100%?
        a. Stage I
        b. Stage II
        c. Stage III
        d. Stage IV

         

         

        ANS:  B

        For a client receiving dental hygiene care, Stage II or the excitement phase of anesthesia indicates to turn the nitrous oxide off and increase the oxygen to 100%. Stage I is the analgesia stage and is appropriate for dental hygiene care. Stage III is the surgical anesthesia phase and is appropriate for oral and maxillofacial surgeons to use. Stage IV anesthesia is surgical anesthesia with respiratory paralysis, used for a patient undergoing major surgery in a hospital setting.

         

        REF:   770

         

        1. Which condition contradicted the use of nitrous oxide–oxygen (N2O-O2) analgesia?
        a. Asthma
        b. Epilepsy
        c. Cerebral palsy
        d. Allergy to local anesthetics

         

         

        ANS:  B

        The presence of epilepsy contradicts the use of nitrous oxide–oxygen (N2O-O2) analgesia. It is safe to use nitrous oxide–oxygen (N2O-O2) analgesia for clients with asthma, cerebral palsy, or an allergy to local anesthetics.

         

        REF:   771

         

        1. Which is a possible effect of long-term exposure to nitrous oxide?
        a. Epilepsy
        b. Nasal obstruction
        c. Spontaneous abortion
        d. Chronic obstructive pulmonary disease

         

         

        ANS:  C

        Spontaneous abortion a possible effect of long-term exposure to nitrous oxide. Nitrous oxide is contraindicated for clients who have epilepsy, nasal obstruction, or chronic obstructive pulmonary disease.

         

        REF:   771

         

        1. Which consideration MOST relates to treatment of a client with communication difficulty?
        a. Triggering an epileptic seizure
        b. Altering one’s perception of reality
        c. Monitoring of appropriate level of sedation
        d. Preventing depression of fetal central nervous system

         

         

        ANS:  C

        The monitoring of the appropriate level of sedation is MOST important when treating a client with communication difficulty. The possibility of triggering an epileptic seizure is MOST important when treating a client with epilepsy. The altering of one’s perception of reality is MOST important when treating a client who is emotional instable. Preventing depression of fetal central nervous system is MOST important when treating a pregnant client.

         

        REF:   771

         

        1. Which BEST explains why aspiration is not a problem disadvantages associated with nitrous oxide–oxygen (N2O-O2) analgesia?
        a. Gag reflex is not eliminated.
        b. Food intake is restricted prior to sedation.
        c. Mouth remains opened during instrumentation.
        d. Contraindicated for administration to persons with behavioral problems.

         

         

        ANS:  A

        Aspiration is not a problem because the client is awake and the gag reflex is not eliminated. Food intake is NOT restricted prior to nitrous oxide–oxygen (N2O-O2) sedation. While it is true that the mouth remains opened during instrumentation and nitrous oxide–oxygen (N2O-O2) analgesia is contraindicated for administration to persons with behavioral problems, these choices are NOT related to aspiration.

         

        REF:   772

         

        1. The dental hygienist determines when an appropriate level of sedation has been achieved to relax the client sufficiently based on signs and symptoms. The signs of nitrous oxide–oxygen (N2O-O2) analgesia are reported subjectively by the client, and the symptoms are observed objectively by the operator.
        a. Both statements are true.
        b. Both statements are false.
        c. The first statement is true; the second statement is false.
        d. The first statement is false; the second statement is true.

         

         

        ANS:  C

        The first statement is true; the second statement is false. The dental hygienist determines when an appropriate level of sedation has been achieved to relax the client sufficiently based on signs and symptoms. The symptoms of nitrous oxide–oxygen (N2O-O2) analgesia are reported subjectively by the client, and the signs are observed objectively by the operator. Choices A, B, and D do not accurately describe the statements.

         

        REF:   772

         

        1. The designated ideal minimal amount of nitrous oxide–oxygen (N2O-O2) needed to relax the client is the
        a. baseline.
        b. titration benefit.
        c. tidal volume.
        d. 10% to 20% concentration value.

         

         

        ANS:  A

        The designated ideal minimal amount of nitrous oxide–oxygen (N2O-O2) needed to relax the client is the baseline. The titration benefit refers to the combination of nitrous oxide with oxygen. The tidal volume is the amount of air a person needs for one respiration cycle. The concentration of 10% to 20% nitrous oxide–oxygen (N2O-O2) is not always the baseline minimal amount for all clients.

         

        REF:   772

         

        1. Which is a BEST practice when handling compressed-gas cylinders?
        a. Position full cylinders in the horizontal position.
        b. Store cylinders at a cool, non-fluctuating temperature.
        c. Use a certified oil to lubricate parts of the gas machine.
        d. Maintain valves in a semi-opened position to prevent valve stem leakage.

         

         

        ANS:  B

        A BEST practice to institute when handling compressed-gas cylinders include storing the cylinders at a cool, non-fluctuating temperature. Full cylinders should be positioned in the vertical, not the horizontal, position. No grease, oil, or lubricant of any type should be used to lubricate any part of the gas machine that may come into contact with gases as this is extremely dangerous. Valves must be opened fully to prevent gas leakage from the valve stems.

         

        REF:   774

         

        1. Which part of the portable continuous-flow gas machine holds the cylinders in contact with the gas machine?
        a. Yokes
        b. Flowmeter
        c. Pressure gauge
        d. Pin indexing

         

         

        ANS:  A

        Yokes hold the cylinders in contact with the gas machine. The flowmeter is used to indicate the rate of flow of the gas. The pressure gauge is used to indicate the rate of flow of the gas. The pin indexing safety system consists of pins on the yoke do not allow the nitrous cylinder to be accidently hooked to the oxygen cylinder, and vise versa.

         

        REF:   775

         

        1. Which is the MOST effective means of minimizing nitrous oxide–oxygen (N2O-O2) contamination in the oral healthcare treatment area?
        a. Flowmeter
        b. Reservoir bag
        c. Scavenging mask
        d. Suction calibrator

         

         

        ANS:  C

        Use of the scavenging mask is the MOST effective means of minimizing nitrous oxide–oxygen (N2O-O2) contamination in the oral healthcare treatment area. The flowmeter is used to indicate the rate of flow of the gas. The reservoir bag is the part of the machine that stores a mixture of the gases. The suction calibrator calibrates the degree of suction in the high-suction vacuum system.

         

        REF:   777

         

        1. All are built-in safety features of the nitrous oxide–oxygen (N2O-O2) machine EXCEPT one. Which one is the EXCEPTION?
        a. Color-coded tanks
        b. Automatic turnoff
        c. Scavenging mask
        d. Audible alarm system

         

         

        ANS:  C

        The scavenging mask is a removable part that may or may not be utilized as a safety feature of the nitrous oxide–oxygen (N2O-O2) machine. Built-in safety features of the nitrous oxide–oxygen (N2O-O2) machine include the color-coded tanks, automatic turnoff feature, and the audible alarm system.

         

        REF:   778

         

        1. The color of the nitrous oxide cylinder is
        a. red.
        b. blue.
        c. green.
        d. silver.

         

         

        ANS:  B

        The color of the nitrous oxide cylinder is blue. The color of the oxygen tank is green. Red and silver are NOT the colors used for the nitrous oxide or the oxygen tanks.

         

        REF:   772

         

        1. Which best practice explains the reason to eliminate unnecessary talking when the client is receiving nitrous oxide–oxygen (N2O-O2) analgesia?
        a. It interferes with the titration of the gases.
        b. The client is not able to respond to directives.
        c. It expels nitrous oxide into the immediate environment.
        d. Speed is of the essence to reduce client exposure.

         

         

        ANS:  C

        The reason to eliminate unnecessary talking when the client is receiving nitrous oxide–oxygen (N2O-O2) analgesia is because nitrous oxide is expelled into the immediate environment, thus affecting the practitioner. Choices A, B, and D do not accurately reflect best practices.

         

        REF:   780

         

        MULTIPLE RESPONSE

         

        1. Which are disadvantages associated with nitrous oxide–oxygen (N2O-O2) analgesia? (Select all that apply.)
        a. Nausea
        b. Vertigo
        c. Syncope
        d. Aspiration
        e. Seizure occurrence

         

         

        ANS:  A, B

        Disadvantages associated with nitrous oxide–oxygen (N2O-O2) analgesia include nausea and vertigo. Syncope, aspiration, and the occurrence of seizures are not disadvantages associated with nitrous oxide–oxygen (N2O-O2) analgesia.

         

        REF:   772

         

        1. Which are signs of oversedation with nitrous oxide? (Select all that apply.)
        a. Drowsy
        b. Feet point out
        c. Hyperresponsive
        d. Flushing of skin
        e. Exaggerated inspirations

         

         

        ANS:  C, E

        The signs of oversedation with nitrous oxide include demonstration of hyperresponsiveness to stimuli and exaggerated inspirations. Signs that the client has reached a desirable level of nitrous oxide–oxygen (N2O-O2) analgesia include drowsy, feet pointed out, and flushing of skin.

         

        REF:   772-773

        Chapter 51: Cognitively and Developmentally Challenged Persons

        Darby & Walsh: Dental Hygiene: Theory and Practice, 4th Edition

         

        MULTIPLE CHOICE

         

        1. Down syndrome is the most common and frequently observed chromosomal abnormality in humans and incidence is correlated with increased maternal age.
        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.

         

         

        ANS:  A

        Down syndrome is the most common and frequently observed chromosomal abnormality in humans and incidence is correlated with increased maternal age.

         

        REF:   923

         

        1. _____ is a form of autism that develops in children who initially seem normal; after at least 2 years of normal development, the child exhibits a dramatic loss of vocabulary, language, motor, and social skills.
        a. Autistic disorder (classic autism)
        b. Childhood disintegrative disorder
        c. Rett syndrome
        d. Asperger’s syndrome

         

         

        ANS:  B

        Childhood disintegrative disorder is a form of autism that develops in children who initially seem normal; after at least 2 years of normal development, the child exhibits a dramatic loss of vocabulary, language, motor, and social skills.

         

        REF:   931

         

        1. The dental hygienist must determine the need for prophylactic antibiotic premedication based on current guidelines in persons with Down syndrome, because congenital heart disease is common in this population.
        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.

         

         

        ANS:  A

        The dental hygienist must determine the need for prophylactic antibiotic premedication based on current guidelines in persons with Down syndrome because congenital heart disease is common in this population.

         

        REF:   936

         

        1. Prevalence of periodontal disease in the intellectual disability (ID) population is attributed to:
        a. lack of professional care.
        b. lack of funds to support care.
        c. increased susceptibility.
        d. poor oral hygiene.
        e. all of the above.

         

         

        ANS:  E

        Prevalence of periodontal disease in the ID population is attributed to risk factors such as lack of professional care, lack of funds to support or access care, host susceptibility and poor oral hygiene.

         

        REF:   922

         

        1. The language of children with autism spectrum disorder (ASD) consists mainly of naming nouns and adjectives that identify objects and indicating colors and numbers that represent nothing specific. This type of language is referred to as:
        a. articulation disorder.
        b. stuttering.
        c. excellent rote memory.
        d. apraxia.

         

         

        ANS:  C

        Children with ASD are usually devoid of speech or have abnormal language. Their language consists mainly of naming nouns and adjectives that identify objects and indicating colors and numbers that represent nothing specific. This type of language is referred to as excellent rote memory.

         

        REF:   931

         

        1. When treating ASD children, the dental hygienist should try to alleviate fear of dental instruments by:
        a. distracting conversation not related to procedure.
        b. remaining silent during treatment.
        c. explaining each procedure and the use of each instrument to the client.
        d. allowing them to touch the instruments.

         

         

        ANS:  C

        ASD children are not afraid of people but of the objects they acquire. Dental hygienists should try to alleviate a fear of dental instruments by explaining each procedure and the use of each instrument to the client.

         

        REF:   932

         

        1. Clients with mild ID are not educable, so explain and demonstrate oral hygiene instructions based on activities instead of concepts.
        a. Both parts of the statement are true.
        b. Both parts of the statement are false.
        c. The first part of the statement is true, and the second part of the statement is false.
        d. The first part of the statement is false, and the second part of the statement is true.

         

         

        ANS:  D

        Clients with mild ID are educable, so explain and demonstrate oral hygiene instructions based on activities instead of concepts.

         

        REF:   920

         

        1. Employing the show-tell-do method of teaching fundamental skills is recommended for clients with:
        a. mild ID.
        b. moderate ID.
        c. severe ID.
        d. all of the above.
        e. none of the above.

         

         

        ANS:  B

        Persons with moderate ID have poor hand and finger coordination; therefore, clients should be taught only the fundamental skills via the show-and-tell method.

         

        REF:   921

         

        1. When planning oral hygiene interventions for clients with severe or profound ID, the caregiver should be included. Clients with severe ID can learn by habit training but need follow-up by the caregiver.
        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.

         

         

        ANS:  A

        When planning oral hygiene interventions for clients with severe or profound ID, the caregiver should be included. Clients with severe ID can learn by habit training but need follow-up by the caregiver

         

        REF:   936

         

        1. The American Dental Hygienists Association (ADHA) Code of Ethics states that clients should be treated without discrimination. Dental hygienists who are ill-prepared to treat these clients should seek continuing education opportunities and/or refer the client so that high-quality care can be rendered.
        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.

         

         

        ANS:  A

        The ADHA Code of Ethics states that clients should be treated without discrimination. Dental hygienists who are ill-prepared to treat these clients should seek continuing education opportunities and/or refer the client so that high-quality care can be rendered.

         

        REF:   936

         

        1. Many persons with intellectual and developmental disabilities rely on government-funded sources for income and financing healthcare; therefore, access to care is a real problem.
        a. Both parts of the statement are true.
        b. Both parts of the statement are false.
        c. The first part of the statement is true, and the second part of the statement is false.
        d. The first part of the statement is false, and the second part of the statement is true.

         

         

        ANS:  A

        Many persons with intellectual and developmental disabilities rely on government-funded sources for income and financing healthcare; therefore access to care is a real problem.

         

        REF:   935

         

        1. All of the following are strategies for establishing a trusting relationship with ID clients except:
        a. keep the first appointment short and nonthreatening.
        b. explain instructions quickly.
        c. reward positive behavior.
        d. familiarize client with surroundings.

         

         

        ANS:  B

        Strategies for establishing a trusting relationship include familiarizing client with surroundings, give explanations slowly one instruction at a time, keep the first appointment short and nonthreatening and reward positive behavior.

         

        REF:   923

         

        1. All of the following are oral manifestations that can be observed in clients with Down syndrome except:
        a. microdontia.
        b. periodontal disease.
        c. hypersalivation.
        d. low caries risk.

         

         

        ANS:  C

        Clients with Down syndrome often exhibit periodontal disease, low caries risk and microdontia. Hypersalivation is not a characteristic seen in this population.

         

        REF:   928

         

        1. All of the following are oral manifestations that can be observed in clients with intellectual disabilities except:
        a. dental attrition.
        b. bruxism.
        c. delayed tooth eruption.
        d. heavy oral biofilm.
        e. excellent home care.

         

         

        ANS:  E

        Oral manifestations that can be observed in clients with intellectual disabilities include dental attrition, bruxism, delayed tooth eruption and heavy oral biofilm. Most of these clients lack good home care regimes.

         

        REF:   922

         

        1. Rewards can be used to reinforce positive behavior in clients with Intellectual disabilities, all of the following are examples of social rewards except:
        a. going to a party.
        b. attention.
        c. affection.
        d. praise.

         

         

        ANS:  A

        Social rewards include attention, affection, and praise. Going to a party is an example of an activity reward.

         

        REF:   921

         

        1. Individuals with Down syndrome have a high incidence of periodontal disease that can begin as early as age 6, and by adulthood nearly all people with Down syndrome are affected.
        a. Both parts of the statement are true.
        b. Both parts of the statement are false.
        c. The first part of the statement is true, and the second part of the statement is false.
        d. The first part of the statement is false, and the second part of the statement is true.

         

         

        ANS:  A

        Individuals with Down syndrome have a high incidence of periodontal disease that can begin as early as age 6, and by adulthood nearly all people with Down syndrome are affected.

         

        REF:   928-929

         

        1. Malocclusion is rarely corrected in patients with Down syndrome because if a cross-bite is corrected, an earlier tissue breakdown may occur as a result of the underdeveloped maxilla and its relation to basal bone. Lingual movement of mandibular teeth is difficult because of their large, protruding tongues.
        a. Both the statement and the reason are correct, and they are related.
        b. Both the statement and the reason are correct, but they are 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.

         

         

        ANS:  A

        Malocclusion is rarely corrected in patients with Down syndrome because if a cross-bite is corrected, an earlier tissue breakdown may occur as a result of the underdeveloped maxilla and its relation to basal bone. Lingual movement of mandibular teeth is difficult because of their large, protruding tongues.

         

        REF:   928

         

        1. Almost all clients with Down syndrome must be preoperatively medicated prior to dental treatment. When care requires a general anesthetic agent, a thorough health history review is imperative, and all possible needs should be met while the person is anesthetized.
        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.

         

         

        ANS:  D

        Clients with Down syndrome can be preoperatively medicated prior to dental treatment if they are unmanageable. When care requires a general anesthetic agent, a thorough health history review is imperative, and all possible needs should be met while the person is anesthetized.

         

        REF:   929

         

        1. The most severe form of autism in which the person has difficulty talking and relating to others and the environment and displays compulsive, ritualistic behaviors are referred to as:
        a. autistic disorder (classic autism).
        b. childhood disintegrative disorder.
        c. Rett syndrome.
        d. Asperger’s syndrome.

         

         

        ANS:  A

        Autistic disorder (classic autism) is the most severe form of autism in which the person has difficulty talking and relating to others and the environment and displays compulsive, ritualistic behaviors.

         

        REF:   929

         

        1. _____ is a mild form of autism characterized by impairment in social interactions without significant problems in language, cognitive ability, or age-appropriate developmental skills; persons are socially awkward, do not understand the use of gestures, lack empathy, avoid eye contact, and seem unengaged.
        a. Autistic disorder (classic autism)
        b. Childhood disintegrative disorder
        c. Rett syndrome
        d. Asperger’s syndrome

         

         

        ANS:  D

        Asperger’s syndrome is a mild form of autism characterized by impairment in social interactions without significant problems in language, cognitive ability, or age-appropriate developmental skills; persons are socially awkward, do not understand the use of gestures, lack empathy, avoid eye contact, and seem unengaged.

         

        REF:   929

         

        1. Caregivers are encouraged to be present during treatment for clients with autism spectrum disorders, because a familiar face may be necessary and particularly if immobilization is needed for behavior control.
        a. Both the statement and the reason are correct, and they are related.
        b. Both the statement and the reason are correct, but they are 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.

         

         

        ANS:  A

        Caregivers are encouraged to be present during treatment for clients with autism spectrum disorders because a familiar face may be necessary and particularly if immobilization is needed for behavior control.

         

        REF:   932

         

        1. When formulating a care plan for clients with profound ID, the dental hygienist must educate the caregiver about the daily oral care regime and his or her own oral self-care, because a caregiver is usually responsible for the client’s daily general and oral care.
        a. Both the statement and the reason are correct, and they are related.
        b. Both the statement and the reason are correct, but they are 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.

         

         

        ANS:  A

        When formulating a care plan for clients with profound ID, the dental hygienist must educate the caregiver about the daily oral care regime and his or her own oral self-care, because a caregiver is usually responsible for the client’s daily general and oral care.

         

        REF:   921

         

        1. When developing oral hygiene skills in a client with ID, teach based on the client’s chronologic age, not mental age.
        a. Both parts of the statement are true.
        b. Both parts of the statement are false.
        c. The first part of the statement is true, and the second part of the statement is false.
        d. The first part of the statement is false, and the second part of the statement is true.

         

         

        ANS:  B

        When developing oral hygiene skills in a client with ID, teach based on the client’s mental age not chronological age.

         

        REF:   922-923

         

        1. The use of 0.12% chlorhexidine gluconate mouth rinse is commonly prescribed for clients with disabilities to help control oral biofilm and gingivitis. It can be administered via an oral irrigator, a spray, or a swab.
        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.

         

         

        ANS:  A

        The use of 0.12% chlorhexidine gluconate mouth rinse is commonly prescribed for clients with disabilities to help control oral biofilm and gingivitis. It can be administered via an oral irrigator, a spray, or a swab.

         

        REF:   935

         

        1. A severe gag reflex may be managed by eliminating the use of toothpaste to reduce gagging and provide better vision for the caregiver. Water, an ADA-accepted antimicrobial mouth rinse, or an ingestible or low-foaming dentifrice can be used in place of toothpaste.
        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.

         

         

        ANS:  A

        A severe gag reflex may be managed by eliminating the use of toothpaste to reduce gagging and provide better vision for the caregiver. Water, an ADA-accepted antimicrobial mouth rinse, or an ingestible or low-foaming dentifrice can be used in place of toothpaste.

         

        REF:   935

         

        1. When selecting a toothbrush for clients with disabilities the dental hygienist must take into account all of the following except:
        a. grip problems.
        b. use of fine motor skills.
        c. client’s ability to open.
        d. food allergies.

         

         

        ANS:  D

        When selecting a toothbrush for clients with disabilities the dental hygienist must take into account a person’s grip problems, use of fine motor skills and their ability to open their mouth. Food allergies in unrelated to toothbrush selection.

         

        REF:   935

         

        1. Most children with ASD avoid communicating with:
        a. facial expressions.
        b. eye contact.
        c. nonverbal communication.
        d. all of the above.

         

         

        ANS:  D

        Most children with ASD avoid facial expressions, eye contact, and nonverbal communication.

         

        REF:   931

         

        1. _____ is considered an atypical form of autism in which some but not all classic signs are observed, therefore not meeting the criteria for a specific diagnosis; characterized by varying degrees of impairment in communication skills and social interactions, sensitivities to sights and sounds, and restricted, repetitive, and stereotyped patterns of behavior
        a. Autistic disorder (classic autism)
        b. Childhood disintegrative disorder
        c. Rett syndrome
        d. Asperger’s syndrome
        e. Pervasive developmental disorder not otherwise specified

         

         

        ANS:  E

        Pervasive developmental disorder not otherwise specified is considered an atypical form of autism in which some but not all classic signs are observed, therefore not meeting the criteria for a specific diagnosis; characterized by varying degrees of impairment in communication skills and social interactions, sensitivities to sights and sounds, and restricted, repetitive, and stereotyped patterns of behavior

         

        REF:   931

         

        1. Clients with Down syndrome are given the same treatment options as other clients. Treatment objectives must be limited simply because the client has Down syndrome.
        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.

         

         

        ANS:  C

        Clients with Down syndrome are given the same treatment options as other clients. Treatment objectives must not be limited simply because the client has Down syndrome

         

        REF:   928

         

        1. Effective communication leads to a trusting relationship, which in turn allows the oral healthcare experience to be successful for both client and clinician. Frequently caregivers are able to suggest behavioral guidance to achieve a pleasant dental experience.
        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

         

         

        ANS:  A

        Effective communication leads to a trusting relationship, which in turn allows the oral healthcare experience to be successful for both client and clinician. Frequently caregivers are able to suggest behavioral guidance to achieve a pleasant dental experience.

         

        REF:   923

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