Deck 34: Dental and Oral Disorders

Question 1

During a well child exam, the primary care pediatric nurse practitioner notes
yellowish­white serpentine­bordered lesions on the anterior portion of a child's tongue. What will the nurse practitioner do?
A. Order chlorhexidine gluconate rinses to treat the lesions.
B. Prescribe oral acyclovir to shorten the course of the disease.
C. Reassure the parent that these are benign lesions.
D. Refer the child to a pediatric dentist for evaluation.

Answer 1

Reassure the parent that these are benign lesions.

Question 2

A 5­year­old child is hit in the face with a baseball bat and is brought to the clinic
by a parent. An exam reveals three avulsed front teeth. Radiologic studies are negative for facial fractures. What is the recommended treatment?
A. Prescribe tetracycline 4.4 mg/kg twice daily for 7 to 10 days.
B. Refer the child to a dentist for reimplantation of the avulsed teeth.
C. Refer the child to a dentist immediately for further examination.
D. Remove the teeth, place them in saline, and refer the child to a dentist.

Answer 2

Refer the child to a dentist immediately for further examination.

Question 3

A child with cerebral palsy receives all nutrition via gastrostomy tube. What will the
primary care pediatric nurse practitioner recommend to promote dental health in this child?
A. Applying topical iodine every month
B. Daily chlorhexidine gluconate rinses
C. Ordering medications to prevent drooling
D. Prescribing prophylactic antibiotics

Answer 3

Daily chlorhexidine gluconate rinses

Question 4

An adolescent female reports facial pain and frequent popping of her jaw. An
exam reveals unilateral tender facial muscles and a deviation of the mandible to the affected side with opening of the mouth. What will the primary care pediatric nurse practitioner do?
A. Recommend ice packs, NSAIDs, and a soft diet.
B. Refer to a pediatric mental health specialist.
C. Refer to an orthodontist for a surgical intervention.
D. Suggest obtaining Botox injection treatments.

Question 5

A 4­year­old child who has asthma has teeth with smooth, cupped­out teeth on the chewing surfaces. Which is the most likely explanation for this finding?
A. Bruxism
B. Bulimia
C. Decreased saliva
D. Gastroesophageal reflux

Question 6

What will the primary care pediatric nurse practitioner teach the parent of an infant about cleaning the child's teeth?
A. To allow the child to control the amount of toothpaste used
B. To choose a toothpaste with a mint flavor
C. To use a smear of toothpaste and not to rinse the mouth
D. To use a toothpaste containing whitening agents

Question 7

A school­age child has had herpes stomatitis for a week and continues to
complain of pain. What will the primary care pediatric nurse practitioner recommend?
A. Administration of a topical antiviral medication
B. Taking oral acyclovir for 5 to 7 days
C. Topical application of diphenhydramine and Maalox
D. Using a chlorhexidine gluconate rinse

Question 8

What will the primary care pediatric nurse practitioner recommend to the parent of an infant who is teething who asks about comfort measures?
A. Administer oral ibuprofen or apply topical salicylates.
B. Apply a topical anesthetic such a benzocaine to the gums.
C. Give the infant a cold teething ring or wet washcloth to chew.
D. Try Baby Orajel on the infant's gums several times daily.

Question 9

An 18­month­old child has horizontal, bright white lines along the upper gum line
of the teeth. What is the most important question the primary care pediatric nurse practitioner will ask the child's parents?
A. If the child is still drinking milk from a bottle
B. If the child or the parents are brushing the teeth
C. If they are brushing the child's teeth twice daily
D. If they have taken the child to a dentist

Question 10

A 4­year­old child who has had extensive dental surgery to treat dental caries has
white spot lesions on the primary teeth. How often should this child receive fluoride varnish applications?
A. Annually
B. Twice yearly
C. Every 3 to 6 months
D. Every month

Question 11

A parent asks about ways to promote dental health in school­age children while
on a family vacation that are convenient while camping and picnicking. What will the primary care pediatric nurse practitioner recommend?
A. Getting fluoride varnish treatments prior to vacations
B. Giving the children fluoridated water after meals
C. Having the children use a chlorhexidine gluconate oral rinse
D. Offering gum containing xylitol after meals

Question 12

A child has several shallow mucosal lesions on the buccal mucosa and tongue
that are surrounded with an erythematous halo and covered by yellow plaques. What will the
primary care pediatric nurse practitioner recommend?
A. Chlorhexidine gluconate
B. Diphenhydramine and Maalox
C. Oral acyclovir
D. Topical antiviral medication

Question 13

An adolescent has localized bleeding of the gums when brushing the teeth. An
exam of the mouth reveals the presence of plaque and calculus on the teeth, which are not loose. What will the primary care pediatric nurse practitioner recommend?
A. Consistently brushing and flossing the teeth twice daily
B. Referral to an oral surgeon for treatment
C. Rinsing the mouth daily with chlorhexidine gluconate
D. Using a xylitol­containing gum after meals

Question 14

A 9­month­old infant has developed two teeth since the 6­month checkup. The
local water supply contains fluoride. What will the primary care pediatric nurse practitioner do to promote healthy dentition at this visit?
A. Apply sodium fluoride varnish to the infant's teeth.
B. Encourage the parents to make an initial dental appointment.
C. Prescribe oral fluoride supplementation.
D. Teach the parents how to brush the infant's teeth with fluoride toothpaste.

Question 15

The parents of a formula­fed newborn report that they get their drinking water
from a well. What will the primary care pediatric nurse practitioner recommend to provide adequate fluoride for this infant?
A. Giving the infant a fluoride supplement
B. Testing the fluoride level of their water source
C. Using bottled water to prepare the infant's formula
D. Using powdered formula with added fluoride