MOCK EXAM
A barbed needle causes pain upon: A. Insertion B. Withdrawal C. Deposition of anesthetic D. Aspiration
B
During the inferior alveolar block the patient feels a sudden electrical shock. This is due to: A. The needle touching the inferior alveolar nerve B. The needle touching the lingual nerve C. The needle touching the buccal nerve D. The needle touching the pterygomandibular raphe
B
How many cartridges could a patient from the answer in question #7 safely receive if administering a 1:200,000 epinephrine dilution? A. 1.1 cartridges B. 4.4 cartridges C. 2.2 cartridges D. 3.3 cartridges
B
Signs and symptoms of a vasoconstrictor overdose are manifested as: A. CNS depression B. CNS stimulation C. Cardiovascular depression D. Respiratory depression
B
Supraperiosteal injections are less successful on the mandible because of the: A. Porous bone of the mandible B. Density of the bone of the mandible C. pH of the tissue on the mandible D. Large nerve trunks of the mandible
B
what is the highest dose of Epinephrine
1:50,000
treatment of allergic reaction
25- 50 mg adult dose benedryl for mild cutaneous reaction 1:100,000 Epi for severe allergy 60mg methylpredisone ( steriod) or sever allergy
What is the number of milligrams./ml of 4% of prilocaine
40% just add zero
. Which component of the local anesthetic molecule renders the molecule water-soluble? A. Hydrophilic amino group B. Intermediate hydrocarbon ester or amide chain C. Lipophilic aromatic ring D. All of the above
A
After the administration of a local anesthetic, what causes a droopy eyelid? A. Depositing the solution in the parotid gland B. Depositing the solution medial to the mandibular foramen C. Depositing the solution above the infraorbital foramen D. Depositing the solution at the anteromedial border of the neck of the mandibular condyle
A
How much epinephrine does a 1:200,000 dilution contain compared with a 1:100,000 dilution? A. Half B. Twice C. One quarter D. One forth
A
Levonordefrin has how many mg/mL of vasoconstrictor? A. 0.05 mg/mL B. 0.01 mg/mL C. 0.9 mg/mL D. 0.005 mg/mL
A
Sodium bicarbonate is added to local anesthetic solutions: A. Only when a vasoconstrictor is added B. To prevent the oxidation of the amide C. To make the solution isotonic D. To help increase the pH of the vasoconstrictor
A
The dental hygienist administers 3 cartridges of articaine. How many mg of local anesthetic were administered? A. 200 mg B. 162 mg C. 216 mg D. 172 mg
A
What is the best explanation as to why a patient has a lesion on his or her lip the day after receiving an inferior alveolar block? A. Self-mutilation B. Allergic to the anesthetic C. Trauma induced during dental hygiene instrumentation D. Prolonged use of topical anesthetic
A
What is the important of syringe Barrel A. the large window provides direct vision of the cartridge during anesthesia administration B. it is capable of been loaded from the side c.It proves the chance with syringe stability and control D. all of the above
A
What is the primary reason that catecholamines are added to local anesthetic solutions? A. Decrease the risk of toxicity B. Decrease the duration of action C. Decrease the risk of postoperative pain D. Decrease the risk of infection
A
What is the recommended needle gauge for an inferior alveolar block? A. 25 gauge B. 27 gauge C. 30 gauge D. Any gauge is fine
A
What part of the syringe indicates it is an aspirating syringe? A. Harpoon B. Syringe adaptor C. Thumb ring D. Piston
A
Which anesthetic falls under pregnancy risk category B? A. Lidocaine/ prilocaine B. Bupivacaine C. Articaine D. Mepivacaine
A
Which characteristic enhances the onset and effectiveness of local anesthetics? High lipid solubility High pKa Low pH High concentration of cation molecules
A
Which of the following local anesthetic blocks has the HIGHEST risk of hematoma for the patient after administration? A. Posterior superior alveolar block B. Inferior alveolar block C. Gow-Gates mandibular block D. Mental or incisive blocks
A
Which of the following nerves when anesthetized provides soft tissue anesthesia of the lower lip and chin? A. Mental nerve B. Incisive nerve C. Inferior alveolar nerve D. Buccal nerve
A
which of the following is true regarding nodes of Ranvier A. found along the mylinated nerve fibers between adjacent schawnn cells B. occur at unevenly speed interval C all of the above
A
effect that the endogenous release of Epinephrine have on exogenous administration of Epi is A. it may compound the effect B it may conteract the effect
A. it may compound the effect
What is the mechanism of action by which local anesthetic work?
Anesthetic drugs binds to the sodium channels, the influx of the sodium is interrupted, the action potential cannot rise and the signal conduction is inhibited
metabolize in both plasma and liver is
Articiane
The dental hygienist successfully administers an inferior alveolar block, but the patient does not get numb. What is the possible reason why the patient does not get numb? A. Solution deposited superior to the mandibular foramen B. Solution deposited inferior to the mandibular foramen C. Solution deposited too rapidly D. Solution deposited too slowly
B
What is the cardiac dose for epinephrine? A. 0.2 mg B. 0.04 mg C. 1.0 mg D. 2.0 mg
B
What is the main reason anesthesia fails to occur near an abscessed tooth? A. Infection causes an increase in the tissue pH B. Infection causes a decrease in the pH of the tissue C. Infection causes a neutral pH D. None of the above; infection has no relationship to the success of anesthesia
B
What is the most common medical emergency observed in the dental office? A. Cardiac arrest B. Vasodepressor syncope C. Seizures D. Allergic reaction
B
When is lidocaine 1:50,000 epinephrine most effective? A. When postoperative pain control is needed B. When hemostasis is needed C. When treating a cardiovascularly involved patient D. When more profound pain control is needed
B
Which of the following is responsible for allergic reactions to ester anesthetics? A. The parent compound B. Para-amino benzoic acid C. Pseudocholinesterase D. Sodium bisulfite
B
Which of the following local anesthetic blocks can produce hematomas that cause severe swelling and extraoral bruising as a result of nicking a blood vessel? A. Posterior superior alveolar block B. Inferior alveolar block C. Gow-Gates mandibular block D. Mental or incisive blocks
B
Which of the following maintains the resting potential of a nerve fiber? A. The K+ pump B. The Na+ pump C. The concentration gradient D. The electrical impulse
B
Which of the following vasoconstrictor dilutions provides the greatest hemostasis? A. 1:20,000 levonordefrin B. 1:50,000 epinephrine C. 1:100,000 epinephrine D. 1:200,000 epinephrine
B
While administering the inferior alveolar local anesthetic block, the clinician contacts bone at a depth of 10 mm on an adult patient. What should the clinician do? A. Aspirate correctly and then deposit anesthetic agent at the site B. Withdraw the needle almost completely and redirect the syringe barrel more anterior C. Withdraw the needle partially or completely and redirect the syringe barrel more posterior D. Withdraw the needle partially and redirect the syringe barrel more perpendicular to the occlusal plane
B
patient comes into the clinic overly tired and stressed he or she will have a.Higher pain reaction threshold which mean that they have higher tolerance to pain B. lower pain reaction threshold which mean that they have lower tolerance to pain
B
where do you palpate in order to determine the location of mental foramen A. in between the first and second premolar B. from the mandibular first molar to the distal surface of the canine
B
Most commonly cited error contributing to missed IA Block is A. injecting too high B. injecting too low C. failing to aspirate
B injecting too low
. Which of the following local anesthetics has the longest duration of action? A. Prilocaine 4% 1:200,000 epinephrine B. Articaine 4% 1:100,000 epinephrine C. Bupivacaine 0.5% 1:200,000 epinephrine D. Articaine 4% 1:200,000 epinephrine
C
At the first indication of a hematoma, the clinician should: A. Apply ice to the area B. Apply heat to the area C. Apply pressure to the area D. Apply ice for 10 minutes followed by heat for 10 minutes
C
During manufacturing, local anesthetics are formulated as which of the following to render them water-soluble? A. Muriatic acid B. Sodium bisulfite C. Hydrochloride salt D. Sodium bicarbonate
C
How can the clinician correct the problem of hitting bone while administering the PSA injection? A. The needle needs to be bent slightly in order to accomplish the necessary needle angulation. B. The syringe needs to be farther away from the occlusal plane, thereby increasing the angle to more than 45 degrees. C. The syringe needs to be closer to the occlusal plane, thereby reducing the angle to less than 45 degrees. D. The patient most likely has a larger size skull, so a long needle should be utilized for patient comfort.
C
How many mg of epinephrine are in one cartridge of a 1:100,000 dilution? A. 0.009 mg B. 0.01 mg C. 0.018 mg D. 0.02 mg
C
The coronoid notch is a landmark for which nerve block? A. Buccal block B. Mental block C. Inferior alveolar block D. Infraorbital block
C
What does the clinician need to know about a possible epinephrine overdose? A. The body is not very efficient at removing vasoconstrictors. B. Adverse effects associated with epinephrine may last 20 minutes or longer. C. Epinephrine overdose produces overstimulation of adrenergic receptors. D. Normal signs and symptoms of an epinephrine overdose resemble CNS depression.
C
What is tachyphylaxis? A. A term used to describe the anesthetic's inability to reach the nerve membrane because of anatomical barriers B. Reinjection of anesthetic before the mantle fibers have fully recovered C. Increased tolerance to a drug that is administered repeatedly D. A term used to describe only partial anesthesia
C
When a nerve is in its resting state, the: A. K+ is concentrated outside the cell B. Cell membrane is positive on the outside of the cell C. Na+ is concentrated outside the cell D. Cell membrane is more positive on the inside of the cell
C
When energy for conduction is derived from the nerve cell membrane itself and is no longer dependent on the stimulus for continuance, the conduction is considered to be: A. Below the minimal threshold level B. Above the minimal threshold level C. Self-propagating D. In the absolute refractory period
C
Which of the following anesthetics has the shortest duration when administering a local anesthetic block? A. Lidocaine 1:100,000 B. Mepivacaine 1:20,000 C. Mepivacaine 3% D. Prilocaine 4%
C
Which of the following local anesthetics is metabolized in the lungs and liver? A. Mepivacaine B. Bupivacaine C. Prilocaine D. Articaine= plasma and liver
C
Delayed signs and symptoms of an allergic reaction are more intense and serious. If skin reactions develop immediately following the injection, anaphylaxis may occur. 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.
D
How should a clinician respond if after administering an inferior alveolar block the anesthesia is not adequate? A. Administer a second inferior alveolar block more superior than the first block B. Administer a second inferior alveolar block more inferior than the first block C. Administer a second inferior alveolar block more medial than the first block D. Administer a second inferior alveolar block more lateral than the first block
D
Local anesthetics work by penetrating the nerve to inhibit: A. Cl+ influx B. Na+ influx C. K- efflux D. Na+ efflux E. K- influx
D
Prolonged paresthesia of the anterior part of the tongue is caused by which nerve being traumatized? A. Inferior alveolar nerve B. Mental nerve C. Incisive nerve D. Lingual nerve
D
Undesirable side effects of incorporating sympathomimetic agents such as epinephrine into local anesthetic solutions include: A. Increased force of air exchange B. Increased bronchi dilation C. Increased rate and force of heart contractions D. All of the above
D
What are the nerves that conduct signals away from the brain or spinal cord called? A. Neurotransmitters B. Electrical synapses C. Afferent nerves D. Efferent nerves
D
Which anesthetic is primarily metabolized in the blood? A. Lidocaine B. Mepivacaine C. Prilocaine D. Articaine
D
Which nerve when anesthetized also anesthetizes BOTH the anterior and middle superior alveolar nerves? A. Posterior superior alveolar B. Inferior alveolar C. Incisive D. Infraorbital
D
Which of the following BEST describes the (long) buccal nerve? A. Efferent nerve for the facial gingival tissue of the mandibular anterior teeth B. Afferent nerve for the facial gingival tissue of the mandibular anterior teeth C. Efferent nerve for the buccal gingival tissue of the mandibular posterior teeth D. Afferent nerve for the buccal gingival tissue of the mandibular posterior teeth
D
Which of the following local anesthetics will provide the longest duration of action following a nerve block when a vasoconstrictor is absolutely contraindicated? A. 3% mepivacaine B. 0.5% bupivacaine C. 2% lidocaine D. 4% prilocaine, plain
D
Select the following anesthetic(s) available in the US that is(are) formulated with epinephrine 1:200,000 A. Lidocaine B. Mepivacaine C. Prilocaine D. Articaine E. C and D
E
SRP for teeth # 12 -15
MSA, PSA, AND GP
After administering the IA block, your patient reports a lack of anesthesia on the mandibular First molar. what accessory innervation may be present for the teeth.
Mylohyiod Nerve
where should you needle insertion be during supraperiosteal injection
Parallel with the long axis of the tooth
What causes burning sensation
Ph of the local anesthetic and expired anesthetic solution
When harpoon becomes disengages during aspiration what do yo do
Remove the syringe, remove the needle, reengage the harpon, retach the needle and then continue with the procedure
propagation of Action potentials along myelinated Axon from one nodes of Ranvier to another is
Saltatory conduction
While reviewing your patient medical history you see she indicated and allergy to dried fruit, cheese and alcohol you suspect true allergy to
Sodium bisulfite
epinephrine and norepinephrine are secreted by the ------- and they act on ------
adrenal medulla and they act on they sympthathetic nervous system
You have administered 2% lidocaine, 1:50,000 mg/ml epinephrine to a healthy patient. The patient experiences restlessness and nausea and begins to hyperventilate. What should you suspect? A. Central nervous system stimulation B. Overdose of epinephrine C. Metabolic rise in blood sugar D. Local anesthetic overdose
b
The IA has the highest positive aspiration of all block injection of either dental arch. if hematoma occurs in the area of the pterygomandibular space. it is important to let the patient see the bruising when the treatment is finished and discuss that it is basic risk of anesthesia and it is temporarily
both statement are true
which of the following could result if local anesthetic solution is advently deposited in the parotid gland A. incompleted anesthesia of teeth B.Facial paralysis C. Hematoma D all option
facial paralysis
Due to scope of practice for dentist, they are risk for litigation. Risk management identifies methods to negotiate the risk of legal action associated with the delivery of oral care.
first statement is true and second is false
the best reason for choosing a local anesthetic that provides long duration is
if the is need for postoperative pain control
it is necessary to apply pressure to the deposit site for the
incisive
what is the formular for calculating how many mg of anesthetic solution were administered
multiply the number of cartridge administered by the milligrams of anesthesia in each cartridge
local anesthesia overdose of CNS is
muscle twitching and convulsion
what is the first division of the sensory nerve
ophthalmic
how do you correct the problem hitting bone while giving PSA injection
syringe needs to be closer to the occlusal plane, there by reducing the angle less the 45 degrees
A dental hygienist must meet the standard of care set by other practitioners with similar training means
the dental hygienist is expected to gain knowledge and skills throughout his or carrier
Which of the ff is the true regarding the best practice in obtaining informed consent
ultimately is is the pts decision whether to accept or a procedure or not
if an anesthetic contains a vasoconstrictor how is the maximum recommended dose determined
whichever of the drug reaches its MRD first is the limiting factor