Darby Mock Exam Two

Which of the following is MOST successfully used as an agent for the control of plaque biofilm?

.12% CHX

Which of the following is the MOST appropriate time period to perform elective dental procedures on a pregnant woman?

2nd trimester

The continued-care interval recommended for a client during the first year after the completion of nonsurgical periodontal therapy is

3 months

While presenting a treatment plan that includes a gingival grafting procedure surrounding tooth #21, your patient expresses concern that this may be over treatment because her probing depth in this area is only 2 mm. After helping her visualize the 4 mm of recession on the buccal surface of this tooth you explain that her clinical attachment loss (CAL) is

6mm

A dental hygienist, new to the community, learns from friends and clients of the popularity of sports teams for children from age 3 through 12. Noticing the apparent lack of preventive measures to protect against oral and head injuries, she becomes particularly concerned about the child and adolescent population within this community. As a first step toward developing a community-based plan to prevent sports injuries for all participants in this target group, the dental hygienist consults with the high school athletic coach. While researching community resources she learns of a school-based nutrition program, but also discovers that no funding for oral health exists. A client of the dental hygienist, a sixth-grade teacher, would like to include a lesson on reducing sports-related mouth injuries for health class. The teacher indicates she wants to write a measurable objective and e-mails a copy of her plan to the dental hygienist. One objective is "The student will appreciate the need to wear mouthguards." Which of the following would be a more measurable objective?

After a slide presentation and discussion about wearing athletic mouth protectors, the student will be able to identify with 100% accuracy three reasons to wear mouth protectors***

Which of the following is a measure of the energy needed to maintain life while at rest and without food?

BMR

The MOST reliable clinical sign of gingival inflammation is

BOP!!!

During oral cancer self-examination, all of the following conditions indicate to the client a significant deviation from normal that requires a dental examination, EXCEPT one. Which one is the EXCEPTION?

Bilateral, white keratinized linear elevations on the buccal mucosa at the height of the occlusal table.

Cementoblasts calcify the protein matrix during tooth formation. The essential nutrient for this process is

CA

the incisive branch of the inferior alveolar nerve supplies sensation to which of the following?

CANINE AND INSICOR TEETH ON One side

In a review of the client's health history, the client indicates that she uses more than two pillows to sleep at night, becomes out of breath walking short distances, and has constant swelling in her feet and ankles. What condition is MOST likely causing these symptoms?

CHF

Ms. Smith is a 65-year-old tax accountant who had periodontal surgery 12 months ago to reduce her 6- to 8-mm pockets to 3-mm pockets. At each periodontal maintenance care visit since her surgery, the dental hygienist has consistently observed a 1-mm loss of clinical attachment around two of the mandibular molar teeth (1-mm was lost at 4 months, 1-mm was lost at 8 months, and now 1-mm was lost again at 12 months for a total of a 3-mm clinical attachment loss over 12 months). The dental hygienist will complete an oral debridement procedure. However, the therapy that might BEST be used to slow disease progression in sites showing ongoing clinical attachment loss is

D. controlled drug delivery such as chlorhexidine chips, doxycycline gel, or minocycline hyclate microspheres. RATIONALE: Given that disease progression is evident in two isolated sites, controlled drug delivery systems that can maintain an antibiotic within a pocket for 7 to 21 days (depending on the product used) may eliminate the pathogen in the area and hence stop the clinical attachment loss. Another strategy called systemic therapy is typically reserved for clients who fail to respond to mechanical and controlled delivery drug therapy and who experience a more generalized loss of clinical attachment. Systemic antibiotics should be used cautiously to avoid the emergence of antibiotic-resistant bacteria. Another form of systemic therapy, systemic subantimicrobial doses of doxycycline hyclate (Periostat) are not a substitute for therapy designed to minimize the bacterial load. Local chemotherapy such as 0.12% chlorhexidine mouthrinse is effective in controlling plaque and gingivitis, but is not effective for the treatment of periodontal disease

As part of the overall community health plan for this target group, you seek to assess the oral hygiene status of the students. For a pilot assessment, you sample grades 1, 3, and 6 within the school to determine the children's oral hygiene status. Your focus is specifically on oral debris. What is the simplest dental index that can be used to evaluate oral debris?

DI-S which is debris index simplified

Which of the following is the MOST radiosensitive area of the cell?

DNA

A 40-year-old client with a history of infrequent dental care was treated more than 2 years ago when a large restoration had been placed on tooth #30. As noted in the dental record, the restoration was placed close to the pulp. Right after the restoration was placed, the client said he experienced pain when biting down, but he did not return to the office for care. The pain subsided after a period of time. You suspect that this patient has occlusal trauma. Occlusal trauma can cause each of the following EXCEPT one. Which one is the EXCEPTION?

HBL

Which of the following is a branch of the nerve that exits at the mental foramen?

IA nerve

In the inflammatory process, which one of the following immunoglobulins is produced first, following a bacterial challenge to the periodontium?

IGM***

Lorene Smith, a college freshman living on campus, arrives for her emergency visit. She appears tired and pale, and indicates that she has not slept well for 4 days because she is studying for her final examinations. Oral examination reveals areas of gray, sloughing tissues; blunted papilla; and heavy bleeding. Ms. Smith indicates that her gums became very painful 2 nights ago and that she is unable to brush her teeth. The signs and symptoms demonstrated by Ms. Smith describe

NUG

After 2 years in private practice, your concerns for unmet oral health care needs prompt you to join the Indian Health Service. As part of an initial 3-month internship you are assigned to work with teachers in an understaffed school (grades 2 through 12). The primary goal is to assist in incorporating oral health concepts and practices into the curriculum for this community's Native American students. The school has two classrooms for each grade, with approximately 30 to 40 students per grade. There is one teacher for each classroom, with an occasional volunteer parent who serves as a teacher's aide. While doing some initial research you learn that this region is nonfluoridated and you find no evidence of school-based fluoride programs. Also disconcerting, in many Native American tribes 37% of both male and female students, grades 7 to 12, use spit tobacco. While you are unable to locate numerical values to document alcohol abuse in this age group, extensive literature reports it as prevalent. Before your first in-service presentation to the teachers, you want to determine their cumulative dental experience as well as their oral hygiene status. You select the DMF for cumulative dental caries experience. What is the BEST index to evaluate the oral hygiene status of this group?

PII ***

Slightly excessive occlusal pressure on the periodontal ligament results in which of the following changes to the tissues of the periodontium?

RESOPRTION of alveolar bone

The Health Insurance Portability and Accountability Act pertains to the universal principle of autonomy because HIPPA was designed to protect client's confidential information.

STATEMNT IS NOT CORERCT, but reason is

Which of the following statements concerning nitrous oxide-oxygen analgesia is TRUE?

The agent can be used to relieve anxiety and pain in clients with a history of cardiac disease. B.

What are the primary objectives and rationale for periodontal debridement and root planing?

To treat established periodontal disease, establish conditions conducive to healing of the periodontium, and eliminate pathogenic microorganisms or shift subgingival microflora toward less harmful microorganisms

Which of the following statements is TRUE regarding the use of vasoconstrictors for clients who have previous coronary artery disease?

Use of vasoconstrictors is advisable if the concentration is not greater than 1:100,000 epinephrine and the total dose is not greater than 0.04 mg.

Your client is taking Flagyl (metronidazole) and requires a mouthrinse to help control dental plaque and gingivitis. Which of the following should be recommended?

a mouth rinse without alcohol

Energy is produced by the oxidation of alcohol (ethanol) into which of the following?

acetyl CoA and actehehyde

Which of the following medications is the antiviral agent of choice for the treatment of herpetic infections?

acylovir

All local anesthetic solutions currently used in professional oral healthcare are categorized as

amides

Clients with periodontitis have an increased risk for coronary heart disease. Increased release of inflammatory mediators by endotoxins is a major factor contributing to coronary heart disease in clients with periodontitis.

both are true

When using a mechanized instrument, the sequence for calculus removal is accomplished in a coronal-to-apical sequence (beginning at the gingival margin and working toward the junctional epithelium). When using a mechanized instrument, a tapping motion against large deposits and sweeping motion against small deposits are recommended.

both are true

A health care provider who reports a case of suspected child abuse without obtaining parental consent is in compliance with the law because beneficence requires health care providers to place the health and welfare of the client above all other considerations.

both correct

Clients with hypothyroid conditions often require increasing doses of opioid analgesics to control their dentally related pain. An appropriate opioid to use to control dentally related is nitrous oxide-oxygen.

both false

Mrs. Hernandez is a 69-year-old client who comes to the dental office every 3 to 4 months for supportive periodontal maintenance visits. She retired approximately 1 year ago and plays cards almost daily. She takes several prescription medications for arthritis and blood pressure control and reports having a "very dry mouth." She finds that sucking on hard candies, which her friends always serve at these card games, effectively relieves her dryness. At home, she drinks copious amounts of water. Although she has been caries-free and periodontally stable for a number of years, four early root carious lesions were apparent at this appointment. In view of the new carious lesions on root surfaces, a power toothbrush should be recommended for Mrs. Hernandez. Clearly, her long-term plaque control has been ineffective, because she is getting new carious lesions.

both false

Plaque-induced gingivitis will always progress to chronic periodontitis if left untreated. Both plaque-induced gingivitis and chronic periodontitis are manifested by alveolar bone loss.

both false

Your client who takes Ativan (lorazepam) for "pre-dental nerves" approximately 1 hour before her scheduled procedure can drive herself to and from the appointment because this medication does not impair cognitive functioning.

both false

Gingival exudate is considered an exogenous factor that influences oral microbial composition because exudate originates outside of the exocrine (glandular) system.

both false***

Mrs. Hernandez is a 69-year-old client who comes to the dental office every 3 to 4 months for supportive periodontal maintenance visits. She retired approximately 1 year ago and plays cards almost daily. She takes several prescription medications for arthritis and blood pressure control and reports having a "very dry mouth." She finds that sucking on hard candies, which her friends always serve at these card games, effectively relieves her dryness. At home, she drinks copious amounts of water. Although she has been caries-free and periodontally stable for a number of years, at this appointment, four early root carious lesions have been found. A prescription for daily use of neutral 1.1% NaF fluoride gel should be given to Mrs. Hernandez to help remineralize early lesions. This fluoride gel will also help prevent new carious lesions.

both true

A dental hygienist, new to the community, learns from friends and clients of the popularity of sports teams for children from age 3 through 12. Noticing the apparent lack of preventive measures to protect against oral and head injuries, she becomes particularly concerned about the child and adolescent population within this community. As a first step toward developing a community-based plan to prevent sports injuries for all participants in this target group, the dental hygienist consults with the high school athletic coach. While researching community resources she learns of a school-based nutrition program, but also discovers that no funding for oral health exists. Anxious to seek input from student athletes about methods to encourage sports teams to wear mouth protectors during practices and games, the dental hygienist initiates an assessment strategy. Which of the following is the BEST method to obtain ideas from students?

brainstorming session

Persons with the following conditions commonly take medications that can cause drug-influenced gingival enlargement, EXCEPT one. Which one is the EXCEPTION?

bronchial asthma

A dental hygienist, new to the community, learns from friends and clients of the popularity of sports teams for children from age 3 through 12. Noticing the apparent lack of preventive measures to protect against oral and head injuries, she becomes particularly concerned about the child and adolescent population within this community. As a first step toward developing a community-based plan to prevent sports injuries for all participants in this target group, the dental hygienist consults with the high school athletic coach. While researching community resources she learns of a school-based nutrition program, but also discovers that no funding for oral health exists. The dental hygienist wants to educate the local neighborhood soccer league for 3- to 8-year-old children about sports-related oral injuries and consequences. Which of the following is (are) the MOST appropriate target group (groups)?

coaches and parents ***

Which of the following would be LEAST effective for controlling plaque in class II molar furcations?

dental floss

Infective endocarditis (bacterial endocarditis) is a life-threatening disease because microorganisms that colonize the endocardium may cause

destcuction of heart valves

Which one of the following restorative materials is the LEAST resistant to scratching during extrinsic stain removal procedures (selective polishing)?

dog inlays or crowns

Which of the following is a dental concern associated with the use of Procardia (nifedipine), a calcium blocker?

drug induced gingival enlargement

Which of the following is MOST important for dental sealant effectiveness?

effective etching and bonding in dry conditions

A probe reading of 6 mm measures the distance from which of the following two oral structures?

epithelial attachment and gingival margin

Concerned about the lack of water fluoridation, a local dental hygienist initiates a community education project to educate residents about the advantages of water fluoridation. The project includes several presentations beginning with a meeting of the local dental and dental hygiene societies to provide an overview of current information. The focus of this initial presentation will be mottled enamel as well as strategies to prevent this form of dental fluorosis. Subsequent presentations will address community leaders, non-profit philanthropic organizations, and community coalitions. Within a few weeks of the first presentations a group of citizens begins writing letters to the local newspaper about the dangers of fluoridation with specific emphasis on toxicity from "overfluoridation." Mottled enamel results from vigorous toothbrushing with dentifrice products with significant abrasive levels. Mottled enamel is a chronic endemic form of hypoplasia of dental enamel caused by the ingestion of excessive amounts of fluoride.

false, true

The red spots on the palate are MOST likely palatine fovea. The red spots may be correlated with a client's smoking habit.

false, true

Dentinal hypersensitivity is MOST related to which of the following?

flid flow into dentinal tublues

Which of the following conditions is MOST likely to exist for a client with type 1 diabetes mellitus, generalized gingival inflammation, localized 4-mm probe readings due to pseudopockets, and no clinical or radiographic evidence of bone loss?

gingivitis with associated systemic disease

Which of the following are early bacterial colonizers of the tooth surfaces?

gram positive cocci

Which of the following organisms is NOT associated with halitosis?

halotosis although, proph, prevotella, fusobacterium and treponema have been

Your client has arrived for her appointment and has a 6-mm, slightly elevated encrusted lesion on her lower lip. She says that it has been there for approximately 1 week. You find that she has a history of "cold sores" on her chart. The infectious agent responsible for this infection is the

herpes simplex virus

Each of the following oral lesions results from injury to soft tissues that involve major or minor salivary glands and/or their ducts EXCEPT one. Which one is the EXCEPTION?

hyperkeratosis

In an effort to collect data about sports-related injuries that result in emergency department visits, the dental hygienist conducted a telephone survey of three community hospitals and five walk-in emergency clinics. The purpose of this survey was to determine the number of sports-related injuries to children and adolescents ages 18 and younger who obtained emergency care during the past 3-month period. Which of the following terms BEST describes the data collected?

incidence**

Mrs. Hernandez is a 69-year-old client who comes to the dental office every 3 to 4 months for supportive periodontal maintenance visits. She retired approximately 1 year ago and plays cards almost daily. She takes several prescription medications for arthritis and blood pressure control and reports having a "very dry mouth." She finds that sucking on hard candies, which her friends always serve at these card games, effectively relieves her dryness. At home, she drinks copious amounts of water. Although she has been caries-free and periodontally stable for a number of years, at this appointment, four early root carious lesions have been found. What is the MOST likely risk factor for her new root caries?

innaporiprate managamnent of dry mouth

Which of the following is the BEST tool for bacterial plaque disruption on interproximal surfaces in areas with type III embrasure spaces?

interdental brushes

Which of the following describes the process by which x-radiant energy removes an orbital electron from an atom to yield an ion pair?

ionization

Community water fluoridation is an ideal public health measure characterized by all of the following EXCEPT one. Which one is the EXCEPTION?

it can prevent osteoporosis

The presence of which of the following conditions in an HIV-positive client is diagnostic of AIDS?

kaposis sarcoma

All of the following would improve the visual appearance of the radiographic image, EXCEPT one. Which one is the EXCEPTION?

large focal spot

A client presents with a recently broken cheekbone that was treated by his physician. His chief complaint is "moderate tenderness on closing my jaw." Which of the following muscles is MOST likely to be damaged or tender?

masster

Which of the following is the anatomic feature of the maxillary molar used in Angle's classification of malocclusion?

medial cusp

Which of the following produces the shiny surface on a dry polished dental amalgam?

mercury released by melting the matrix phase

Preventive care plans are based on many factors including the practitioner's personal preferences because it is the practitioner who will implement the plan.

neither is correct

Sally Westerly, who is blind, brings her seeing-eye dog to her dental hygiene appointment. The BEST strategy for the dental hygienist when interacting with the dog is to provide treats because this will distract the dog and ensure a more relaxed environment.

neither is true

What is the single BEST criterion for evaluating the success of periodontal debridement and root planing as well as oral hygiene 4 to 6 weeks after treatment?

no evidence of bleeding on probing

When taking radiographs during a continued-care appointment, the dental hygienist observes that the area apical to tooth #14 is still abscessed 1 year after the last radiographs were taken. The dental hygienist can correctly inform the client that infection in this area could lead to primary sinusitis and perforation of the sinus because tooth #14 is located beneath the floor of the maxillary sinus.

not correct then correct reason***

Several dental professionals ask your opinion about a dentifrice they recently read about in a peer-reviewed journal article. As a community health dental hygienist you seek to determine whether this newly developed fluoride dentifrice will be effective in reducing dental caries. A first step in determining whether the claims made in the advertisement are reliable and valid is to do which of the following?

obtain and critically read a copy of the research report

Which of the following is NOT an oral manifestation of human immunodeficiency virus (HIV)?

penmocystosis jivoreci

Studies of the natural history of periodontal disease have shown which of the following to be TRUE?

pier therapy and oral self care will sow the rate of attachment loss in peiro

Which of the following risk factors MOST positively correlates with the incidence of chronic periodontitis?

plaque and their specific putative pathogens

Lorene Smith, a college freshman living on campus, arrives for her emergency visit. She appears tired and pale, and indicates that she has not slept well for 4 days because she is studying for her final examinations. Oral examination reveals areas of gray, sloughing tissues; blunted papilla; and heavy bleeding. Ms. Smith indicates that her gums became very painful 2 nights ago and that she is unable to brush her teeth. Prior to performing periodontal procedures, you consult your periodontal textbook and learn that the causative agents related to her condition are MOST likely

prevetoellea and spriochetes

The x-ray photons emitted from the radiation generated at the target of the dental x-ray tube are categorized as which of the following types of radiation?

primary

A dental hygienist records a client's blood pressure as 165/96 mm Hg. Professional responsibility and current guidelines of the American Heart Association require that the hygienist

recheck BP in 5 mins. if stillest elated do a consult

Periapical radiographs taken by the dental hygienist show the formation of additional dentin on tooth #30. Formed in response to injury, this dentin is referred to as

reparative dentin

Which of the following medications is used as a protease inhibitor in HIV therapy?

ritonavir

The causative agent of HIV is

single stranded RNA

Which of the following is an incorrect step in fabricating a mouth protector?

soaking them out protector in stare before intial use

Which of the following agents is BEST for remineralizing tooth surfaces?

sodium fluoride

After periodontal therapy, the MOST important single factor determining the frequency of continued-care appointments for maintenance care (supportive periodontal therapy) is the

state of health or disease evident at the time of re-eval

Which of the following describes a dental implant that is placed on the surface of the bone beneath the periosteum?

subperiosteal

Which of the following is NOT a factor in the rate of tooth surface abrasion when performing extrinsic stain removal with a polishing agent?

temp of polishing paste

The dental hygienist is invited by three local high schools to speak to the physical education classes about the importance of wearing athletic mouth protectors during sports-related activities. Several weeks following her presentation, the dental hygienist plans to visit the high schools unannounced to observe the use of mouth protectors by the students. The dental hygienist is seeking to evaluate which of the following?

terminal behavior

A high school student in your target group has questions about an advertisement for a new mouthrinse in a health-related journal. Accompanying the advertisement is a graph indicating a baseline mean plaque score of 3.1. After 21 days of normal toothbrushing and the use of the mouthrinse being advertised, data analysis indicated the mean plaque score was 1.5. No other commentary is offered about the study. In reviewing the information in the mouthrinse advertisement, which of the following can be concluded?

there appears to be a clinically signifanct reduction in plaque scores

Which of the following is a risk factor associated with oral and pharyngeal cancer?

tobacco use

Which of the following would be the BEST projection to image the developing permanent maxillary lateral incisors of a 7-year-old child?

topographical occlusal

A pregnancy tumor has the same clinical appearance as a pyogenic granuloma. A pregnancy tumor is a malignant lesion.

true, false

Amperage is the measurement of the number of electrons flowing in an electrical circuit. Increasing the amperage increases the force that moves the electrons along an electrical conductor.

true, false

Clients who abuse intravenous drugs are at an increased risk for contracting blood-borne diseases. Clients who abuse intravenous drugs seem to be immune to contracting hepatitis C

true, false

Under civil law, a health care provider can elect to terminate the client-practitioner relationship after giving the client notice and an opportunity to secure an alternative source of future treatment. Contractual responsibilities of the health care provider include usage of standard drugs and materials as well as an option for use of off-label treatment options.

true, false

Total daily water intake usually ranges from 1500 to 3000 mL. Total water output is 1200 to 2000 mL.

true, false the total water output should be equal to input

An appropriate topic to discuss with the fourth- and fifth-grade classes and teacher is "Tobacco and Alcohol Product use and their role in Oral and Pharyngeal Cancer." The topic "How to Respond to Peer Pressure Regarding Risky Behaviors" should not be shown to students, but instead should be reviewed with teachers so that they may relay the information at an appropriate time.

true, false***

Overconsumption of MOST nutrients can result in detrimental health effects. Overconsumption of vitamins and minerals are recommended.

true, then false

Which of the following pain medications is indicated for clients taking Ticlid (ticlopidine)?

tylenol

the only drug to not have an effect on bleeding is?

tylenol or ace-

Extraoral and intraoral findings on a client: Face/neck markings: an 8 × 1-mm scar between the borders of the philtrum. TMJ: 20-mm maximum opening. Lymph nodes: within normal limits. Lips: dry and cracked. Buccal mucosa: linea alba. Tongue: geographic. Palate: small (1-mm) red spots scattered throughout. Oropharyngeal area: right palatine tonsil enlarged. Frena: within normal limits. Salivary glands: prominent palatal duct openings. The facial marking noted is located between which of the following?

upper lip and nose

if lips are dry and cracked this is due to with what?

vermillion border

An elderly male client with a history of high blood pressure and coronary artery disease complains of sudden loss of vision in one eye and a severe headache. You observe that the client has slurred speech and appears confused. What other signs and symptoms are MOST likely to occur in this client as this emergency episode evolves?

weakness on one side as this is a stroke

How should mouth protectors be cleaned?

with cool soap and water solutions