M&A Questions Ch. 16-18

Body contact can be a form of nonverbal communication. It was found that this type of physical contact was especially helpful for children aged 7-10 years. A. Both statements are true B. Both statements are false C. First statement is true, second statement is false D. First statement is false, second statement is true

A. Both statements are true

Patients with tonsillar tissue that occupies more than — of the pharyngeal space are not good candidates for pharmacologic management. A) 40% B) 50% C) 60% D) 70%

B) 50%

What is the onset of sedation for Midazolam? A. 5-10 minutes B. 12-16 minutes C. 20-30 minutes D. 45-60 minutes

C. 20-30 minutes

Nitrous oxide concentrations greater than __ may cause patients to experience ataxia, giddiness, dysphoria, and increased sleepiness. A. 40% B. 50% C. 60%

C. 60%

Name an opioid receptor antagonist used to reverse the effects of opioid drug overdose.

Naloxone/Narcan

True/False: Dental fear/anxiety is not synonymous with dental behavior management problems.

True

True/False: It is generally agreed upon that at least one or two attempts be made using conventional behavior management techniques or conscious sedation before general anesthesia is considered.

True

True/False: It is recommended that at least one or two attempts be made using conventional behavior management techniques or conscious sedation before general anesthesia is considered

True

True/False: Most children see things as "black" or "white"

True

True/False: The magnitude of depression caused by inhalation general anesthetics is proportional to the partial pressure of inhalation agents reaching specific sites in the CNS after entering though the lungs and being distributed by the circulation to the tissues.

True

Comorbidities possibly necessitating postoperative hospital observation include all the following except a. Asthma, poorly controlled b. Seizure disorder c. Mitochondrial myopathy d. Morbid obesity e. Hemophilia f. All the above are true

f. All the above are true

The discharge criteria to the care of a responsible adult include: a. Heart rate, respiratory rate, and blood pressure are within 10 percent of preoperative values b. Oxygen saturation is greater than 95 percent or pre-operative value c. Older child can speak clearly, and infant has a clear cry d. Patient is alert and awake, but pain is not under control e. All the above f. All the above beside D

f. All the above beside D

How much time does drug absorption take in the intramuscular route?

2-10 minutes

Which of the following is considered to be a merit of pre-appointment modeling procedures? A) Stimulation of new behaviors B) Facilitation of behavior in a more appropriate manner C) Disinhibition of inappropriate behavior due to fear D) Extinction of fears E) All of the above

*****

How much time does drug absorption take in the enteric route?

15-40 minutes

How much time does drug absorption take in the IV route?

20 seconds from vein to brain

Which of the following is true regarding dental fear/anxiety and dental behavior management problems? A) They are relatively common in pediatric dental patients B) Boys exhibit more dental anxiety and behavior management problems than girls C) Dental fear/anxiety is more closely related to/connected with activity and impulsivity D) All of the above statements are true

A) They are relatively common in pediatric dental patients

When is stress first experienced? A. In utero B. Within the first week of life C. Within the first month of life D. Within the first year of life

A. In utero

Based on multiple studies which of the following procedures has been shown to have the highest success rate in an operative room setting? A. Stainless steel crowns B. Amalgam restorations C. Composite restorations D. Sealants

A. Stainless steel crowns

History of epistaxis is an absolute contraindication for nasotracheal intubation. Sevoflurane can safely be used to induce an anesthetic in an awake patient. A) First statement is true, second statement is false B) First statement is false, second statement is true C) Both statements are true D) Both statements are false

B) First statement is false, second statement is true

Which of the following terms is NOT a part of Wright's clinical classification? A) Potentially cooperative B) Pre-cooperative C) Cooperative D) Lacking in cooperative ability E) All are part of Wright's classification

B) Pre-cooperative

The pharmacokinetic properties of nitrous oxide are well suited to producing: A) minimal sedation B) moderate sedation C) Deep sedation D) General anesthesia

B) moderate sedation

Multisensory communication, like placing a hand on a child's shoulder conveys a feeling of warmth and friendship. Studies found that this type if physical contact helped children relax, especially those from what age? A. 3-6 years B. 7-10 years C. 10-13 years

B. 7-10 years

What is the typical blood pressure for children ages 3-6 years old? A. 90-105/55-70 B. 95-110/60-75 C. 100-120/60-75 D. 110-135/65-85

B. 95-110/60-75

Which of the following inhalation anesthetics used in children is the least soluble halogenated volatile agent, has a rapid onset and offset but has a noxious odor? A. Nitrous oxide B. Desflurane C. Sevoflurane D. Isoflurane

B. Desflurane

Please identify which timeline is INCORRECT for the amount of time it takes a drug to reach the brain. A. Enteric absorption: 15-40 mins B. Intramuscular drug absorption: 15 mins C. Intravenous drug absorption: 20 seconds D. None of the above are incorrect

B. Intramuscular drug absorption: 15 mins

Which of the following is NOT an age related phycological trait or skill for 2 year old children? A. Like to see and touch B. Very active imagination, like stories C. Play alone, rarely share D. Geared to gross motor skills

B. Very active imagination, like stories

What age group of children are most affected by their mother's anxieties? A. age0- 1 B. age 4 and younger C. age 8 and younger D. age 12-16

B. age 4 and younger

A child's coordination can be judged by physical size. Physical strength of a child is not related to dental development. A. the first statement is true but the second is false B. the first statement is false but the second is true C. both statements are true D. both statements are false

B. the first statement is false but the second is true

The concentration of nitrous oxide should not routinely exceed what percentage, as concentrations in this range increase the likelihood of nausea, vomiting and disorientation? A) 30% B) 40% C) 50% D) 60% E) 70 %

C) 50%

What percentage of children who received general anesthesia exhibited some type of behavior change, positive or negative? A) 25% B) 50% C) 75% D) 100%

C) 75%

Which of the following statements regarding midazolam is FALSE? A) The onset of sedation occurs within 20-30minutes B) Midazolam is much more potent than diazepam C) Midazolam is the first water insoluble benzodiazepine D) Midazolam produces more anterograde amnesia during moderate sedation than diazepam E) All of the statements are true

C) Midazolam is the first water insoluble benzodiazepine

The following are contraindications to nitrous oxide administration EXCEPT: A) acute otitis media B) pregnancy C) asthma D) claustrophobia E) All of the above are contraindications

C) asthma

At what age does a child start to take pride in possessions? A. Age 3 B. Age 4 C. Age 5 D. Age 6

C. Age 5

Which of the following is correct? A. The mechanism of action of N2O is well-understood B. Nitrous oxide is a slightly sour-smelling inert gas C. It is relatively easy to achieve a steady state of moderate sedation D. The concentrations of N2O should not exceed 40%

C. It is relatively easy to achieve a steady state of moderate sedation

Please identify which of the following is INCORRECT regarding Hydroxyzine. A. It is an antihistamine B. It inhibits the H-1 histamine receptors in the hypothalamus, affecting the sleep-wake cycle C. Onset of action is 5-10 minutes D. Dosage is 0.5-1.0 mg/kg

C. Onset of action is 5-10 minutes

The term _______ refers to the steps taken to return the patient to the initially desired level of sedation. A. Step-back B. Management C. Rescue D. Reverse

C. Rescue

Intramuscular administration relies upon the high vascularity of the muscle tissue. Onset of action occurs within 30 seconds - 1 minute. A. Both statements are true B. Both statements are false C. The first statement is true, the second is false D. The first statement is false, the second is true

C. The first statement is true, the second is false

Voice control includes sudden and firm commands used to get a child's attention. When using voice control, what is said is more important than how it is said. A. Both statements are true B. Both statements are false C. The first statement is true, the second is false D. The first statement is false, the second is true

C. The first statement is true, the second is false

According to a research study, only _______ percent of dental patients undergoing a treatment in the OR returned for 6 month recall visits. A. ~30% B. ~40% C. ~60% D. ~70%

C. ~60%

Which of the following is not considered a common postoperative complication following general anesthesia? A) Fever B) Vomiting C) Sore throat D) All of the above are common postoperative complications of GA

D) All of the above are common postoperative complications of GA

If hyperventilate or apnea occurs during benzodiazepine sedation, the appropriate first step is flumazenil administration. Proper and effective airway management is the second step undertaken when respiratory distress is encountered during benzodiazepine sedation. A) First statement is true, second statement is false B) First statement is false, second statement is true C) Both statements are true D) Both statements are false

D) Both statements are false

The three components of the pediatric treatment triad include all of the following except? A) Child B) Dentist/dental team C) Parent/caregiver D) Siblings

D) Siblings

Which of the following are considered toxic stressors? A. Child abuse/neglect B. Chronic exposure to drugs or violence C. Parental depression or mental illness D. All of the above

D. All of the above

According to the developmental, cognitive, and psychosocial stages of children, at what age does a child easily separate from mom and dad? A. 6 months B. 12 months C. 24 months D. 36 months E. 48 months

D. 36 months

Children younger than what age are most affected by their mothers' anxiety? A. 7 years B. 6 years C. 5 years D. 4 years

D. 4 years

Which of the following children has the highest likelihood of needing post-op observation? A. 7 year old male with well-controlled diabetes B. 12 year old female with hypothyroidism C. 12 year old male with ADHD D. 5 year old male with uncontrolled diabetes

D. 5 year old male with uncontrolled diabetes

Which of the following are positive changes a child may experience after receiving dental treatment under general anesthesia? A. Less fuss about eating B. Fewer temper tantrums C. Better appetite D. All of the above

D. All of the above

Which of the following about stress is incorrect? A. Stress is first experienced in utero B. Stress is necessary for survival C. Stress that continues over a prolonged period is called toxic stress D. Stress is first experienced around age 1

D. Stress is first experienced around age 1

MAC of an agent will abolish the response to stimulus in 22% of patients. MAC values are additive when different gases are used in combination. A. Both statements are true B. The first statement is true, the second is false. C. Both statements are false D. The first statement is false, the second is true.

D. The first statement is false, the second is true.

What are the most common postoperative complications following general anesthesia in children younger than the age of 5 years? A) Vomiting B) Headache C) Sore throat D) Fever E) A, C and D F) All of the above

E) A, C and D

Patients for whom general anesthesia is the management technique of choice, includes which one of the following? A) Patient is unable to cooperate due to a lack of psychological maturity and/or those who have a physical, mental or medically compromising disability that precludes conscious sedation. B) Patients requiring immediate, extensive comprehensive oral or dental needs. C) Patients with dental restorative or surgical needs for whom local anesthesia is ineffective because of accrue infection, anatomical variations or allergy. D) Patients who have sustained extensive orofacial/dental trauma and/or require significant surgical procedures E) All of the above

E) All of the above

Which of the following is INCORRECT? A. The brain of a newborn accounts for 10% B. Only 25% of the neuronal cells of an adult are present at birth C. By 12 months, brain stem development is nearly complete D. Growth in the CNS of an infant is rapid E. All are correct

E. All are correct

Which of the following are valid discharge criteria? A. Dressing is intact with minimal/no drainage B. Postoperative orders have been addressed C. Patient is tolerating oral fluids D. Breaths sounds are equal and respirations are sound E. All of the above

E. All of the above

Please identify which of the following comorbidities would not necessitate post-operative hospital observation. A. Apnea B. Congestive heart failure C. Seizure disorder D. Cardiac transplantMorbid obesity E. All of the above would require post-operative hospital observation

E. All of the above would require post-operative hospital observation

True or false? When treating mandibular primary molars with a pulpotomy and SSC, research shows that the IAN block method was more effective than the infiltration/intrapapillary injection method in regards to patient pain.

False

True/False: Autonomic control of the heart is a balance between the sympathetic and parasympathetic nervous systems, which both develop at the same rate.

False

True/False: Breast milk, infant formula and nonhuman milk can all be ingested up to 6 hours before a procedure requiring sedation.

False

True/False: Dental fear/anxiety is synonymous with dental behavior management problems

False

True/False: Modern hospital care has encouraged the use of abbreviations with the onset of paperless charts.

False

What is the specific reversal agent to treat benzodiazepine (i.e. Midazolam) overdose ?

Flumazenil (Romazicon)

An anesthetic's potency is defined as the concentration of the agent required to inhibit response to a standard surgical stimulus. The potency is expressed in terms of ___ value for the agent.

Minimal alveolar concentration (MAC)

True/False: Behavior management is the preferred term globally over behavior guidance.

True

Stress that continues over a prolonged period and has long effects is termed ______ stress. These include child abuse/neglect, chronic exposure to drugs or violence in the home, and parental depression or mental illness.

Toxic

True or False: Many dentists believe that when age groups are kept together (preschoolers in the morning and older children in the afternoon), the peer group has a positive influence, with children serving as models for each other.

True

True or false: Most modeling studies indicate that there is merit in introducing children to dentistry in this way, but not all studies show statistically improved cooperative behavior on the part of the children.

True

True or false: The most common estimate of analgesic efficacy suggests that 30% nitrous oxide delivered by full mask is equivalent to 10 to 15 mg of morphine.

True

In order to be discharged after sedation, The child should be able to remain awake for at least _______, unstimulated, before discharge. a. 20 minutes b. 30 minutes c. 1 hour d. 2 hours

a. 20 minutes

Statement 1: Using larger gauge needles is recommended for injection into highly vascular areas or areas where needle deflection through soft tissue may be a factor. Statement 2: When using larger gauge needles, it is important to inject the anesthetic slower compared to when using a smaller gauge needle. a. Statement 1 is true. Statement 2 is false b. Statement 1 is false. Statement 2 is true c. Both statements are true d. Both statements are false

a. Statement 1 is true. Statement 2 is false.

What are the external landmarks to help align the needle for the Gow-Gates Mandibular Block Technique? a. Tragus of the ear and corner of the mouth b. Upper helix of the ear and corner of the mouth c. Lobule of the ear and the corner of the mouth

a. Tragus of the ear and corner of the mouth

When using the Frankl behavior scale to describe patient behavior, what number is used to describe "negative?" a. 1 b. 2 c. 3 d. 4

b. 2

According to NPO guidelines for children over 1-year clear liquids are permitted until 2 hours prior to scheduled surgery. Breast milk is permitted until 4 hours prior to scheduled surgery. a. First statement is true, second if false b. First statement is false, second is true c. Both are true d. Both are false

b. First statement is false, second is true

________ became the least accepted technique, whereas _______ became the third most accepted method for behavior guidance. a. Hand over mouth, voice control b. Hand over mouth, general anesthesia c. General anesthesia, voice control

b. Hand over mouth, general anesthesia

The ____ route typically works within 5-10 minutes. The _____ route typically works within 20 to 40 seconds. a. IV, IM b. IM, IV c. Enteral, IV d. IM, enteral

b. IM, IV

Although analysis of the scientific data reveals that children of all ages can be affected by their mothers' anxieties, the effect is greatest with those younger than ____years of age. a. 2 b. 3 c. 4 d. 5

c. 4

The dentist's simple act of placing a hand on a child's shoulder while sitting on a chairside stool conveys a feeling of warmth and friendship. Greenbaum and colleagues found that this type of physical contact helped children to relax, especially those from ________ years of age a. 3-5 b. 5-7 c. 7-10 d. 10-13

c. 7-10

Midazolam is much more potent than diazepam, as predicted by its greater affinity to bind benzodiazepine receptors in the brain. The clinical potency of midazolam is estimated to be 2 to 5 times the potency of diazepam a. First statement is true, second is false b. First statement is false, second is true c. Both are true d. Both are false

c. Both are true

Which of the following is NOT an age-related psychosocial trait and skill for a 2 year old child? a. Geared to gross motor skills, such as running and jumping b. Likes to see and touch c. Has very active imagination; likes stories d. Plays alone; rarely shares

c. Has very active imagination; likes stories

What is the dosage for Acetaminophen for postoperative pain management in a pediatric patient? a. 5-10 mg/kg/dose given at 6-8 hour intervals b. 5-10 mg/kg/dose given at 4-6 hour intervals c. 10-15mg/kg/dose given at 6-8 hour intervals d. 10-15mg/kg/dose given at 4-6 hour intervals

d. 10-15mg/kg/dose given at 4-6 hour intervals

Which of the following is FALSE about Nitrous oxide? a. Most frequently used pediatric sedation technique today b. Slightly sweet-smelling, colorless, inert gas c. Compressed in cylinders as a liquid but vaporizes on release d. Non-flammable, and non-combustible

d. Non-flammable, and non-combustible

All of the following are true regarding obtaining hospital privileges EXCEPT: a. The applicant must have graduated from an accredited dental school. b. The applicant must be licensed to practice dentistry in the state in which the facility is located. c. The applicant must have high moral and ethical standards. d. The applicant must have at least 1 year of work experience after graduation from dental school

d. The applicant must have at least 1 year of work experience after graduation from dental school