Deck 55: The Older Adult

Question 1

All of the following are reasons to recommend a powered toothbrush for older clients except one. Which is the one exception?

A) Require less physical skill and cognitive ability
B) Remove more plaque in less time
C) Reduce gingivitis and bleeding
D) Reduce caries rates

Answer 1

Reduce caries rates

Question 2

In addition to gestures and sign language, adaptations necessary for older patients with hearing decline include which of the following?

A) Large print pamphlets
B) Increased repetition in verbal and written communication
C) Increased volume in speech
D) Waiting room TV presentations for educational topics

Answer 2

Increased repetition in verbal and written communication

Question 3

Increased rates of dental decay in the aging can be explained by all of the following except one. Which is the one exception?

A) Visual and motor decline in ability to complete oral hygiene
B) Reduced chewing ability and efficiency
C) Reduced salivary function as part of normal aging
D) Exposed roots associated with gingival recession seen in periodontitis

Answer 3

Reduced salivary function as part of normal aging

Question 4

All of the following are true regarding aging theories except one. Which is the one exception?

A) Error theory: Accumulation of errors in protein synthesis over time impairs cell function and results in steady decline until function is lost.
B) Activity theory: Older adults have a renewed sense of life after retirement to complete activities not possible during working years.
C) Programmed: Biologic clock programs cells for decline and loss of function.
D) Free radical theory: Reduced oxidation decreases free radicals necessary for cell function and life.

Question 5

All of the following are expected to decline normally in aging except:

A) vision.
B) hearing.
C) thickness of epithelium.
D) salivary function.

Question 6

Which of the following preventive products is most appropriately recommended for an older patient with moderate risk for dental decay, especially root decay?

A) 1.1% stannous fluoride paste
B) Oral irrigation with water
C) Essential oil mouthrinse

Question 7

Access to dental care remains relatively high for older individuals, because all Medicare Plus plans include dental services.

A) Both the statement and the reason are correct, and they are related.
B) Both the statement and the reason are correct, but they are not related.
C) The statement is correct, but the reason is not.
D) The statement is not correct, but the reason is correct.
E) Neither the statement nor the reason is correct.

Question 8

Many older clients may benefit from daily use of a nonalcoholic mouth rinse to:

A) reduce periodontal disease.
B) reduce oral malodor.
C) assist in the removal of plaque biofilm.
D) increase salivary flow.

Question 9

Routine assessment of the temporomandibular joint (TMJ) in the elderly includes all of the following except one. Which is the one exception?

A) Bilateral palpation
B) Range of motion assessment during opening and closing
C) Cephalometric radiography
D) Questions regarding subjective assessment of chewing function

Question 10

During a cranial nerve evaluation with an older patient, the clinician notices that the patient has difficulty with motor movements during facial expression. Which of the following cranial nerves is most likely affected?

A) CN 5
B) CN 7
C) CN 9
D) CN 12

Question 11

Which of the following is a cause of dry mouth in the elderly?

A) Anticholinergic properties of many common medications
B) Result of normal aging
C) Decreased bioavailability of vitamins, specifically vitamin C and B complex vitamins
D) Loss of integrity of parotid gland tissue

Question 12

Demographic projections for elderly in the United States from 2010 to 2030 indicate that the elderly will comprise 19% of the population because of increases in life span, as well as an increase in life expectancy.

A) Both the statement and the reason are correct, and they are related.
B) Both the statement and the reason are correct, but they are not related.
C) The statement is correct, but the reason is not.
D) The statement is not correct, but the reason is correct.
E) Neither the statement nor the reason is correct.

Question 13

Which of the following are common age-related changes seen in the oral tissues?

A) Oral epithelium becomes thicker and fuller.
B) Osteoarthritis often affects TMJ function and occlusion.
C) Increased immune response masks any oral diseases.
D) Sense of taste becomes more acute due to increase of fungiform and filiform papilla.

Question 14

Which of the following decreases when xerostomia is present in an older patient?

A) Risk for gingivitis
B) Abilities to chew and swallow food
C) Oral microbial levels
D) Risk for oral fungal infections

Question 15

Which of the following is true regarding periodontal health and aging?

A) Severe chronic periodontitis is an inevitable consequence of aging.
B) Tooth loss is an inevitable consequence of periodontitis in the elderly.
C) In the elderly, gingivitis more quickly progresses to periodontitis.
D) Severe periodontitis affects a small percentage of the elderly.

Question 16

All of the following increase the risk for dental decay in older adults except one. Which is the one exception?

A) May perform less effective oral hygiene
B) May have more exposed root surfaces due to past disease
C) Have diminished chewing function
D) Consume fewer vitamins and minerals, specifically Vitamins A and D

Question 17

Which of the following are common age-related changes seen in teeth?

A) Occlusal surface wear as a result of long-term use
B) Increased enamel sensitivity due to tooth wear
C) Increase in reparative dentin that reduces tooth fracture
D) Increase in opacity and whiteness of teeth

Question 18

Which of the following is true regarding diagnosis of oral disease in the elderly?

A) Clear cut oral manifestation makes diagnosis of soft-tissue lesions relatively easily
B) Most oral lesions are commonly associated with systemic disease
C) Most oral lesions are generally inflammatory
D) Generally painful and obvious to the patient

Question 19

Oral cancer accounts for approximately what percentage of new cancers diagnosed each year?

A) 1%
B) 2.5%
C) 5%
D) 10%

Question 20

How does aging affect periodontal therapy considerations with elderly clients?

A) Emphasizes the need for good control of biofilm, as well as nonsurgical care
B) Changes the sequence and speed of nonsurgical and surgical therapy
C) Is a relative contraindication for use of host modulatory therapy
D) Is an absolute contraindication for dental implants

Question 21

Mrs. Smith, an 80-year-old dental client, agrees to a dental treatment plan that includes extraction and replacement of removable partial dentures for better function and esthetics. When Mrs. Smith's daughter calls to cancel the follow-up dental appointment and describes the treatment unnecessary and unwanted, you question the daughter since you believe Mrs. Smith is as competent long-time patient based on which following ethical principles?

A) Autonomy
B) Justice
C) Nonmaleficence
D) Beneficence

Question 22

For an older adult client needing considerable restorative dental care, which one of the following options is the best appointment scheduling?

A) Several, brief midmorning appointments
B) Several, brief late afternoon appointments
C) One long midafternoon appointment
D) One long appointment scheduled first in the morning

Question 23

Routine assessment of salivary glands in older adults is accomplished by (select all that apply):

A) visual assessment of salivary gland ducts on mucosa opposite teeth No. 2 and No. 15.
B) evaluation of symmetry of cheeks.
C) palpation of salivary glands in floor of mouth.
D) collection and assessment of stimulated saliva.
E) microbiologic testing of saliva.
F) verbal report of client about comfort in chewing and speaking with sufficient saliva.

Question 24

Unlike dental decay, gingival recession, loss of periodontal attachment, and periodontitis can be attributed to the normal aging process.

Question 25

Chronic conditions most commonly seen in the elderly include which of the following? (Select all that apply.)

A) Arthritis
B) Hypertension
C) Diabetes
D) Scurvy
E) Primary herpetic gingivostomatitis
F) Hepatitis A
G) HIV disease

Question 26

The presence and degree of dysplasia is the most reliable standard for predicting the malignant potential of a lesion in the elderly.

Question 27

The edentulous rate among older adults is expected to rise to 40% by the year 2030.

Question 28

Demographic projections for the elderly in the year 2030 include which of the following? (Select all that apply.)

A) Seventy-eight percent of elderly will live in metropolitan areas.
B) Central and Midwest states (Kansas, Missouri, North Dakota, South Dakota) will have the highest percentage of elderly individuals.
C) Women are more likely to be widowed than men at every age over 65.
D) Older minority individuals will comprise fewer than 15% of elderly population.
E) Women will comprise over two-thirds of the elderly over the age of 90.

Question 29

A client's family tells you that the elderly mother who lives in a nursing home is complaining of soreness under her full maxillary and full mandibular denture. The mother reports that she doesn't have help to routinely take out her dentures and clean them. Which of the following would you expect to find upon oral examination? (Select all that apply.)

A) Caries
B) Periodontal disease
C) Fetor oris
D) Oral candidiasis
E) Enlarged, red tissue
F) Dental plaque and food debris

Question 30

The need for dental care for the elderly is expected to greatly increase by the year 2030, primarily because of the large expected increase in the percentage of older adults living in nursing care facilities.

A) Both the statement and the reason are correct, and they are related.
B) Both the statement and the reason are correct, but they are not related.
C) The statement is correct, but the reason is not.
D) The statement is not correct, but the reason is correct.
E) Neither the statement nor the reason is correct.