Clinic II TEST

Responsibility for oral health sign or symptom associated with a deficit in that human need for a tobacco using client.

Inadequate ownership of personal oral hygiene

All of the following are nonnicotine replacement products except one. Which is the one exception? a. Varenicline b. Chantix c. Sustained-release bupropion d. Nicotine patch e. Zyban

Nicotine patch The nicotine patch is a replacement product. The other choices are non-nicotine replacement products.

Protection from health risks sign or symptom associated with a deficit in that human need for a tobacco using client.

Tobacco-related illness (e.g., heart disease, high blood pressure, cancer, and delayed wound healing)

Freedom from fear and stress sign or symptom associated with a deficit in that human need for a tobacco using client.

Withdrawal due to nicotine addiction

Which of the following statements best describes why eating disorders have been referred to as an eclipse of the persons thinking? a. Overshadow of healthy thought process b. Reoccur throughout the client's lifetime c. Regular periods of recovery relapse d. Transient mental illnesses of youth e. Monthly imbalance of hormones

a. Overshadow of healthy thought process Response Feedback: Eating disorders have been referred to the eclipsing of the person's thinking with the eating disorder thoughts; that behind the eating disorder is the person who has been overshadowed by the illness, which has literally possessed the person's "normal" thinking and being.

Anorexia nervosa may be comorbid with which one of the following conditions? a. Autism b. Alcoholism c. Substance abuse d. Brain injury e. Sociopathology

c. Substance abuse In addition to medical problems, persons with anorexia nervosa present with psychologic challenges, such as major depression and anxiety disorders, substance abuse, self-injurious behavior, and restricted affect and capacity for insight.

What is the recommended daily allowance (RDA) of calcium in a healthy young adult diet? a. 1300 mg b. 500 mg c. 1000 mg d. 800 mg

1000 mg Response Feedback: For a healthy adult ages 19 to 50, the current RDA is 1000 mg. For a healthy adult 51 and older, the current RDA is 1200 mg. For young adults between 14 and 18 years of age, it is 1300 mg/day. For children 1 to 3 years of age, it is 500 mg and for children ages 4 to 8, the recommended daily intake is 800 mg.

During pregnancy, a woman's caloric needs increase by approximately how many calories per day? a. 150 b. 350 c. 0 d. 550

350 Response Feedback: During pregnancy, a woman's daily caloric needs increase by approximately 350 to 450 calories. However, an underweight or teenage pregnant woman will often have greater calorie needs.

All of the following management strategies should be considered when planning treatment care and education for the client with bulimia nervosa except one. Which is the one exception? a. Provide palliative care for dentinal hypersensitivity. b. Discuss stain-inducing food products. c. Apply acidulated phosphate fluoride (APF) gel. d. Rinse with sodium bicarbonate following an oral purge. e. Avoid diet carbonated beverages.

Apply acidulated phosphate fluoride (APF) gel. Response Feedback: Both stannous fluoride and APF fluorides are low pH and should be avoided because of the preexisting problem with low pH associated with vomiting behavior.

What is the single most preventable cause of disease and premature death in the world? A. Sexually transmitted diseases B. Tobacco use C. Diabetes D. Obesity E. Auto accidents

B. Tobacco use

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. The first statement is false, and the second statement is true. b. Both statements are false. c. Both statements are true. d. The first statement is true, and the second statement is false.

Both statements are true. Response Feedback: 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.

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. The statement is not correct, but the reason is correct. c. Both the statement and the reason are correct, but they are not related. d. The statement is correct, but the reason is not. e. Neither the statement nor the reason is correct.

Both the statement and the reason are correct, and they are related. Response Feedback: 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.

Louise is an 85-year-old female client that presents to the dental office with complaints of burning mouth? Which of the following vitamin deficiencies may be causing her to experience this oral discomfort a. Niacin b. Folate c. Pyridoxine (B6) d. Cyanocobalamin (B12)

Cyanocobalamin (B12) As we age, the intrinsic factor, which is necessary for the absorption of cyanocobalamin (B12) is decreased. Pernicious anemia and burning mouth can occur when there is a deficiency in B12.

Nutritional counseling for dental caries prevention targets which of the following? a. Consumption of nutrient dense foods b. Decreased consumption of fermentable carbohydrates c. Proper toothbrushing technique d. Regularity of flossing

Decreased consumption of fermentable carbohydrates Response Feedback: The focus of nutritional counseling for dental caries prevention should target the eliminator or reduction of fermentable carbohydrates from the diet.

After discussion with a client with an eating disorder, which of the following actions should be taken initially by the dental hygienist for legal purposes? a. Obtain informed consent form from the client to contact other healthcare providers. b. Share the findings with dental personnel in the dental hygiene practice setting. c. Document appointment discussion and decisions in the client's chart. d. Direct the client to begin restorative dental care. e. Consider referral of the client to an eating disorder clinic.

Document appointment discussion and decisions in the client's chart. Response Feedback: Discussions with clients must be documented in the client's chart as part of legal record-keeping. A prudent dental hygienist would refer the client to an eating disorder treatment center, keep confidential client information unless informed consent has been provided by the client to share their information for the purposes of their care, and know that dental restorations are part of the recovery phase of the illness.

Perimylolysis is commonly characterized by each of the following criteria except one. Which is the one exception? a. Pitting appearance on the incisal edges of maxillary anterior teeth b. Glossy appearance of enamel c. Vertical reduction of tooth height d. Amalgams appear raised above the surrounding enamel e. Dished out shape of lingual surface of teeth

Glossy appearance of enamel Response Feedback: Perimylolysis is difficult for practitioners to identify because initial tooth structure loss usually is subtle. Slight pitting on the incisal surfaces of the anterior teeth and a cupping appearance on the cusps of the posterior teeth are usually the erosive changes that are the first to be detected in the client with frequent vomiting behavior. As perimylolysis progresses, the teeth exhibit a loss of normal anatomic features, such as developmental grooves and pits, and they develop a matte like surface (thus teeth do not have a glossy appearance) with rounded margins. This may become so extensive that a complete loss of enamel is evident. Loss of enamel around amalgam restorations results in a raised island appearance of the amalgam. Teeth without restorations show a significant loss of occlusal contours.

Which of the following would be wise food choices for the dental hygienist to recommend as snacks for young children because of their noncariogenicity? a. Low-fat yogurt, apples, carrots, string cheese, and skim milk b. Popcorn, oranges, saltine crackers, sports drinks, and dry unsweetened cereal c. Fruit flavored tea and tortilla chips d. Peanut butter crackers and noncarbonated fruit drink

Low-fat yogurt, apples, carrots, string cheese, and skim milk Response Feedback: Dairy foods are cariogenic. Crunchy foods, such as fruits and vegetables, have a detergent cleansing effect on the teeth. Sticky foods, such as crackers, cereal and peanut butter crackers, do not clear readily from the mouth; acidogenic beverages, such as sports drinks and noncarbonated fruit drink, contribute to the increased risk of dental caries.

Which of the following nutrients is not necessary for adequate maintenance of bone growth and mineralization? a. Phosphorus b. Calcium c. Magnesium d. Vitamin D

Magnesium Calcium, phosphorus, and vitamin D are needed for adequate maintenance of bone growth and mineralization.

Conceptualization and problem solving sign or symptom associated with a deficit in that human need for a tobacco using client.

Misconceptions and lack of knowledge about systemic and oral effects of tobacco use

Biologically sound and functional dentition sign or symptom associated with a deficit in that human need for a tobacco using client.

Missing teeth

Wholesome facial image sign or symptom associated with a deficit in that human need for a tobacco using client.

Tooth staining, halitosis, missing teeth, facial wrinkling

Hookah use is equivalent to inhaling 100-200 times the volume of smoke from one cigarette. True False

True

If a patient quits smoking, their risk of periodontal disease will be reduced. True False

True

The transient, well-localized, sharp pain associated with dentinal hypersensitivity is most likely the result of the stimulation of which of the following nerve fibers near the pulp-dentin interface? a. A-delta fibers b. A-beta fibers c. A-delta fibers, A-beta fibers, and C-fibers d. C-fibers

a. A-delta fibers Response Feedback: Activation of specific nerve fibers in the dentin results in different types of nerve pain. The transient, well-localized, sharp type of pain is a result of the stimulation of the A-delta fibers—small myelinated fibers that evoke a sensation of this type of pain. Activation of the A-delta fibers is responsible for dentinal hypersensitivity. The A-beta fibers are susceptible to the same type of stimuli but respond more sensitively to electrical stimulation. Stimulation of the unmyelinated C-fibers results in a dull, poorly localized, aching type of pain usually associated with pulpal pain.

All of the following identify ways to help clients become tobacco-free except one. Which is the one exception? . Advising about the health benefits of chemicals added to tobacco b. Advising of health risks with tobacco use c. Advising about all aspects of nicotine addiction d. Being supportive and assisting the client with problem solving e. Advising about coping strategies f. All of the above are appropriate ways. g. Options b, c, d, and e are appropriate ways.

a. Advising about the health benefits of chemicals added to tobacco Response Feedback: Advising about the health benefits of chemicals added to tobacco is the correct answer since there are no health benefits. The other choices are incorrect.

Medical consultation often is recommended for clients with a deficit in their human need for protection from health risks. The need for medical consultation is necessary for a client wishing to make a quit attempt if they have symptoms of an underlying depressive disorder. 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.

a. Both statements are true. Response Feedback: Both statements are correct. The other choices are incorrect.

A deficit in the need for a wholesome facial image is a dissatisfaction with the appearance of one's teeth. This need creates an ideal teachable moment in the advising stage of the 5 As approach because tobacco use stains teeth and can adversely affect one's breath. a. Both statements are true. b. Both statements are false. c. The first statement is false, and the second statement is true. d. The first statement is true, and the second statement is false.

a. Both statements are true. Response Feedback: Both statements are true. The other choices are incorrect.

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. The first statement is false, and the second statement is true c. The first statement is true, and the second statement is false. d. Both statements are false.

a. Both statements are true. Response Feedback: 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.

Dentinal hypersensitivity is most common on what region of the tooth? a. Buccal cervical b. Occlusal c. Facial d. Lingual

a. Buccal cervical Response Feedback: Dentinal hypersensitivity is most prevalent on the buccal cervical regions of teeth.

Which of the following is an example of a thinking response? Answers: a. Delay b. Distraction c. On the quit date d. Avoidance e. Use of oral substitutes

a. Delay Response Feedback: Thinking responses are the client's thoughts about quitting tobacco use.6 Some thinking responses that the client can use to cope with temptation to use tobacco are positive thinking, delay, and rewards.

_____ 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. Pervasive developmental disorder not otherwise specified b. Rett syndrome c. Asperger's syndrome d. Childhood disintegrative disorder e. Autistic disorder (classic autism)

a. Pervasive developmental disorder not otherwise specified Response Feedback: 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

Mark is a 12-year-old male with cystic fibrosis. Malabsorption of fat is a side effect of this condition. As a result, deficiency of the fat soluble vitamins must be closely monitored and treated. This would be an example of which of the following? a. Secondary nutrient deficiency b. Systemic nutrient deficiency c. Tertiary nutrient deficiency d. Primary nutrient deficiency

a. Secondary nutrient deficiency Response Feedback: A secondary deficiency is caused by a systemic disorder that interferes with the ingestion, absorption, digestion, transport, and use of nutrients.

For a client experiencing xerostomia, all of the following are recommended except: a. frequent sips of flavored water. b. chewing gum with xylitol. c. use of sugar-free gums and candies. d. moderate intake of diet sodas.

a. frequent sips of flavored water. Sugar-free gums and candies, chewing gums with xylitol and moderate intake diet sodas are indicated for people with xerostomia. Water is a good choice, but flavored water often has low pH due to additives.

_____ 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. Rett syndrome b. Asperger's syndrome c. Autistic disorder (classic autism) d. Childhood disintegrative disorder

b. Asperger's syndrome Response Feedback: 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.

Which of the following of the 5 As approach to tobacco cessation involves coping skills training? a. Advising b. Assisting c. Asking d. Assessing e. Arranging

b. Assisting Response Feedback: Assisting with the quitting process involves coping skills training. The other choices are incorrect.

What term is used to refer to sites of tooth structure wear commonly found on the incisal or occlusal surfaces of teeth as a result of masticatory forces? a. Abfraction b. Attrition c. Abrasion d. Erosion

b. Attrition Response Feedback: Attrition is the term used to refer to tooth structure wear on the incisal and occlusal surfaces that occurs from normal tooth use, including the mechanical tooth-to-tooth wear of the dentition from normal tooth contact. Erosion is the loss of tooth structure as a result of a chemical process. Abfraction consists of the ongoing flexion, tension, and compression forces exerted in the cervical area of a tooth from mastication, and occlusal trauma can result in cracking and eventual loss of cervical tooth structure. Abrasion is the loss of tooth structure associated with toothbrush stiffness and bristle configuration. The technique, frequency, duration, and force of brushing and toothbrush filaments have been implicated in recession.

Binge eating disorder is characterized by which of following? a. Excessive exercise before a purge b. Binging without purging c. Restricting eating to nighttime only d. Restriction following a purge e. Laxative use following a binge

b. Binging without purging Response Feedback: For a diagnosis of EDO-NOS the person must present with patterns of behavior not consistent with either anorexia or bulimia nervosa, yet they are involved in thinking and behaving around food and have a body image that is not within normal limits. Binge-eating disorder is described as repeated binge eating without compensatory behaviors, such as vomiting, but associated with shame, guilt, and lack of control.

Intrinsic erosion is a result of dietary factors that contribute to a highly acidic oral environment. The frequent consumption of acidic, carbonated, sports, or fruit drinks or frequent sugar consumption can cause intrinsic erosion. a. The first statement is true, and the second statement is false. b. Both statements are false. c. Both statements are true. d. The first statement is false, and the second statement is true.

b. Both statements are false. Response Feedback: Both statements are false. Intrinsic erosion is caused by acid regurgitation associated with medical and psychologic disorders (e.g., morning sickness and bulimia). The statements given in the question refer to extrinsic erosion, not intrinsic erosion.

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. The first statement is true, and the second statement is false. b. Both statements are true. c. Both statements are false. d. The first statement is false, and the second statement is true.

b. Both statements are true. Response Feedback: 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.

What term refers to the reduction of the dentinal tubule lumen as a result of the deposition of intratubular dentin? a. Abfraction b. Dentinal sclerosis c. Abrasion d. Attrition

b. Dentinal sclerosis Response Feedback: Dental sclerosis is the reduction of the dentinal tubule lumen as a result of the deposition of intratubular dentin. Abfraction consists of the ongoing flexion, tension, and compression forces exerted in the cervical area of a tooth from mastication; occlusal trauma can result in cracking and eventual loss of cervical tooth structure. Abrasion is the loss of tooth structure associated with toothbrush stiffness and bristle configuration. The technique, frequency, duration, and force of brushing and toothbrush filaments have been implicated in recession. Attrition is the term used to refer to tooth structure wear on the incisal and occlusal surfaces that occurs from normal tooth use, including the mechanical tooth-to-tooth wear of the dentition from normal tooth contact.

What are the four general principles that underlie motivational interviewing? Answers: a. Ask open-ended questions, develop discrepancy, roll with resistance, and support self-efficacy b. Express empathy, develop discrepancy, roll with resistance, and support self-efficacy c. Open-ended questioning, affirm change talk, reflective responding, summarizing the results of the dialogue d. Express empathy, ask open-ended questions, affirm change talk, and support self-efficacy

b. Express empathy, develop discrepancy, roll with resistance, and support self-efficacy Response Feedback: Express empathy, develop discrepancy, roll with resistance, and support self-efficacy. The other choices are incorrect.

All of the following factors are considered possible etiologies in the development of an eating disorder except one. Which is the one exception? a. Genetic b. Gastrointestinal c. Psychodevelopmental d. Neurochemical e. Sociocultural

b. Gastrointestinal Response Feedback: Current theories regarding the etiology of anorexia and bulimia suggest a complex interrelationship between genetic, psychodevelopmental, neurochemical, and sociocultural components.

Which one of the following describes the psychosocial dimension of bulimia nervosa? a. Feelings of grandeur and superiority b. Guilt and shame c. Expressive and loud d. Shy and socially inept e. Blame-oriented and opinionated

b. Guilt and shame Response Feedback: In bulimia nervosa, low self-esteem and subsequent feelings of inadequacy are reinforced by the guilt and embarrassment associated with binge and purge behavior. The behavior itself becomes self-reinforcing because achievement and maintenance of low weight are perceived as bringing increased attractiveness and more friends; hence the eclipsing analogy. Persons with bulimia nervosa do obsess about body image. They may appear quite successful in the management of life. Affective expression may appear gregarious to the casual observer; however, underlying the facade is a flattened affect resulting from the associated anxiety, guilt, and dysphoria.

Chief Complaint • "My teeth are very sensitive when I eat or drink cold foods and beverages." Dental History • Regular 6-month continued-care appointments • Brushes twice daily (uses a hard toothbrush) Clinical Examination • Light to moderate dental calculus • Localized attrition along anterior incisal and canine tooth surfaces • Localized recession and cervical abfraction evident on teeth 6, 7, 8, 9, 22, 23, 24, 25, 26, 27, 28, and 29 • Occlusal trauma on 6, 7, 8, 9, 22, 23, 24, 25, 26, 27, 28, and 29 All of the following factors from the client's assessment data might be the cause of gingival recession except which one? a. Presence of occlusal trauma b. Presence of carious lesions c. Use of a hard toothbrush d. Presence of abfraction

b. Presence of carious lesions Response Feedback: The presence of incipient caries is not a cause of gingival recession. Factors that contribute to gingival recession include the use of a hard toothbrush, abfraction (which causes eventual loss of cervical tooth structure followed by recession), and occlusal trauma, which can alter the attachment of the gingiva to the tooth.

Enamel erosion is the most common oral finding in individuals with bulimia. Enamel erosion is unlikely to result from other systemic illnesses or physical conditions. a. Both statements are false. 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 true.

b. The first statement is true, and the second statement is false. Response Feedback: Perimylolysis, or dental erosion, is the most common dental finding in the vomiting-eating disorder client. Although dental erosion is the most common oral finding in the bulimia and binge/purge subtype of anorexia, it has also been associated with vomiting as a result of gastric disturbances, such as gastroesophageal reflux disease (GERD); dietary habits, such as drinking high-citric acid fruit; intake or habitual eating or sucking on chewable vitamin C tablets or sweet-and-sour type candies; Antabuse therapy for alcoholism, medications containing hydrochloric acid, and exposure to industrial acids.

During the oral assessment of a 46-year-old male client, the dental hygienist notes that the client's gums are swollen, spongy, and bleeding. Which of the following nutrients might be deficient in the client's diet? a. Riboflavin b. Vitamin C c. Vitamin B12 d. Folacin

b. Vitamin C Deficiencies in vitamin C can cause swollen, spongy, and bleeding gums.

Which of the following nutrients are produced in the large intestine? a. Vitamin D b. Vitamin K c. Vitamin A d. Vitamin E

b. Vitamin K Vitamin K is produced in the large intestine. It can also be found in foods, such as cauliflower, cabbage, spinach, garbanzo beans, and beef liver.

All of the following would be recommended for a child under 2 years of age except: a. fluoridation. b. artificial sweeteners. c. good oral hygiene care. d. healthy snack choices.

b. artificial sweeteners. Response Feedback: Artificial sweeteners should not be a part of the diet of infants or children under 2 years of age.

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

b. food allergies. Response Feedback: 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.

Examples of oral and systemic effects of tobacco use include all of the following, except: Answers: a. hypertension and stroke. b. hyperkeratosis. c. oral and pharyngeal cancers. d. osteoporosis. e. xerostomia.

b. hyperkeratosis. Response Feedback: Hyperkeratosis is not an example of the oral and systemic effects of tobacco use. Osteoporosis, oral and pharyngeal cancers, hypertension and stroke, and xerostomia are all examples of the oral systemic effects of tobacco.

All of the following are hallmarks of nicotine addiction except: a. pleasant (euphoric effects). b. intolerance to nicotine. c. recurrent drug cravings. d. use despite harmful effects. e. compulsive use. f. physical dependence. g. tolerance.

b. intolerance to nicotine. Response Feedback: Intolerance to nicotine is incorrect, The remaining choices are the hallmarks of nicotine addiction and are incorrect.

Nicotine withdrawal symptoms can be hunger or weight gain. Behavioral coping strategies to address these symptoms are aerobic exercise, healthy eating, drinking water, chewing xylitol gum, and/or eating xylitol hard candy. a. The first statement is correct, but the second is not. b. Both the statement and the reason are correct, but they are not related. c. Both the statement and the reason are correct, and they are related. d. The first statement is not correct, but the second is correct. e. Neither the statement nor the reason is correct.

c. Both the statement and the reason are correct, and they are related. Response Feedback: Both the statement and reason are correct, and related nicotine withdrawal symptoms can be hunger or weight gain; a suggested behavioral or coping strategy could be aerobic exercise, healthy eating, drinking water, chewing xylitol gum, eating xylitol hard candy. The other choices are incorrect.

The following list identifies the type of chemicals released by the brain when exposed to nicotine except one. Which is the one exception? a. Beta-endorphin b. Serotonin c. Cyclosporine d. Acetylcholine e. Norepinephrine f. Dopamine g. Vasopressin

c. Cyclosporine Response Feedback: Cyclosporine is not a type of chemical released by the brain when it is exposed to nicotine. The other chemicals are all chemicals in the brain that are released when exposed to nicotine and therefore are incorrect choices.

Which one of the following is the best self-applied home product to help decrease dentinal hypersensitivity? a. Oral irrigation system b. Medium- to hard-bristled toothbrush c. Fluoride mouth rinse or gel d. Nonfluoride antibacterial mouth rinse

c. Fluoride mouth rinse or gel Response Feedback: Use of a daily fluoride mouth rinse or gel and a low-abrasive fluoride dentifrice for sensitive teeth is helpful for arresting dentinal hypersensitivity. An antibacterial mouth rinse, oral irrigation, and the use of a medium- to hard-bristled toothbrush will not arrest dentinal hypersensitivity. Products that contain NovaMin, arginine bicarbonate, amorphous calcium phosphate, and casein phosphopeptide-amorphous calcium phosphate are currently under investigation for their potential ability to control dentinal hypersensitivity, but more research is needed.

Chief Complaint • "My teeth are very sensitive when I eat or drink cold foods and beverages." Dental History • Regular 6-month continued-care appointments • Brushes twice daily (uses a hard toothbrush) Clinical Examination • Light to moderate dental calculus • Localized attrition along anterior incisal and canine tooth surfaces • Localized recession and cervical abfraction evident on teeth 6, 7, 8, 9, 22, 23, 24, 25, 26, 27, 28, and 29 • Occlusal trauma on 6, 7, 8, 9, 22, 23, 24, 25, 26, 27, 28, and 29 All of the following interventions could be provided in the dental setting to treat this client's areas of dentinal hypersensitivity except which one? a. Use of a desensitizing agent such as potassium nitrate b. Use of a 5% sodium fluoride varnish c. In-office oral irrigation with 0.12% chlorhexidine d. Placement of Class V restorations

c. In-office oral irrigation with 0.12% chlorhexidine Response Feedback: An in-office oral irrigation procedure with 0.12% chlorhexidine is not an evidence-based intervention for the treatment of dentinal hypersensitivity. She would benefit from fluoride varnish therapy, placement of a Class V restoration, or the use of a desensitizing agent.

Which of the following are considered to be a good source of vitamin A? a. Carrots b. Spinach c. Milk d. Sweet potatoes

c. Milk Vitamin A is only found in animal foods, such as meat, milk, and cheese. Beta carotene, a derivative of vitamin A, is found in orange fruits and vegetables, as well as leafy green vegetables.

All of the following health professionals are important in managing the individual with an eating disorder except one. Which is the one exception? a. Dental hygienist b. Exercise therapist c. Speech language pathologist d. Psychologist e. Physician

c. Speech language pathologist Response Feedback: Successful treatment of the individual with an eating disorder may require coordination among the client's psychologist/psychiatrist, physician, dentist, dental hygienist, exercise therapist, nutritionist, and/or family therapist.

The focus of nutritional counseling for children in the dental setting should be on: a. proper toothbrushing technique. b. importance of adequate calorie intake. c. caries control. d. minimizing fat in diet.

c. caries control. Response Feedback: The focus of nutritional counseling in the oral care setting should focus on caries control. Focus on vitamins and minerals important for bone growth should also be included in a discussion with the child and caregiver.

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

c. explain instructions quickly. Response Feedback: 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.

All of the following are OTC pharmacotherapies except nicotine: Answers: a. lozenge. b. gum. c. inhaler. d. patch.

c. inhaler. Response Feedback: The nicotine inhaler is not an OTC pharmacotherapy. The other choices are OTC pharmacotherapies.

Withdrawal symptoms of tobacco cessation peak within: a. 24 to 48 hours b. 2 to 4 weeks c. 48 to 72 hours d. 12 to 24 hours e. 1 to 2 weeks

d. 12 to 24 hours Response Feedback: Symptoms peak within 12 to 24 hours and last 2 to 4 weeks if tobacco use is discontinued.

A national survey reported that ____ of smokers want to quit. Each year approximately ____ try to quit, but less than 10% achieve abstinence. Among smokers who attempt to quit, 60% relapse within the first 7 days of quitting and ____ relapse within the first month. a. 71%; 36%: 65% b. 74%; 45%; 72% c. 72%; 50%; 60% d. 70%; 46%; 70%

d. 70%; 46%; 70% Response Feedback: Seventy percent of smokers want to quit; 46% try to quit; 70% relapse within the first month. The remaining choices are incorrect.

For dentinal hypersensitivity to occur, all of the following conditions must exist except which one? a. Dentin must be exposed. b. Vital pulp must be present. c. Dentinal tubules must be open. d. A smear layer must cover the opening of the dentinal tubules.

d. A smear layer must cover the opening of the dentinal tubules. Response Feedback: In nonsensitive dentin, the smear layer covers the opening of the dentinal tubules or mineral compounds occlude the tubules, reducing the ability of stimuli to induce fluid flow. Loss or removal of the smear layer may result in a pain response. Therefore, for dentinal sensitivity to occur, dentin must be exposed, dentinal tubules must be open, and a vital pulp must be present for the client to respond to the stimulus.

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. The first statement is false, and the second statement is true. b. The first statement is true, and the second statement is false. c. Both statements are false. d. Both statements are true.

d. Both statements are true. Response Feedback: 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

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. The first statement is true, and the second statement is false. b. The first statement is false, and the second statement is true. c. Both statements are false. d. Both statements are true. Response Feedback: 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.

d. Both statements are true. Response Feedback: 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.

The physical aspects of nicotine addiction include reinforcing effects, tolerance, and physical dependence. Nicotine causes the brain to release chemicals such as dopamine, norepinephrine, acetylcholine, vasopressin, serotonin, and beta-endorphins. a. Neither the statement nor the reason is correct. b. The statement is not correct, but the reason is correct. c. The statement is correct, but the reason is not. d. Both the statement and the reason are correct, and they are related. e. Both the statement and the reason are correct, but they are not related.

d. Both the statement and the reason are correct, and they are related. Response Feedback: Both the statement and reason are correct and related. The physical aspects of nicotine addiction include reinforcing effects, tolerance and physical dependence. The others are incorrect.

_____ 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. Rett syndrome b. Asperger's syndrome c. Autistic disorder (classic autism) d. Childhood disintegrative disorder

d. Childhood disintegrative disorder Response Feedback: 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.

All of the following physical findings are commonly found in individuals with bulimia except one. Which is the one exception? a. Parotid enlargement b. Palatal trauma c. Calluses on the knuckles d. Lanugo e. Commissure lesions

d. Lanugo Response Feedback: A common physical finding in anorexics is lanugo, a fine downy hair usually found on the lower half of the face and upper body. In bulimia nervosa and purging type anorexia nervosa, presence of a callus on the knuckle(s) can occur from repeated self-induced vomiting, as well as commissure lesions; dry, cracked lips; and intraoral trauma may be evident along with parotid enlargement.

When assisting clients who are not ready to quit, the recommended goal is to help them think about the benefits of using tobacco versus the benefits of stopping tobacco use. What type of interview is recommended? a. Protection from health risks interviewing b. Makes a note in the chart when the client is not ready c. Personal advice to quit interviewing d. Motivational interviewing e. Responsibility for oral health interviewing

d. Motivational interviewing Response Feedback: Motivational interviewing is the correct answer. The other choices are incorrect.

Common systemic complications that can arise from anorexia nervosa include all of the following conditions except one. Which is the one exception? a. Hematologic b. Gastrointestinal c. Cardiovascular d. Respiratory e. Renal

d. Respiratory Response Feedback: The most common physiologic effect of anorexic behavior is hormonal abnormalities. Cardiovascular, gastrointestinal, renal, and hematologic systems may be compromised in clients with anorexia.

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

d. all of the above. Response Feedback: Most children with ASD avoid facial expressions, eye contact, and nonverbal communication.

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. Rett syndrome. b. childhood disintegrative disorder. c. Asperger's syndrome. d. autistic disorder (classic autism).

d. autistic disorder (classic autism). Response Feedback: 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.

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. allowing them to touch the instruments. d. explaining each procedure and the use of each instrument to the client.

d. explaining each procedure and the use of each instrument to the client. Response Feedback: 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.

All of the following are characteristics of teeth observed to have dentinal hypersensitivity except: a. dentinal tubules open to the oral cavity. b. large and numerous dentinal tubules. c. ability of dentinal surface to communicate with vital pulp. d. intact cementum.

d. intact cementum. Response Feedback: Cementum is not intact in areas of dentinal hypersensitivity. For dentinal hypersensitivity, dentin must be exposed, dentinal tubules must be open at the dentinal surface and open to vital pulp, and the layer of cementum is thin and labile and easily abraded or eroded away, therefore offering little protection against sensitivity.

All of the following are nicotine replacement products except: Answers: a. nicotine patch. b. nicotine lozenge. c. nicotine gum. d. varenicline.

d. varenicline. Response Feedback: Varenicline is not a nicotine replacement product. It is a nicotine receptor blocker. The other choices are nicotine replacement products.

What are the major aspects of nicotine addiction that sustain tobacco use? Answers: a. Psychologic aspects b. Behavioral aspects c. Sensory aspects d. Social-cultural aspects e. All of the above

e. All of the above Response Feedback: All of the above is the correct answer because all items listed are major aspects of nicotine addiction that sustain tobacco use.

All of the following are contraindications of using the nicotine patch as an over-the-counter (OTC) pharmacotherapy except one. Which is the one exception? a. Psoriasis b. Recent myocardial infarction c. Lactation d. Stomach ulcer e. Headaches f. Severe or worsening angina

e. Headaches Response Feedback: Headaches are not a contraindication of using the nicotine patch. The other choices are contraindications of using the nicotine patch.

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.

e. all of the above. Response Feedback: 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.

All of the following identify symptoms of nicotine withdrawal except: a. cravings. b. anxiety. c. insomnia. d. stomach problems. e. concern about confidentiality. f. hunger or weight gain. g. All of the above identify symptoms.

e. concern about confidentiality. Response Feedback: Concern about confidentiality is not a nicotine withdrawal symptom. The other choices are all nicotine withdrawal symptoms and therefore are correct answers.

When assessing a client for tobacco use, all these questions can be asked of current tobacco users except one. Which is the one exception? a. Have you tried to stop using tobacco before? b. If you chew/use snuff, what type? How much? c. If you smoke, what type and how many times per day d. How interested are you in stopping your use of tobacco? e. How many days of the week do you use tobacco? f. Do you have ill-fitting dentures? g. How long do you keep chew in your mouth? ____minutes

f. Do you have ill-fitting dentures? Response Feedback: Do you have ill-fitting dentures is the correct answer for the exception. The other questions are the incorrect choices since they are all questions that would be asked of tobacco users.