Deck 7: Preanesthetic Assessment

Question 1

What does the collection of preanesthetic data guide the dental hygienist in determining?

A) Need for medical consultation
B) Appropriateness of administering a local anesthetic or vasoconstrictor
C) Modification of dental care plan
D) All of the above
E) Some combination

Answer 1

All of the above

Question 2

Vasoconstrictors can increase a patient's blood pressure.

Answer 2

True

Question 3

MATCHING
Match the drug or medical condition in the left-hand column with the description of the significant concern in the right-hand column. Each description is used only once.
Patients with renal dysfunction

A)Life-threatening syndrome caused by general anesthetics
B)Avoid use of vasopressors; may lead to myocardial infarction
C)Competitively inhibits PABA in microorganisms
D)Will inhibit the reuptake of vasoconstrictor
E)Frequently prescribed for the treatment of myasthenia gravis and glaucoma
F)Increases effects of epinephrine; avoid levonordefrin
G)Use esters or amides judiciously because they may increase risk of toxicity
H)Administer prilocaine or articaine because this drug reduces liver capacity to metabolize amides
I)Administer prilocaine or articaine as these drugs decrease hepatic blood flow
J)Limit amount of vasopressor because it can increase ocular pressure

Answer 3

Use esters or amides judiciously because they may increase risk of toxicity

Question 4

Local anesthetics containing a vasoconstrictor are relative contraindications for a patient who reports experiencing an allergic reaction to local anesthetics in the past.

Question 5

MATCHING
Match the drug or medical condition in the left-hand column with the description of the significant concern in the right-hand column. Each description is used only once.
Patients taking MAOI

A)Life-threatening syndrome caused by general anesthetics
B)Avoid use of vasopressors; may lead to myocardial infarction
C)Competitively inhibits PABA in microorganisms
D)Will inhibit the reuptake of vasoconstrictor
E)Frequently prescribed for the treatment of myasthenia gravis and glaucoma
F)Increases effects of epinephrine; avoid levonordefrin
G)Use esters or amides judiciously because they may increase risk of toxicity
H)Administer prilocaine or articaine because this drug reduces liver capacity to metabolize amides
I)Administer prilocaine or articaine as these drugs decrease hepatic blood flow
J)Limit amount of vasopressor because it can increase ocular pressure

Question 6

What is the term that describes a situation in which a drug should not be administered to an individual under any circumstances?

A) Absolute contraindication
B) Relative contraindication
C) Atypical contraindication
D) Drug to drug interaction

Question 7

Vasoconstrictors are an absolute contraindication for a patient with uncontrolled diabetes.

Question 8

MATCHING
Match the drug or medical condition in the left-hand column with the description of the significant concern in the right-hand column. Each description is used only once.
Patients with glaucoma

A)Life-threatening syndrome caused by general anesthetics
B)Avoid use of vasopressors; may lead to myocardial infarction
C)Competitively inhibits PABA in microorganisms
D)Will inhibit the reuptake of vasoconstrictor
E)Frequently prescribed for the treatment of myasthenia gravis and glaucoma
F)Increases effects of epinephrine; avoid levonordefrin
G)Use esters or amides judiciously because they may increase risk of toxicity
H)Administer prilocaine or articaine because this drug reduces liver capacity to metabolize amides
I)Administer prilocaine or articaine as these drugs decrease hepatic blood flow
J)Limit amount of vasopressor because it can increase ocular pressure

Question 9

MATCHING
Match the drug or medical condition in the left-hand column with the description of the significant concern in the right-hand column. Each description is used only once.
Patients taking beta blockers

A)Life-threatening syndrome caused by general anesthetics
B)Avoid use of vasopressors; may lead to myocardial infarction
C)Competitively inhibits PABA in microorganisms
D)Will inhibit the reuptake of vasoconstrictor
E)Frequently prescribed for the treatment of myasthenia gravis and glaucoma
F)Increases effects of epinephrine; avoid levonordefrin
G)Use esters or amides judiciously because they may increase risk of toxicity
H)Administer prilocaine or articaine because this drug reduces liver capacity to metabolize amides
I)Administer prilocaine or articaine as these drugs decrease hepatic blood flow
J)Limit amount of vasopressor because it can increase ocular pressure

Question 10

MATCHING
Match the drug or medical condition in the left-hand column with the description of the significant concern in the right-hand column. Each description is used only once.
Patients with malignant hyperthermia

A)Life-threatening syndrome caused by general anesthetics
B)Avoid use of vasopressors; may lead to myocardial infarction
C)Competitively inhibits PABA in microorganisms
D)Will inhibit the reuptake of vasoconstrictor
E)Frequently prescribed for the treatment of myasthenia gravis and glaucoma
F)Increases effects of epinephrine; avoid levonordefrin
G)Use esters or amides judiciously because they may increase risk of toxicity
H)Administer prilocaine or articaine because this drug reduces liver capacity to metabolize amides
I)Administer prilocaine or articaine as these drugs decrease hepatic blood flow
J)Limit amount of vasopressor because it can increase ocular pressure

Question 11

MATCHING
Match the drug or medical condition in the left-hand column with the description of the significant concern in the right-hand column. Each description is used only once.
Cocaine abusers

A)Life-threatening syndrome caused by general anesthetics
B)Avoid use of vasopressors; may lead to myocardial infarction
C)Competitively inhibits PABA in microorganisms
D)Will inhibit the reuptake of vasoconstrictor
E)Frequently prescribed for the treatment of myasthenia gravis and glaucoma
F)Increases effects of epinephrine; avoid levonordefrin
G)Use esters or amides judiciously because they may increase risk of toxicity
H)Administer prilocaine or articaine because this drug reduces liver capacity to metabolize amides
I)Administer prilocaine or articaine as these drugs decrease hepatic blood flow
J)Limit amount of vasopressor because it can increase ocular pressure

Question 12

MATCHING
Match the drug or medical condition in the left-hand column with the description of the significant concern in the right-hand column. Each description is used only once.
Patients taking cimetidine on a regular basis

A)Life-threatening syndrome caused by general anesthetics
B)Avoid use of vasopressors; may lead to myocardial infarction
C)Competitively inhibits PABA in microorganisms
D)Will inhibit the reuptake of vasoconstrictor
E)Frequently prescribed for the treatment of myasthenia gravis and glaucoma
F)Increases effects of epinephrine; avoid levonordefrin
G)Use esters or amides judiciously because they may increase risk of toxicity
H)Administer prilocaine or articaine because this drug reduces liver capacity to metabolize amides
I)Administer prilocaine or articaine as these drugs decrease hepatic blood flow
J)Limit amount of vasopressor because it can increase ocular pressure

Question 13

Dilantin will decrease the efficacy of epinephrine.

Question 14

The use of amide local anesthetic agents,not prilocaine or topical benzocaine,is recommended for a patient with methemoglobinemia.

Question 15

Local anesthetics containing a vasoconstrictor are an absolute contraindication for a patient who reports being allergic to wine and dried fruits.

Question 16

MATCHING
Match the drug or medical condition in the left-hand column with the description of the significant concern in the right-hand column. Each description is used only once.
Patients taking cholinesterase inhibitors

A)Life-threatening syndrome caused by general anesthetics
B)Avoid use of vasopressors; may lead to myocardial infarction
C)Competitively inhibits PABA in microorganisms
D)Will inhibit the reuptake of vasoconstrictor
E)Frequently prescribed for the treatment of myasthenia gravis and glaucoma
F)Increases effects of epinephrine; avoid levonordefrin
G)Use esters or amides judiciously because they may increase risk of toxicity
H)Administer prilocaine or articaine because this drug reduces liver capacity to metabolize amides
I)Administer prilocaine or articaine as these drugs decrease hepatic blood flow
J)Limit amount of vasopressor because it can increase ocular pressure

Question 17

Patients who report an allergy to sulfa drugs should be given the local anesthetic articaine.

Question 18

MATCHING
Match the drug or medical condition in the left-hand column with the description of the significant concern in the right-hand column. Each description is used only once.
Patients taking sulfonamides

A)Life-threatening syndrome caused by general anesthetics
B)Avoid use of vasopressors; may lead to myocardial infarction
C)Competitively inhibits PABA in microorganisms
D)Will inhibit the reuptake of vasoconstrictor
E)Frequently prescribed for the treatment of myasthenia gravis and glaucoma
F)Increases effects of epinephrine; avoid levonordefrin
G)Use esters or amides judiciously because they may increase risk of toxicity
H)Administer prilocaine or articaine because this drug reduces liver capacity to metabolize amides
I)Administer prilocaine or articaine as these drugs decrease hepatic blood flow
J)Limit amount of vasopressor because it can increase ocular pressure

Question 19

A patient who has had heart bypass surgery 1 year ago should not have local anesthetics with vasoconstrictors.

Question 20

MATCHING
Match the drug or medical condition in the left-hand column with the description of the significant concern in the right-hand column. Each description is used only once.
Patients taking tricyclic antidepressants

A)Life-threatening syndrome caused by general anesthetics
B)Avoid use of vasopressors; may lead to myocardial infarction
C)Competitively inhibits PABA in microorganisms
D)Will inhibit the reuptake of vasoconstrictor
E)Frequently prescribed for the treatment of myasthenia gravis and glaucoma
F)Increases effects of epinephrine; avoid levonordefrin
G)Use esters or amides judiciously because they may increase risk of toxicity
H)Administer prilocaine or articaine because this drug reduces liver capacity to metabolize amides
I)Administer prilocaine or articaine as these drugs decrease hepatic blood flow
J)Limit amount of vasopressor because it can increase ocular pressure

Question 21

Your patient reports taking birth control medications and herbal supplements.You should consider:

A) Using an ester derivative local anesthetic
B) Using a local anesthetic with a higher concentration of vasoconstrictor
C) Reducing the amount of vasoconstrictors to 0.04 mg per appointment
D) Reducing the amount of vasoconstrictors to 0.4 mg per appointment

Question 22

The body's response to fear provokes symptoms that could include:

A) Irritability
B) Muscular tension
C) Increase blood pressure
D) All of the above

Question 23

A patient presents to your dental office with a toothache.His blood pressure is 200/116.What should you do?

A) Refuse treatment and refer the patient immediately to the hospital emergency.
B) Implement anxiety control measures, including the use of nitrous oxide/oxygen analgesia.
C) Take no unusual precautions related to patient management based on blood pressure readings after medical approval is obtained are warranted.
D) Have the dentist retake the patient's blood pressure and have him initial the patient's chart, granting you permission to treat this patient.

Question 24

What is the best reason for the relative contraindication to amide local anesthetics for patients with liver disease?

A) Amides are metabolized to ortho-toluidine.
B) Biotransformation of the amides occurs primarily in the liver.
C) Ester derivative drugs that are metabolized primarily in the lungs are available.
D) Cyanosis of the lips and mucous membranes may be observed.

Question 25

Which of the following statements is the best definition of teratogenic?

A) The development of abnormal structures in an embryo
B) The death of an embryo
C) The degree of danger to a developing fetus
D) The term for the contraindication for dental treatment of a pregnant patient

Question 26

Which of the following are best practices to use to reduce a dental patient's level of anxiety about dental treatment?
1) Consider appointment length and time of day.2. Administer adequate pain control during treatment and after the operation.3. Premedicate the patient for anxiety control.4. Telephone the patient after treatment

A) 1, 2, 4
B) 1, 2, 3, 4
C) 2, 3, 4
D) Some other combination

Question 27

What is the standard prophylaxis for an adult not allergic to amoxicillin?

A) 500 mg orally 1 hour prior to dental procedures
B) 600 mg orally 1 hour prior to dental procedures
C) 600 mg within 30 minutes prior to dental procedures
D) 2 g orally 1 hour prior to dental procedures

Question 28

Best practices include which of the following?
1) Take preanesthetic vital signs to provide a standard of comparison in the event of an emergency.2. Take preanesthetic blood pressure readings to provide baseline information.3. Take preanesthetic blood pressure readings to determine whether to use a local anesthetic with a vasoconstrictor.4. Take preanesthetic vital signs to identify diagnosed or undiagnosed conditions.

A) 1, 2, 3, 4
B) 2, 3, 4
C) 1, 2
D) Some other combination

Question 29

Which of the listed local anesthetics could produce an emergency situation characterized by the inability of the blood to bind to oxygen?

A) Prilocaine
B) Mepivacaine
C) Lidocaine
D) Epinephrine

Question 30

What does this statement mean?
"The potentially adverse action of the released catecholamines on cardiovascular function in the patient with clinically significant heart or blood vessel disease warrants the inclusion of vasoconstrictors in the local anesthetic solution."

A) The release of catecholamines has the potential to adversely affect a patient's cardiovascular function.
B) Without adequate control of pain, sedation and stress reduction are impossible to achieve; however, use of local anesthetic plus a vasoconstrictor will help to ensure adequate pain control.
C) A patient with significant heart or blood vessel disease should always have a local anesthetic plus a vasoconstrictor solution.
D) A patient with significant heart or blood vessel disease should never have a local anesthetic plus a vasoconstrictor solution.

Question 31

Which of the following statements is the correct consideration regarding the use of amide local anesthetic plus vasoconstrictor in treating a patient with a known bleeding disorder?

A) The amide local anesthetic should not be used because it has a vasodilatory effect.
B) A high concentration of vasoconstrictor should be utilized.
C) The risk of a positive aspiration is the greatest concern.
D) All of the above

Question 32

What is the name of the inherited syndrome that is triggered by the exposure to certain drugs used for general anesthesia and the neuromuscular blocking agent succinylcholine?

A) Methemoglobinemia
B) Cirrhosis
C) Malignant hyperthermia
D) Cancer

Question 33

For which of the following conditions are prophylaxis antibiotics recommended?

A) Patients who have had joint replacements within the past 2 years
B) Patients with history of previous prosthetic joint infection
C) Joint replacement patients who are immunocompromised
D) All of the above