Deck 15: Dental Hygiene Process of Care

Question 1

All of following procedures, EXCEPT one, are required when localized bleeding on probing is noted during a four to six week re-evaluation appointment. Which one is the EXCEPTION?

A)Determining presence of residual or new deposits
B)Establishment of continued-care (recare) interval
C)Evaluation of self-care practices
D)Referral to physician

Answer 1

Referral to physician

Question 2

Use Case B to answer The Following questions
CASE B
A 25-year old female presents for dental hygiene care. Her records indicated that 10 months have lapsed since receiving dental hygiene care and she scheduled the appointment because her teeth are sensitive when she eats candy and her "gums" hurt when she brushes her teeth. She reports an arrhythmia but is not sure of the type or cause and irregularly takes the prescribed medication for its treatment. Her vital signs are within normal limits.
During the dental and periodontal assessment, you record generalized marginal gingival inflammation, generalized moderate interproximal subgingival calculus deposits, generalized bleeding on probing, with 2-4 mm probing depths. Existing restorations include teeth #14-MO, #4-MOD, #13-MO, #18-MO, and #19-B. Radiographs reveal no evidence of bone loss, proximal carious lesions on 29D, 30M, and 19M and restoration overhangs on #14M and #4D. She brushes once a day and does not use an interproximal cleaning aid.
Based on the periodontal assessment, what is the BEST re-evaluation interval for this client?

A)One to two weeks
B)Four to six weeks
C)Three to four months
D)Six months to one year

Answer 2

Four to six weeks

Question 3

Use Case A to answer The Following questions
CASE A
A 44-year old man presents as a new client for dental hygiene care. His medical history reveals type 2 diabetes, high blood pressure controlled with medication and a hip replacement. He reports no blood glucose monitoring and controls diabetes with diet and exercise. His last physical examination was last year. However, he is not sure of the examination results. He assumes everything is fine. You record his blood pressure reading at 150/102 mm Hg.
Which human need should be considered during the dental hygiene process of care?

A)Freedom from head and neck pain
B)Protection from health risks
C)Skin and mucous membrane integrity of head and neck
D)Wholesome facial image

Answer 3

Protection from health risks

Question 4

When reviewing a health history, the client has indicated that he has allergies to kiwis, avocados, and bananas. To what condition is this client at risk?

A)Acute adrenal insufficiency
B)Asthma
C)Diabetes
D)Latex allergy

Question 5

Use Case B to answer The Following questions
CASE B
A 25-year old female presents for dental hygiene care. Her records indicated that 10 months have lapsed since receiving dental hygiene care and she scheduled the appointment because her teeth are sensitive when she eats candy and her "gums" hurt when she brushes her teeth. She reports an arrhythmia but is not sure of the type or cause and irregularly takes the prescribed medication for its treatment. Her vital signs are within normal limits.
During the dental and periodontal assessment, you record generalized marginal gingival inflammation, generalized moderate interproximal subgingival calculus deposits, generalized bleeding on probing, with 2-4 mm probing depths. Existing restorations include teeth #14-MO, #4-MOD, #13-MO, #18-MO, and #19-B. Radiographs reveal no evidence of bone loss, proximal carious lesions on 29D, 30M, and 19M and restoration overhangs on #14M and #4D. She brushes once a day and does not use an interproximal cleaning aid.
Which of the following conditions represents the MOST accurate periodontal disease classification?

A)Case type I - gingivitis
B)Case type II - mild periodontitis
C)Case type III - moderate periodontitis
D)Case type IV - advanced periodontitis

Question 6

The American Academy of Periodontology (AAP) classification for advanced periodontitis is:

A)Case type I
B)Case type II
C)Case type III
D)Case type IV

Question 7

What phase of dental care focuses on periodontal surgery?

A)Preliminary phase
B)Phase I
C)Phase II
D)Phase III

Question 8

Use Case B to answer The Following questions
CASE B
A 25-year old female presents for dental hygiene care. Her records indicated that 10 months have lapsed since receiving dental hygiene care and she scheduled the appointment because her teeth are sensitive when she eats candy and her "gums" hurt when she brushes her teeth. She reports an arrhythmia but is not sure of the type or cause and irregularly takes the prescribed medication for its treatment. Her vital signs are within normal limits.
During the dental and periodontal assessment, you record generalized marginal gingival inflammation, generalized moderate interproximal subgingival calculus deposits, generalized bleeding on probing, with 2-4 mm probing depths. Existing restorations include teeth #14-MO, #4-MOD, #13-MO, #18-MO, and #19-B. Radiographs reveal no evidence of bone loss, proximal carious lesions on 29D, 30M, and 19M and restoration overhangs on #14M and #4D. She brushes once a day and does not use an interproximal cleaning aid.
All of the following human need categories relates to the client's current conditions EXCEPT one. Which one is the EXCEPTION?

A)Protection from health risks
B)Freedom from anxiety and stress
C)Skin and mucous membrane integrity of head and neck
D)Biologically sound and functional dentition

Question 9

Use Case B to answer The Following questions
CASE B
A 25-year old female presents for dental hygiene care. Her records indicated that 10 months have lapsed since receiving dental hygiene care and she scheduled the appointment because her teeth are sensitive when she eats candy and her "gums" hurt when she brushes her teeth. She reports an arrhythmia but is not sure of the type or cause and irregularly takes the prescribed medication for its treatment. Her vital signs are within normal limits.
During the dental and periodontal assessment, you record generalized marginal gingival inflammation, generalized moderate interproximal subgingival calculus deposits, generalized bleeding on probing, with 2-4 mm probing depths. Existing restorations include teeth #14-MO, #4-MOD, #13-MO, #18-MO, and #19-B. Radiographs reveal no evidence of bone loss, proximal carious lesions on 29D, 30M, and 19M and restoration overhangs on #14M and #4D. She brushes once a day and does not use an interproximal cleaning aid.
What is the overall prognosis for this client after phase I therapy?

A)Excellent
B)Good
C)Fair
D)Poor

Question 10

Use Case A to answer The Following questions
CASE A
A 44-year old man presents as a new client for dental hygiene care. His medical history reveals type 2 diabetes, high blood pressure controlled with medication and a hip replacement. He reports no blood glucose monitoring and controls diabetes with diet and exercise. His last physical examination was last year. However, he is not sure of the examination results. He assumes everything is fine. You record his blood pressure reading at 150/102 mm Hg.
What is the BEST course of action for the dental hygienist related to the blood pressure reading?

A)Recheck blood pressure in five minutes; if it is still elevated within that range, dismiss the client and seek immediate consultation with physician
B)Recheck blood pressure at each appointment; if it is still within range for three consecutive appointments, refer to physician
C)Recheck blood pressure in five minutes; if it is still elevated within that range, continue with noninvasive care only and consult with physician before dental hygiene therapy
D)Recheck blood pressure in five minutes, and continue with dental hygiene care

Question 11

Use Case C to answer The Following questions
CASE C
A heavy tea drinker just purchased over-the-counter whitening strips to see if her discolored teeth could be whitened. She wants to know if using whitening strips is better than using the professional custom bleaching tray system at home. You want to provide an evidence-based answer (based on a search of the research literature).
Which of the following would be an example of a well-developed question to help narrow your research literature search?

A)For clients with discolored teeth, are whitening strips the best method to increase whitening?
B)Are whitening strips the best method to increase whitening?
C)Are whitening strips more effective than custom tray bleaching systems?
D)For clients with tooth discoloration from tea stain, are whitening strips more effective in increasing teeth whitening when compared with professional at-home custom tray bleaching?

Question 12

Use Case C to answer The Following questions
CASE C
A heavy tea drinker just purchased over-the-counter whitening strips to see if her discolored teeth could be whitened. She wants to know if using whitening strips is better than using the professional custom bleaching tray system at home. You want to provide an evidence-based answer (based on a search of the research literature).
Which type of study will provide the BEST evidence to answer the client's question?

A)Case-control studies
B)Randomized controlled clinical trials
C)In vitro research
D)Case reports

Question 13

Use Case B to answer The Following questions
CASE B
A 25-year old female presents for dental hygiene care. Her records indicated that 10 months have lapsed since receiving dental hygiene care and she scheduled the appointment because her teeth are sensitive when she eats candy and her "gums" hurt when she brushes her teeth. She reports an arrhythmia but is not sure of the type or cause and irregularly takes the prescribed medication for its treatment. Her vital signs are within normal limits.
During the dental and periodontal assessment, you record generalized marginal gingival inflammation, generalized moderate interproximal subgingival calculus deposits, generalized bleeding on probing, with 2-4 mm probing depths. Existing restorations include teeth #14-MO, #4-MOD, #13-MO, #18-MO, and #19-B. Radiographs reveal no evidence of bone loss, proximal carious lesions on 29D, 30M, and 19M and restoration overhangs on #14M and #4D. She brushes once a day and does not use an interproximal cleaning aid.
The restoration on tooth #14 would be BEST classified as a:

A)Class I restoration
B)Class II restoration
C)Class III restoration
D)Class IV restoration

Question 14

Use Case A to answer The Following questions
CASE A
A 44-year old man presents as a new client for dental hygiene care. His medical history reveals type 2 diabetes, high blood pressure controlled with medication and a hip replacement. He reports no blood glucose monitoring and controls diabetes with diet and exercise. His last physical examination was last year. However, he is not sure of the examination results. He assumes everything is fine. You record his blood pressure reading at 150/102 mm Hg.
Which of the following should be considered before implementing invasive dental hygiene care for this client?

A)Dental hygiene care can be implemented immediately without any considerations
B)Dental hygiene care can be started immediately as long as the client consents to treatment
C)Consult with client's physician to establish a definitive diagnosis of diabetes and level of control for diabetes and hypertension before initiating invasive dental hygiene care
D)Appointments should be longer than normal to reduce the number of appointments needed and to reduce stress

Question 15

A dental hygienist records a client's blood pressure as 152/85 mm Hg. What blood pressure category is represented?

A)Prehypertension
B)Stage I hypertension
C)Stage II hypertension
D)Stage III hypertension

Question 16

The written care plan includes all of the following components EXCEPT one. Which one is the EXCEPTION?

A)Appointment sequence for therapy to be provided
B)Approximate time for each appointment
C)Cost of each presented procedure
D)Expected outcomes and limitations of care

Question 17

Which is a correct statement regarding the assessment phase of care?

A)Includes the comprehensive collection, analysis, and permanent documentation of client data.
B)Involves the collection of only subjective information
C)Assessment data should be updated only during continued-care (recare) appointments
D)Data should not be discussed with the client or appropriate health care providers

Question 18

Use Case B to answer The Following questions
CASE B
A 25-year old female presents for dental hygiene care. Her records indicated that 10 months have lapsed since receiving dental hygiene care and she scheduled the appointment because her teeth are sensitive when she eats candy and her "gums" hurt when she brushes her teeth. She reports an arrhythmia but is not sure of the type or cause and irregularly takes the prescribed medication for its treatment. Her vital signs are within normal limits.
During the dental and periodontal assessment, you record generalized marginal gingival inflammation, generalized moderate interproximal subgingival calculus deposits, generalized bleeding on probing, with 2-4 mm probing depths. Existing restorations include teeth #14-MO, #4-MOD, #13-MO, #18-MO, and #19-B. Radiographs reveal no evidence of bone loss, proximal carious lesions on 29D, 30M, and 19M and restoration overhangs on #14M and #4D. She brushes once a day and does not use an interproximal cleaning aid.
All of the following are related to the overhanging restorations EXCEPT one. Which one is the EXCEPTION?

A)Increase bacterial plaque biofilm retention
B)Restorations should be replaced
C)Restorations are risk factors for periodontal disease
D)Restorations are treated using margination procedures

Question 19

Use Case A to answer The Following questions
CASE A
A 44-year old man presents as a new client for dental hygiene care. His medical history reveals type 2 diabetes, high blood pressure controlled with medication and a hip replacement. He reports no blood glucose monitoring and controls diabetes with diet and exercise. His last physical examination was last year. However, he is not sure of the examination results. He assumes everything is fine. You record his blood pressure reading at 150/102 mm Hg.
What is this client's ASA physical status classification?

A)PS1
B)PS2
C)PS3
D)PS4

Question 20

Use Case B to answer The Following questions
CASE B
A 25-year old female presents for dental hygiene care. Her records indicated that 10 months have lapsed since receiving dental hygiene care and she scheduled the appointment because her teeth are sensitive when she eats candy and her "gums" hurt when she brushes her teeth. She reports an arrhythmia but is not sure of the type or cause and irregularly takes the prescribed medication for its treatment. Her vital signs are within normal limits.
During the dental and periodontal assessment, you record generalized marginal gingival inflammation, generalized moderate interproximal subgingival calculus deposits, generalized bleeding on probing, with 2-4 mm probing depths. Existing restorations include teeth #14-MO, #4-MOD, #13-MO, #18-MO, and #19-B. Radiographs reveal no evidence of bone loss, proximal carious lesions on 29D, 30M, and 19M and restoration overhangs on #14M and #4D. She brushes once a day and does not use an interproximal cleaning aid.
Based on the oral assessment findings, what is the classification of caries risk for this client?

A)Low risk
B)Moderate risk
C)High risk
D)Not enough data to determine

Question 21

Which of the following conditions is indicated by yellow sclera of the eye?

A)Difficulty breathing
B)Drug abuse
C)Jaundice
D)Medical emergency status

Question 22

When reviewing a health history, the client has indicated that she urinates more than six times a day, is frequently thirsty, and her mouth is always dry. What condition manifests these characteristics?

A)Asthma
B)Diabetes mellitus
C)Hypertension
D)Thyroid disease

Question 23

What phase of the dental hygiene process of care immediately follows diagnosis?

A)Assessment
B)Evaluation
C)Implementation
D)Planning

Question 24

To engage in effective verbal behaviors, which one of the following skills is necessary?

A)Appropriate voice tone
B)Gestures
C)Paraphrasing
D)Posture

Question 25

Each of the following represents standard client assessment information that is necessary for planning comprehensive dental hygiene care EXCEPT one. Which one is the EXCEPTION?

A)Extraoral assessment
B)Current self-care practices
C)Dentition evaluation
D)Fluoride varnish application

Question 26

All of the following are components of assessment, EXCEPT one. Which one is the EXCEPTION?

A)Health history
B)Intraoral photographs
C)Periodontal probing
D)Self-care education

Question 27

After a comprehensive assessment, findings show chronic periodontitis with moderate bone loss, generalized pocket depths of 4 to 6 mm with bleeding, light subgingival biofilm and calculus on the maxillary arch and moderate to heavy subgingival biofilm and tenacious calculus on the mandibular arch. Based on these findings, what would be a realistic approach to NSPT for this client?

A)A 60-minute appointment consisting of oral self-care education and supragingival and subgingival debridement
B)Two 60-minute appointments consisting of oral self-care education, debridement, and scaling and root planing
C)Five 60- to 90-minute appointments consisting of oral self-care education, debridement, scaling and root planing, and re-evaluation
D)Six 60- to 90-minute appointments consisting of oral self-care education, debridement, scaling and root planing, and re-evaluation

Question 28

Which of the following BEST identifies the procedure that is immediately followed after a client declines a component of the dental hygiene care plan?

A)Alternative approaches to care are suggested
B)Outcomes of therapy are explained
C)Informed refusal form is completed
D)Client's right to decline care is clarified

Question 29

What is the BEST method for examining the mentalis muscle?

A)Circular compression
B)Digital palpation
C)Indirect vision
D)Auscultation

Question 30

The client is not able to correctly demonstrate the use of the floss threader with floss. The discrepancy in performance is MOST likely the result of which of the following?

A)Management deficiency
B)Motivation
C)Readiness to learn
D)Skills deficiency

Question 31

What would be a reasonable prognosis for a client with chronic periodontitis and moderate bone loss with localized areas of grade II furcation involvements, improvable oral self-care methods, and irregular continued-care (recare) intervals?

A)Excellent
B)Good
C)Fair
D)Poor

Question 32

When client-oriented goals are developed during the planning phase of care, to what do affective goals relate?

A)Increasing client's knowledge level about bacterial biofilm
B)Influencing changes in beliefs and attitudes
C)Providing information related to bacterial biofilm
D)Modifying a toothbrushing method

Question 33

All of the following are included in the case presentation, EXCEPT one. Which one is the EXCEPTION?

A)Desired outcomes of treatment
B)Alternative approaches to care
C)Risks of all proposed therapeutic options
D)Treatment outcome guarantee

Question 34

A client presents with a type III overhang on an amalgam restoration. Which of the following statements related to this overhang is correct?

A)Covers less than one third of interproximal space
B)Restoration indicated for replacement
C)Indicated for a margination procedure
D)Clinically not detectable

Question 35

Individuals with stable angina pectoris, COPD and/or mild congestive heart failure are in which ASA physical status classification category?

A)PS1
B)PS2
C)PS3
D)PS4

Question 36

A 53-year-old client presents for a periodontal maintenance appointment. When developing a dental hygiene care plan, which of the following should be addressed first?

A)Chlorhexidine stain on teeth
B)Localized light plaque
C)Pain on tooth #28
D)Smoking habit

Question 37

Which of the following is LEAST significant when determining the continued-care (recare) interval for periodontal maintenance therapy?

A)Presence of light plaque, biofilm
B)Elimination of pocket depths
C)Bleeding on probing
D)Cost of care

Question 38

Each of the following factors is considered when providing dental hygiene care for diabetic clients EXCEPT one. Which one is the EXCEPTION?

A)Cardiovascular conditions
B)Continued-care (recare) interval
C)Susceptibility to oral infection
D)Rapid healing

Question 39

Assessment findings reveal that an 11-year-old client has deep pits and fissures, generalized areas of heavy plaque, marginal gingival inflammation, incipient carious lesions on teeth #3 and #14, #19 and #30. Given these findings, what would be the degree of caries risk?

A)Low
B)Moderate
C)High
D)No risk

Question 40

What is the G.V. Black classification of dental caries and restorations located on the gingival buccal third of #18?

A)Class II
B)Class III
C)Class IV
D)Class V

Question 41

The term prognosis refers specifically to which factor?

A)Diagnosis
B)Care planning
C)Evaluation
D)Prediction

Question 42

Which of the following conditions require prophylactic antibiotic premedication for dental hygiene care?

A)Rheumatic heart disease
B)Functional heart murmur
C)Prosthetic heart valve
D)Mitral valve prolapse with regurgitation

Question 43

When providing dental hygiene care, all of the following relate to safe practice issues EXCEPT one. Which one is the EXCEPTION?

A)Failure to obtain written informed consent
B)Failure to provide comprehensive care
C)Failure to follow infection-control protocol
D)Failure to use proper instrumentation during the provision of dental hygiene care

Question 44

Which of the following conditions is commonly related to a nutritional deficiency?

A)Black hairy tongue
B)Burning tongue
C)Geographic tongue
D)Macroglossia

Question 45

Failure to refer a client to a medical professional when indicated constitutes which one of the following issues?

A)Ethical
B)Legal
C)Safety
D)Breach of contract

Question 46

To determine a care plan that is BEST for a client, which one of the following actions should be addressed first?

A)Periodontal debridement for the entire mouth
B)Consultation and treatment for areas of pain
C)Tobacco cessation counseling
D)Consultation for periodontal surgery

Question 47

When implementing a tobacco cessation program into practice, the second step is which of the following?

A)Ask
B)Advise
C)Assist
D)Arrange

Question 48

What recare interval is recommended for a client who has maintained good results for the first year following routine nonsurgical periodontal therapy, but displays localized pockets?

A)One to two months
B)Three to four months
C)Four to six months
D)Six months

Question 49

The submental glands are BEST examined using which type of palpation?

A)Bilateral digital
B)Circular compression
C)Digital palpation
D)Auscultation

Question 50

When reviewing the health history, the client indicates that he has a persistent cough that is nonproductive, difficulty breathing, and night sweats. What condition is manifested by these characteristics?

A)Acute adrenal insufficiency
B)Asthma
C)Tuberculosis
D)Common cold

Question 51

What is a grade III furcation involvement?

A)Exposure of furcation with bone remaining between roots
B)Complete loss of bone between roots
C)Loss of some bone between roots
D)Severe bone loss and furcation are clearly visible