question

What potent drug used for pain control was derived from opium?

answer

Morphine

question

All of the following are reasons why procaine was NOT as desirable as lidocaine for pain control EXCEPT one. Which one is the EXCEPTION?

answer

D. It was addictive

question

Injectable amides are recommended over esters because there is:

answer

A and B (Less risk of allergic reactions and Increased potency)

question

What drug did Horace Wells first introduce into dentistry for pain control?

answer

Nitrous Oxide

question

What is the most popular local anesthetic used in the US today?

answer

Lidocaine

question

What is the definition of pain threshold?

answer

The point at which a sensation starts to be painful and discomfort results

question

What is pain perception?

answer

A neurologic experience of pain related to the process of receiving pain stimuli and transmission of this pain to the brain that differs little among individuals

question

what is pain?

answer

The sensation of discomfort that the patient feels, ranging from mild to severe

question

What is pain reaction?

answer

Personal interpretation and responses to the pain message that is highly variable among individuals

question

Pain can be influenced by all of the following EXCEPT one. Which one is the EXCEPTION?

answer

D. Positive attitude

question

What theory helps dental hygienists understand the relationship between human-need fulfillment and human behavior?

answer

Human-needs theory

question

What is the definition of stress?

answer

A physical and emotional response to a particular situation

question

Which of the following may negatively influence the pain reaction threshold?

answer

Fear

question

If a patient has a high pain threshold, he or she will experience more intense pain than a patient who has a low pain threshold.

answer

False

question

Which of the following is the personal interpretation and response to the pain message, and is highly variable among individuals?

answer

Pain reaction

question

In what year was the first local anesthetic introduced?

answer

1884

question

It is best to schedule apprehensive patients for long appointments to complete as much work as possible, and it is best to schedule these appointments in the morning.

answer

Both statements are NOT correct.

question

What percentage of patients has reported to have had onset of dental anxiety by adolescence?

answer

50-85%

question

Which of the following are signs of moderate anxiety?

answer

B and C only (History of frequently missed appointments and History of emergency appointments only)

question

What is the best method of managing an anxious patient?

answer

Prevention

question

A stimulus is an electrical message from one part of the body to another. An impulse is an environmental change in an excitable tissue.

answer

e first statement is correct, but the second is NOT.

question

Which fibers are the principle fibers in the transmission of sharp, bright dental pain?

answer

Aδ fibers

question

Local anesthetics work by:

answer

Penetrating the nerve to inhibit Na+ influx

question

Local anesthetics mostly have their effect on myelinated nerves in which way?

answer

Mostly at the node of Ranvier

question

The minimal threshold stimulus required to excite a C fiber will also be sufficient to stimulate an A fiber.

answer

False

question

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:

answer

Self-propagating

question

The absolute refractory period occurs during the fraction of a millisecond when a nerve fiber can be excited only by a much stronger stimulus than the initial stimulus.

answer

False

question

Saltatory conduction refers to:

answer

Rapid transmission of nerve impulses along a myelinated nerve fiber

question

What is the type of glial cell located in the peripheral nervous system?

answer

Schwann

question

Myelin (lipoprotein sheath) is composed of:

answer

Approximately 75% lipid, 20% protein, and 5% carbohydrate

question

The sympathetic division is involved with the "rest or digest" response. The parasympathetic division is known as the "fight or flight" response.

answer

NEITHER statement is CORRECT

question

The afferent division consists of all incoming information traveling along sensory or afferent pathways. The efferent divisions consist of all outgoing information along motor or efferent pathways.

answer

Both statements are CORRECT

question

What is the outer layer of the myelin sheath that wraps the entire nerve is called?

answer

Epineurium

question

The axon hillock:

answer

Decides whether to send the impulse further down the axon

question

In a resting neuron, what positive ion is most abundant outside the plasma membrane?

answer

Sodium

question

In a resting neuron, what positive ion is most abundant inside the plasma membrane?

answer

Potassium

question

The electrical potential of nerve axoplasm in the resting state is approximately:

answer

-70 mV

question

Mantle bundles will be anesthetized first by a local anesthetic compared with core bundles.

answer

True

question

Chemical synapses use chemical transmitters called:

answer

Neurotransmitters

question

The "all-or-none principle" occurs:

answer

Once a nerve is excited by the minimal threshold level

question

Infection and inflammation cause the following effects when administering a local anesthetic:

answer

Increased tissue vascularity, which can inactivate the local anesthetic more rapidly

question

All of the following are desirable properties of local anesthetic EXCEPT one. Which one is the EXCEPTION?

answer

Slow biotransformation

question

Which characteristic enhances the effectiveness of local anesthetics?

answer

High lipid solubility

question

Where is the action site for local anesthetic?

answer

The calcium receptors

question

Which part of the chemical structure of the local anesthetic determines if the local anesthetic agent is classified as an ester or an amide?

answer

Intermediate chain

question

Local anesthetics have their effect on myelinated nerves mostly in which way?

answer

Mostly at the nodes of Ranvier

question

The quaternary form of the local anesthetic molecule:

answer

Is the ionized form in the cartridge and is responsible for binding to the receptor site.

question

Ester type local anesthetics are no longer manufactured in injectable form for dentistry because:

answer

Of their high degree of hypersensitivity

question

During manufacturing, local anesthetics are formulated as which of the following to render them water-soluble?

answer

Hydrochloride salt

question

Which of the following anesthetics will provide the most rapid onset based on its pKa?

answer

Benzocaine

question

Which of the following local anesthetics is the most lipid soluble?

answer

Bupivacaine

question

The mantle bundles of the inferior alveolar nerve innervate which teeth?

answer

The molar area

question

When the local anesthetic is administered, the solution reaches the core bundles first.

answer

False

question

What is tachyphylaxis?

answer

Increased tolerance to a drug that is administered repeatedly

question

Recovery of local anesthetics following the inferior alveolar block begins in the posterior teeth, but as the anesthetic in the anterior teeth, chin, and lip (core bundles) begin to diffuse into the mantle region of the molar teeth, these structures will recover before the molar teeth.

answer

Both statements are CORRECT

question

Which of the following are true regarding local anesthetics?

answer

1,, 2, 4 (Are potent vasodilators, Exhibit anticonvulsant properties, Cause hypotension)

question

Which of the following is responsible for allergic reactions in ester anesthetics?

answer

Para-amino benzoic acid

question

Most amide local anesthetics are biotransformed in the:

answer

Liver

question

Local anesthetic overdose has an effect on which system?

answer

Central nervous system

question

Topical anesthetics are available in both esters and amides.

answer

True

question

The activity of the sympathetic autonomic nervous system neurotransmitters is terminated mainly by:

answer

Reuptake by adrenergic nerves

question

Which of the following is a sign of epinephrine toxicity?

answer

Tachycardia (high blood pressure)

question

What is the maximum recommended dose of epinephrine per appointment for a patient with significant cardiovascular disease?

answer

0.04 mg

question

Epinephrine should be avoided in patients with:

answer

A and D (Untreated hyperthyroidism and Myocardial infarction or stroke within the prior 6 months)

question

What is epinephrine used for?

answer

Anaphylactic reactions

question

An effect of epinephrine used in dentistry is to:

answer

Increase vasoconstriction and slow bleeding

question

Which of the following is a systemic effect of vasoconstrictors used with local anesthetics?

answer

A and C (Increased diastolic blood pressure and Increased systolic blood pressure)

question

Vasoconstrictors are added to local anesthetics for what reason(s)?

answer

A, B, C (Reduce bleeding, Counteract the vasodilatory effects of local anesthetics, Decrease possibility of an anesthetic overdose)

question

Which of the following is the preservative added to local anesthetic solutions containing epinephrine to prevent its oxidation?

answer

Sodium bisulfite

question

There is no difference in pain control when using a 1:50,000 or 1:100,000 dilution of epinephrine.

answer

True

question

Epinephrine causes direct stimulation of which of the following adrenergic receptors resulting in cardiac stimulation?

answer

𝝱1 (𝝱2 results in lung stimulation)

question

Which of the following vasoconstrictors can safely be administered to a patient with uncontrolled hyperthyroidism?

answer

Felypressin

question

The half-life of epinephrine is approximately:

answer

1 to 3 minutes

question

What is a 1:1000 dilution of epinephrine used for?

answer

Anaphylaxis

question

Levonordefrin is added to which of the following local anesthetics?

answer

2% Mepivacaine

question

Vasoconstrictor drugs are known as all of the following EXCEPT one. Which one is the EXCEPTION?

answer

Vasodilators

question

Epinephrine and norepinephrine are endogenous hormones excreted by:

answer

Adrenal gland

question

Which adrenergic receptor causes epinephrine to have inhibitory actions that cause vasodilation and bronchodilation?

answer

𝝱2

question

Which of the following concentrations of epinephrine is the most diluted?

answer

1:200,000 (1:1000 is the most concentrated)

question

Signs and symptoms of a vasoconstrictor overdose manifest as:

answer

Central nervous system stimulation

question

What is the most important advantage of amide over ester local anesthetics?

answer

Less allergenicity

question

Which local anesthetic is the longest acting?

answer

Bupivacaine with epinephrine

question

Which local anesthetic has the least vasodilatory effect when used without epinephrine?

answer

Mepivacaine

question

Which local anesthetic has the greatest vasodilatory effect when used without epinephrine?

answer

Procaine

question

One cartridge of anesthetic contains how much solution?

answer

1.8 mL

question

Factors in selection of local anesthetic of a patient include all of the following EXCEPT one. Which one is the EXCEPTION?

answer

Vitamin intake

question

Which of the following is FALSE?

answer

Topical benzocaine is an amine (False because it is an ester)

question

Which of the following local anesthetics is metabolized in the plasma and liver?

answer

Articaine

question

Which of the following is an advantage of having a local anesthetic metabolized in the plasma and liver?

answer

Shorter half-life of drug

question

Which of the following local anesthetics is metabolized in the lungs and liver?

answer

Prilocaine

question

Methylparaben is a:

answer

Bacteriostatic agent that is no longer added to dental cartridges due to high incidence of allergic reactions

question

How is 3% mepivacaine formulated?

answer

3% plain

question

Which of the following is a concern when selecting bupivacaine?

answer

Patient self-mutilation

question

Which of the following local anesthetics is the BEST option for re-administration of anesthetic to provide a lessened likelihood of blood concentration build-up?

answer

Articaine

question

The lower the pKa of a drug, the more cations are present, which decreases the onset of action.

answer

False (More pKa means more anions)

question

Which of the following is NOT a factor in the duration of local anesthetic?

answer

Patient health assessment

question

Which of the following local anesthetics used without a vasoconstrictor provides intermediate duration of action when administering a block?

answer

Prilocaine

question

Which of the following is the BEST reason for choosing a local anesthetic that provides a long duration?

answer

Need for postoperative pain control

question

When is lidocaine 1:50,000 epinephrine most effective?

answer

When hemostasis is needed

question

Where is procaine metabolized?

answer

Plasma

question

Which of the following topical anesthetics is classified as an amide?

answer

Lidocaine (injectable)

question

Benzocaine is available in all of the following preparations EXCEPT one. Which one is the EXCEPTION?

answer

Injectable (available in cream, gel, spray, and patch)

question

All of the following statements are true EXCEPT one. Which one is the EXCEPTION?

answer

The more topical placed at the site of the needle penetration the better

question

Which of the following topical anesthetics has a U.S. Food and Drug Administration pregnancy category B?

answer

Lidocaine/Prilocaine

question

Which of the following would be an indication for use of a topical anesthetic?

answer

To minimize patient's gag reflex

question

All of the following are true regarding maximum recommended doses for topical anesthesia EXCEPT one. Which one is the EXCEPTION?

answer

Exact doses can be measured using a cotton tip applicator.

question

Concentrations available in over-the-counter products can be as high as those administered professionally in the dental office.

answer

True

question

Which of the following topical anesthetics do not always require a prescription?

answer

Benzocaine

question

All of the following are considered ideal properties of a topical anesthetic EXCEPT one. Which one is the EXCEPTION?

answer

It should be allergenic

question

Which method of delivery is recommended to decrease the risk of methemoglobinemia?

answer

Metered spray with disposable nozzle

question

Topical anesthetics generally penetrate _______ into to the tissue.

answer

2-3 mm

question

Which of the following local anesthetic agents is found in Oraqix?

answer

Prilocaine (and Lidocaine)

question

The concentrations of topical anesthetics are greater than those of their injectable counterparts. Topical anesthetics do not contain vasoconstrictors.

answer

Both statements are true.

question

All of the following describes advantages of single unit-dose applications of topical anesthetics EXCEPT one. Which one is the EXCEPTION?

answer

Requires less administration time

question

EMLA is approved by the U.S. Food and Drug Administration for use on which of the following areas?

answer

Intact skin

question

Pulpal anesthesia can be achieved using. 2.5% lidocaine and 2.5% prilocaine gel mixture.

answer

False

question

Which of the following topical anesthetic agents is considered a ketone?

answer

Dyclonine hydrochloride

question

If plasma concentrations in the body become too high, the most prominent systemic effect will occur in which of the following systems?

answer

B and C (Cardiovascular system and Central nervous system)

question

Allergic reactions associated with topical anesthetics are rare. It is not necessary to review a patient's medical history before applying a topical anesthetic agent.

answer

The first statement is true; the second statement is false.

question

All of the following are possible localized adverse reactions associated with topical anesthesia EXCEPT one. Which one is the EXCEPTION?

answer

Increased heart rate

question

What drug is most likely to exhibit a drug interaction with epinephrine?

answer

Tricyclic antidepressants (because epinephrine is a vasoconstrictor)

question

Before injecting a patient with local with or without a vasoconstrictor, the dental hygienist should perform all of the following EXCEPT one. Which one is the EXCEPTION?

answer

Administer nitrous oxide

question

Patients with bleeding disorders will most likely be susceptible to:

answer

Technique of anesthetic administration

question

Following the admin of a local with a vasoconstrictor, the patient experiences mild itching and a slight rash. This is most likely caused by:

answer

Sodium bisulfate

question

Patients with an artificial heart valve need premedication before a local anesthetic injection.

answer

False

question

What is an absolute contraindication to the use of vasoconstrictors?

answer

Heart attack 5 months ago

question

Which of the following drugs is the best choice to administer when a patient has a history of hepatitis B?

answer

Nonselective (Articaine is nonselective)

question

What of the following anesthetics should be avoided if a patient has methomoglobinemia?

answer

Prilocaine

question

What anesthetic falls under the pregnancy risk category B?

answer

Lidocaine (or Prilocaine)

question

It is recommended to monitor a patient's blood pressure throughout treatment for symptoms of altered (increased) blood pressure when a patient is taking which of the following medications?

answer

Nonspecific beta-blockers

question

When a patient is taking a tricyclic antidepressant and is also given loevonordefrin, blood pressure enhancement is fivefold greater than with levonordefrin alone.

answer

True

question

Select the local anesthetic that is most likely to inhibit the antibacterial activity of sulfonamides.

answer

Procaine

question

Patients with atypical plasma cholinesterase should not receive which classification of drugs?

answer

All esters (Amides are your friend, Esters are not)

question

Methemoglobinemia is cause by the metabolite:

answer

Orthotoluidine

question

Which of the following treatment modifications are important for patients with alcoholism?

answer

Administer the minimal effective dose of lidocaine, mepivacaine, or bupivacaine

question

Patients taking Elavil should:

answer

Receive lowest effective dose of epinephrine similar to that recommended for cardiovascularly involved patient

question

ASA II describes a patient:

answer

With a mild systemic disease that that does not interfere with daily activity

question

Which of the following can cause a false high blood pressure reading?

answer

Blood pressure cuff is too narrow

question

Which of the following is a relative contraindication to the use of an amide local anesthetic?

answer

Patient is taking Tagamet

question

A patient is considered to have tachycardia if beats per minute is greater than 80.

answer

False: Tachycardia is >100 bpm (Bradychardia is <60 bpm)

question

What is the cardiac does of epinephrine?

answer

0.04 mg

question

A 2% local solution means all of the following EXCEPT one. Which one is the EXCEPTION?

answer

2000 mg per 10 mL

question

The dental hygienist administered 2.3 cartridges of 3% mepivacaine. How many cc were administered?

answer

4.4 cc (Remember: 1 cc = 1 mL)

question

What is the MRD of 2% lidocaine for a 120-lb patient?

answer

381 mg (Solution: 120 lb x (1 kg/2.2 lb) x (7mg/1kg)= 381 mg MRDs on table 8-1 in new book

question

How many cartridges of 2% lidocaine 1:100,000 epinephrine can be safely administered to a 120-lb patient taking tricyclic antidepressants?

answer

2.2 (Table 8-5 new book)

question

How many cartridges of 4% prilocaine can a healthy 150-lb patient receive?

answer

8.3

question

What is the most important improvement that has been made to the local anesthetic syringe?

answer

The addition of the aspirating harpoon

question

Which of the following are important criteria for an acceptable local anesthetic syringe?

answer

Inexpensive, self-contained, and able to withstand repeated sterilization without damage

question

What is the purpose for applying negative pressure to the harpoon?

answer

To evaluate whether needle is within a blood vessel

question

Computer-controlled anesthetic devices are beneficial because they deliver exact amounts of anesthetic at a controlled rate. They are less ergonomic for the clinician.

answer

First statement is true and second statement is false

question

What is the definition of the needle bevel?

answer

The angled point or tip of the needle

question

Which of the following intraoral needle gauges used in dentistry are listed from smallest to largest?

answer

30, 27, 25

question

It is safe to insert the needle to the hub. The hub of the needle is the strongest part of the needle.

answer

NEITHER the statement nor the reason is CORRECT

question

Larger gauge needles have what advantages over smaller gauge needles?

answer

B and C (Greater accuracy and Increased injection success)

question

The bevel of the needle should:

answer

Be turned toward the bone

question

What are the two commonly used needle lengths for intraoral injections?

answer

25mm, 32mm

question

All are acceptable ways to recap a needle EXCEPT one. Which one is the EXCEPTION?

answer

Using fingers to recap the needle when it has NOT entered the patient's mouth

question

All are ways that increase the risk of needle breakage EXCEPT one. Which one is the EXCEPTION?

answer

Using a 25-gauge needle

question

The color-coded band on the anesthetic cartridges identifies what?

answer

Anesthetic drug inside the cartridge

question

Warming the anesthetic agent is recommended for patient comfort because it can activate the vasoconstrictor. This can cause an increase in the duration of the action.

answer

NEITHER the statement nor the reason is correct

question

Which of the following indicates that the cartridge should be used?

answer

Small bubbles less than 2mm

question

All of the following cause a burning sensation when the anesthetic is injected into the tissue EXCEPT one. Which one is the EXCEPTION?

answer

Buffered anesthetic

question

What are characteristics of topical anesthesia?

answer

Provide soft tissue anesthesia

question

What is optional when prepping to give an intraoral injection?

answer

Topical anesthetic

question

How should a clinician properly dispose of anesthetic needles?

answer

Recapping utilizing the scoop method and disposal in an approved sharps container

question

Which of the following is a way to decrease pain during injections?

answer

Change needle after 3 to 4 tissue penetrations

question

Which of the following BEST describes the reason for greater incidence of clinically adequate local anesthesia for the maxillary teeth when the local anesthetic agent is administered as a supraperiosteal injection than would occur with similar teeth on the mandibular arch?

answer

More porous alveolar process

question

Which foramen carries branches of BOTH the right and left nasopalatine nerves?

answer

Incisive foramen

question

Which of the following is a landmark for the administration of the posterior middle superior alveolar local anesthetic block?

answer

Maxillary tuberosity

question

Which of the following is a landmark for the administration of the anterior middle superior alveolar local anesthetic block?

answer

Median palatine raphe

question

Which of the following skull bones in the ONLY freely movable bone of the skull?

answer

Mandible

question

The mental foramen is USUALLY located inferior to the apices of the mandibular:

answer

First and second premolars

question

For which of the following mandibular teeth is a supraperiosteal local anesthetic injection or local infiltration MOST effective?

answer

Anterior teeth

question

Which of the following is a landmark for the administration of the inferior alveolar local anesthetic block?

answer

Coronoid notch

question

Which of the following is a landmark for the Gow-Gates mandibular local anesthetic block?

answer

Condylar neck

question

A patient may have a bifid inferior alveolar nerve. A second mandibular canal can be detected on radiographs.

answer

Both statements are true.

question

Which of the following nerves is ONLY present in approximately 28% of the population?

answer

Middle superior alveolar

question

Which of the following BEST describes the (long) buccal nerve?

answer

Afferent nerve for the buccal gingival tissue of the mandibular molars

question

Which of the following is the division of the trigeminal nerve that does NOT innervate the teeth?

answer

Ophthalmic

question

The zygomatic nerve is a branch of which of the following nerves?

answer

Maxillary

question

Which nerve when anesthetized also anesthetizes BOTH the anterior and middle superior alveolar nerves?

answer

Infraorbital

question

Which of the following is considered the largest division of the trigeminal nerve?

answer

Mandibular

question

Which of the following nerves is formed from afferent branches from the body of the tongue?

answer

Lingual

question

Which of the following nerves may ALSO innervate the mandibular first molar in some cases?

answer

Mylohyoid

question

The mental nerve serves as a an afferent nerve for the:

answer

Labial mucosa of the mandibular anterior teeth

question

Which of the following local anesthetic block injections when given INCORRECTLY may pierce the pterygoid plexus of veins causing a hematoma?

answer

Posterior superior alveolar block

question

Surface anesthesia can be achieved by all of the following EXCEPT one. Which one is the EXCEPTION?

answer

Injections

question

When soft tissue anesthesia is needed in a limited area, it is best to perform a:

answer

Local infiltration

question

The dental hygienist will provide nonsurgical perio therapy of teeth #18 to 24. Which injection administration technique should the dental hygienist use?

answer

Nerve block

question

If the dental hygienist wants to anesthetize tooth #12, which injection administration technique should the clinician use?

answer

Supraperiosteal

question

What type of injection administration technique is the anterior superior alveolar (ASA)?

answer

Supraperiosteal

question

What is the most common medical emergency observed in the dental office?

answer

Vasodepressor syncope

question

During the pre-anesthetic assessment, what are appropriate clinical considerations?

answer

All are important considerations (Vital signs, Length of appointment, Anticipated postoperative pain control)

question

When checking armamentarium, why is it important to expel a few drops of the anesthetic?

answer

To ensure a free flow of anesthetic through the needle

question

What is the recommended patient position when administering anesthesia?

answer

Supine

question

Following a positive aspiration, the dental hygienist must always change the cartridge and redo the procedure.

answer

False

question

Topical anesthetic should be applied after the application of a topical antiseptic. Topical antiseptic can be used to decrease infection.

answer

Both statements are true.

question

After the patient has consented to treatment, when is a good time to communicate with the patient to alleviate fears of needle injection?

answer

When preparing the tissue for injection

question

All of the following are the benefits of establishing a fulcrum during the administration of local EXCEPT one. Which one is the EXCEPTION?

answer

To clearly see a positive aspiration

question

Pulling the tissue taut before needle insertion helps all of the following EXCEPT one. Which one is the EXCEPTION?

answer

Burning sensation felt by patient

question

What is the main goal of aspirating on two planes?

answer

To determine if the bevel of the needle is abutting against a blood vessel providing a false negative aspiration on the first aspiration test

question

What is the minimum number of times a clinician should aspirate before administering the anesthetic solution?

answer

Twice

question

Depositing anesthetic agent should be done quickly to promote patient comfort.

answer

False

question

After removing the needle, what is the immediate next step?

answer

Recapping the needle

question

When do most reactions or dental emergencies associated with the administration of local anesthetics happen?

answer

Within 5 minutes of the procedure

question

Following the local anesthetic procedure, what information is important to document?

answer

B and C only (Anesthetic used and amount in mg and Vasoconstrictor used and amount in cartridges)

question

Anesthesia of the maxillary teeth is MORE clinically effective than the mandibular teeth BECAUSE the bone of the maxillae overlying the teeth is denser and less porous.

answer

The statement is correct, but the reason is NOT.

question

When performing maxillary nerve anesthesia, which is the ONLY local anesthetic block that requires the clinician to gently contact bone with the needle to ensure clinically affecting outcome?

answer

Infraorbital block

question

Which block is MOST appropriate to administer so as to allow for clinically effective anesthesia of the associated buccal periodontium and gingiva of the maxillary premolars?

answer

Middle superior alveolar block

question

Where is the recommended injection site or needle insertion point for local anesthetic deposition of the agent located when administering a supraperiosteal injection on the surface of the maxilla?

answer

Height or depth of the mucobuccal fold

question

It is ALWAYS important for the clinician to orient the needle as close as possible to the periosteum. This is to ensure the needle glides along the periosteum allowing for more stability.

answer

NEITHER the statement NOR the reason is correct.

question

Which of the following local anesthetic blocks anesthetizes the mesiobuccal root of tooth #3 (#1.6) in ONLY approximately 28% of the population?

answer

Middle superior alveolar block

question

Which of the following structures does the infraorbital local anesthetic block USUALLY anesthetize?

answer

Anterior and middle superior alveolar nerves within one maxillary quadrant

question

Where is the recommended target area of deposit location for the posterior superior alveolar local anesthetic block?

answer

Posterior superior alveolar nerve entering the maxilla through the posterior superior alveolar foramina

question

Which local anesthetic block listed below requires the recommended injection site or needle insertion point to be at the height of the maxillary mucobuccal fold superior to the apex of the maxillary second molar?

answer

Posterior superior alveolar block

question

If the clinician wanted to anesthetize teeth #9 to 11 and associated facial and palatal periodontium and gingiva for a limited procedure, it would be BEST to administer which of the following local anesthetic blocks?

answer

Infraorbital and nasopalatine blocks

question

Since the greater palatine block does NOT provide pulpal anesthesia, the use of the middle superior alveolar block and/or posterior superior alveolar block is also indicated when instrumenting on the maxillary premolars.

answer

The statement is correct, but the reason is NOT.

question

Which of the following local anesthetic blocks requires the needle and syringe barrel angulation to be at 45 degrees within three separate planes during administration?

answer

Posterior superior alveolar block

question

Where is the recommended injection site or needle insertion point for the nasopalatine block?

answer

Lateral to the incisive papilla

question

Where is the recommended injection site or needle insertion point for the middle superior alveolar local anesthetic block?

answer

Apex of the maxillary second premolar

question

Where is the recommended injection site or needle insertion point for the anterior superior alveolar local anesthetic block?

answer

Maxillary mucobuccal fold superior to the apex of the maxillary canine

question

What is the USUAL approximate depth of needle insertion for the anterior superior alveolar local anesthetic block?

answer

5 millimeters

question

What is the recommended injection site or needle insertion point for the infraorbital block?

answer

Height of the maxillary mucobuccal fold of the maxillary first premolar

question

After receiving an infraorbital local anesthetic block, the patient reports slight numbness of the lower eyelid. What should the clinician do next?

answer

Explain to the patient that this is a usual reaction to the block

question

Where is the greater palatine foramen usually located?

answer

Approximately 10 mm medial and directly superior to the palatal gingival margin

question

Pressure anesthesia to control patient discomfort upon injection with the needle can be used during which of the following local anesthetic blocks?

answer

Greater palatine and nasopalatine local anesthetic blocks

question

Which of the following supplemental injections is RARELY used within the maxillary arch before nonsurgical periodontal therapy?

answer

Periodontal ligament injection

question

Which of the following supplemental injections are also intraosseous injections?

answer

Both the intraseptal and periodontal ligament injections

question

What is the injection site or needle insertion point for an intraseptal injection within the maxillary arch?

answer

Center to the interdental papilla

question

Which of the following supplemental injections increase hemostasis when used with a higher level of vasoconstrictor upon instrumenting within the maxillary arch?

answer

Intraseptal injection

question

Which of the following supplemental injections within the maxillary arch is palpated before administration to ensure soft tissue entry before the needle is inserted?

answer

Supraperiosteal injection

question

What is the approximate needle insertion depth into soft tissue in MOST cases for the inferior alveolar local anesthetic block?

answer

20 millimeters

question

The mandibular nerve or third division is a branch of which cranial nerve?

answer

V (Roman numeral 5)

question

The posterior mandibular sextant is denser and less porous than the mandibular anterior sextant, which allows for MORE clinically effective molar anesthesia.

answer

The statement is correct, but the reason is NOT.

question

Which injection is USUALLY administered along with the inferior alveolar block to provide complete anesthesia of a mandibular quadrant on a patient before nonsurgical periodontal therapy WITHOUT any overlapping coverage?

answer

Buccal block

question

Which of the following local anesthesia blocks will NOT provide pulpal anesthesia to tooth #23 (#3.2) before restorative dental procedures?

answer

Buccal block

question

After administering a mental local anesthetic block, the patient reports slight numbness of the chin. What should the clinician do next for the patient?

answer

Explain to the patient that this is the usual reaction and continue with treatment.

question

After a few minutes following the administration of a mental local anesthetic block, a patient reports that some of her contralateral mandibular anterior teeth feel numb. What caused the patient's contralateral mandibular anterior teeth to become anesthetized?

answer

Diffusion of the anesthetic agent to the incisive nerve

question

What injection uses the mesiolingual cusp of the maxillary second molar as a landmark during administration?

answer

Gow-Gates mandibular block

question

When administering the inferior alveolar local anesthetic block, syringe barrel in MOST cases should be in what relation to the mandibular occlusal plane?

answer

Parallel plane

question

When administering the inferior alveolar local anesthetic block, the syringe barrel in MOST cases should usually be superior to which mandibular tooth?

answer

Premolar on the contralateral side

question

If anesthesia of the lingual periodontium and gingiva is required for #25-27 (#4.1-4.3), an incisive block is clinically effective BECAUSE it anesthetizes both the associated facial and lingual periodontium and gingiva of the mandibular anterior teeth.

answer

NEITHER the statement NOR the reason is correct.

question

Which of the following local anesthetic blocks has the HIGHEST risk of hematoma for the patient after administration?

answer

Posterior superior alveolar block

question

While administering the inferior alveolar block, the clinician contacts bone at a depth of approximately 10 millimeters on an average size adult patients. What should the clinician do next?

answer

Withdraw the needed and reinsert with the syringe barrel more anteriorly.

question

While administering the inferior alveolar block, the clinician does NOT contact bone. What should the clinician do?

answer

Withdraw the needle and reinsert with the syringe barrel more posteriorly.

question

The target area for the incisive block is the same as the mental block, but after administering the mental block, the clinician MUST place pressure to the injection site following the injection for clinically effective local anesthesia.

answer

First statement is true and the second is false.

question

There is NO need to palpate for the mental foramen prior to administering the mental local anesthetic block because the mental foramen is USUALLY in the same location on all patients.

answer

Neither the statement nor the reason is correct.

question

With of the following local anesthetic blocks anesthetizes the mylohyoid, mental, and the auriculotemporal nerves?

answer

Gow-Gates mandibular block

question

Which mandibular local anesthetic blocks require the clinician to gently contact the mandible with the anesthetic needed?

answer

Inferior alveolar block and Gow-Gates mandibular block

question

Which of the following situations is NOT related to incomplete anesthesia on the usual areas of the mandible on an adult patient after administering an inferior alveolar local anesthetic block?

answer

Patient experiencing "lingual shock" during the injection

question

Which of the following local anesthetic blocks uses BOTH the mandibular occlusal plane and pterygomandibular raphe as landmarks for administration?

answer

Inferior alveolar block

question

Which of the following supplemental injections in MAINLY used within the mandibular arch?

answer

Periodontal ligament injection

question

Which of the following supplemental injections are NOT intraosseous injections?

answer

Supraperiosteal injection

question

What is the injection site or needle insertion point for a periodontal ligament injection within the mandibular arch?

answer

Depth of the gingival sulcus

question

Which of the following supplemental injections within the mandibular arch is palpated to ensure soft tissue entry before the needle is inserted?

answer

Supraperiosteal injection

question

Which of the following supplemental injections increase hemostasis when used with a LESS diluted vasoconstrictor upon instrumenting within the mandibular arch?

answer

Periodontal ligament injection

question

One of the most common adverse reactions to the administration of a local anesthetic is systemic toxicity. It is usually a result of the administration of the local anesthetic above the patient's maximum recommended dose.

answer

Both the statement and the reason are CORRECT and related

question

Early signs and symptoms of central nervous system overdose are increased heart rate and blood pressure.

answer

True

question

When calculating maximum recommended doses (MRDs) for children, these doses should be calculated by using:

answer

American Academy of Pediatric Dentistry MRDs

question

When calculating the maximum recommended doses (MRDs) for obese children, all of the following should be used EXCEPT one. Which one is the EXCEPTION?

answer

Manufacturer's MRDs

question

Which of the following is an anatomical difference between children and adults?

answer

The roots of primary dentition are shorter

question

Which of the following is a successful management tool when soft tissue injury occurs from biting the lip?

answer

Apply an ice pack on the day of the injury (warm pack would be the day after the injury)

question

Which of the following is an effective way to use a dental assistant during the administration of local anesthetics to a child?

answer

To help stabilize the patient during the injection by gently placing their hands on top of the child's hand

question

Why are inferior alveolar blocks more successful in children compared with adults?

answer

Because of the location of the mandibular foramen in children

question

When administering the inferior alveolar local anesthetic block in children, the syringe barrel in most cases should be in what relation to the mandibular occlusal plane?

answer

Parallel

question

When administering the inferior alveolar local anesthetic block in children, the syringe barrel in most cases should be superior to which mandibular tooth?

answer

First molar on the contralateral side

question

2% Lidocaine 1:100,000 is preferred over 3% mepivacaine for children. This is due to the vasoconstrictor decreasing the risk of local anesthetic system toxicity.

answer

Both the statement and the reason are CORRECT and related.

question

Which of the following local anesthetic blocks has the highest risk of hematoma for the child after administration?

answer

Posterior superior alveolar block

question

What is the typical depth of needle insertion in children for a supraperiosteal injection?

answer

No more than 2 mm

question

The inferior alveolar foramen in children is:

answer

More inferior than adults

question

Bupivacaine is indicated for children because it provides long acting pain control.

answer

The statement is NOT correct, but the reason is CORRECT

question

Phentolamine mesylate should be administrated immediately following the dental procedure for children at risk of self-mutilation of their lip.

answer

Both the statement and the reason are CORRECT and related

question

All of the following are management tools when administering a local anesthetic to a child EXCEPT one. Which one is the EXCEPTION?

answer

Restraining the child tightly

question

All of the following are reasons to administer a long buccal block to a child EXCEPT one. Which one is the EXCEPTION?

answer

A class I restoration

question

Computer-controlled local anesthetic delivery devices should not be used on children.

answer

False

question

It is not necessary to contract bone when administering an inferior alveolar block to children because there is no risk of injecting into the parotid gland on a child?

answer

Neither the statement nor the reason is CORRECT

question

Which of the following BEST describes a localized complication?

answer

A complication that occurs in a region of the injection and is attributed to the needle or the administered anesthetic

question

Which of the following BEST describes a secondary complication?

answer

A complication that is experienced by the patient after the injection

question

If needle breakage occurs and the clinician can easily retrieve the needle, what is the next step by the dental hygienist?

answer

Keep one's hand to the patient's mouth and ask to open widely

question

Anaphylaxis is considered to be what type of complication?

answer

Systemic and severe

question

When a blood vessel is punctured or lacerated by the anesthetic needle, an asymmetrical swelling and discoloration may occur. This is possibly a sign of:

answer

Hematoma

question

What is the first step that needs to be completed by the dental hygienist when managing a hematoma?

answer

Apply pressure

question

What is soreness in the muscles of mastication caused by muscle spasms called?

answer

Trismus

question

An incident of edema in a patient after the administration of a local anesthetic can be caused by all of the following EXCEPT one. Which is the EXCEPTION?

answer

Broken needle

question

Paresthesia occurs MOST commonly during which intraoral local anesthetic injection?

answer

Inferior alveolar block

question

All of the following are ways the dental hygienist can decrease the risk of infection during a local anesthetic injection EXCEPT one. Which one is the EXCEPTION?

answer

Use topical anesthetic

question

Why should topical anesthetics ONLY be applied to the surface tissue for 1 to 2 minutes before administering a local anesthetic?

answer

To prevent tissue sloughing

question

Systemic complications usually occur MORE frequently than local complications. This situation is usually caused by high plasma concentration of the local anesthetic drug.

answer

First statement is NOT correct, second statement is correct

question

All of the following can increase the risk of local anesthetic dose EXCEPT one. Which is the EXCEPTION?

answer

Fast biotransformation

question

What are signs of central nervous system overdose from moderate to high blood levels that can be noted in a patient after administration of a local anesthetic?

answer

Convulsions

question

The patient shows convulsions, respiratory distress, cardiovascular depression, and coma. What is occurring to the patient?

answer

Local anesthetic overdose

question

Which of the following dilutions of local anesthetic agents has the lowest concentration of epinephrine?

answer

1:250,000 epinephrine

question

Which of the following is the appropriate treatment for a mild cutaneous reaction?

answer

Diphenhydramine

question

All of the following are signs of angina pectoris EXCEPT one. Which is the EXCEPTION?

answer

Dizziness

question

If the clinician strongly suspects the patient is having a myocardial infarction, the procedure is stopped and then the clinician should:

answer

Activate emergency medical services

question

If a patient starts to experience involuntary muscle contractions and altered breathing, what should the clinician suspect?

answer

Seizures

question

Before administering local anesthetics, the dental hygienist should describe the risks and benefits to the patient using which type of terms

answer

Terms appropriate for the patient's education level

question

Practicing within the legal scope of practice means?

answer

Practicing only within the limits set forth by your license and state's rules and regulations

question

Which of the following statements is false regarding the administration of local anesthetics?

answer

Never inform the patient of any unanticipated occurrences during and after the administration of the local anesthetic

question

In most states, the dental hygienist is not required to have malpractice insurance, because the dental hygienist is covered under the dentist's insurance.

answer

The statement is correct, but the reason is NOT

question

Dental hygienists are accountable for their own actions and practice. However, the dentist is always liable for any legal actions taken against the hygienist.

answer

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

question

Dental hygienists, who hold a current anesthesia license, are always able to administer local anesthetics without the physical presence of a dentist, but only if the dentist authorizes the procedure.

answer

Both statements are false.

question

What is the appropriate amount of anesthetic to be administered during a procedure?

answer

The amount necessary to complete the area that will be treated and finished in a single appointment

question

All of the following diseases are contractible if a needle stick occurs to the dental hygienist EXCEPT one. Which one is the EXCEPTION?

answer

Adenovirus

question

All of the following should be contained in a post-exposure management protocol for occupational exposures EXCEPT one. Which one is the EXCEPTION?

answer

Procedures for disinfection the operatory

question

Which statement is true regarding the handling of sharps?

answer

It is acceptable to recap a needle only using the one-handed scoop method.

question

If a needle stick injury occurs, it is not necessary to report the details of what happened, only that you were possibly exposed.

answer

Both statements are false.

question

Secondary prevention is when there is containment of an injury after it occurs. Tertiary prevention involves the return of the patient to a functional state and the prevention of further injuries.

answer

Both statements are true.

question

What does PPE stand for?

answer

Providing dental hygiene treatment

question

Risk management occurs when:

answer

You identify preventative methods to reduce or eliminate the risk of legal actions

question

Following exposure, if there is not enough time to get tested right away, it is okay to use bleach to cleanse the exposure site. However, if you are able to get tested immediately then you should just use soap and water.

answer

Both statements are false.

question

Communication, documentation, and risk reduction protocols are all necessary elements when administering a local anesthetic. This is because they help to reduce the chance of possible litigation.

answer

Both statements are true.

question

The qualified health care professional must take into consideration all of the following factors when determining the need for follow-up of occupational exposures EXCEPT one. Which one is the EXCEPTION?

answer

Blood type of the source

question

When handling a contaminated needle, it is only important to avoid being exposed to the end that penetrated the tissues or fluids. The cartridge-penetrating end of the needle is not a risk for contamination.

answer

Both statements are false.

question

It is the responsibility of the dental hygienist to report any illegal activities regarding the administration of local anesthesia to the proper authorities as well as to educate the dentist about current regulations regarding the hygienist's scope of practice.

answer

Both statements are true.

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