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ANSWERS 202 5
cs 79 year old female african american hasnt been to dentist in 3 years stroke 4 years ago diabetic, GERD, hypertension, hyperglycemia, and osteoporosis. HbA1C is 8.0-9.0%. Blood Pressure: 120/80; Pulse: 85 bpm; Respiration: 20 breaths/minute The patient reports she had the mandibular right first molar extracted 4 years ago due to an abscess and has received no dental treatment since. She reports brushing her teeth twice a day with a fairly hard manual toothbrush. She does not floss and is uncertain whether she uses a fluoridated toothpaste. She poses the following questions: She is curious about a power brush since her hands are weak. She questions whether a mouth rinse will reduce the bleeding from her gums. A large nevus is present on the left side of her face. There is a large circular discoloration on the gingiva just above teeth numbers 10 & 11. 81 mg aspirin, daily insulin injections, (Omeprazole) Prilosec®, (Lovastatin) Mevacor®, (Atenolol) Tenormin®, (Ramipril) Altace®, (Clopidogrel bisulfate) Plavix® and (Risedronate sodium) Actonel® - ✔ cs 2
- According to G.V. Black's classification of restorations, the classification for tooth # is: - ✔ class I cs 2 All of the following home care regimens would prove beneficial for this patient except one. What is the EXCEPTION? A. Interdental brush B. Power toothbrush C. Sodium fluoride dentifrice D. 0.12% chlorhexidine gluconate rinse for 2 weeks E. Dental floss - ✔ C cs The left premolar bitewing radiograph lacks diagnostic quality due to: A. Poor film placement B. Incorrect horizontal angulation C. Decreased kVp setting D. Increased mA setting - ✔ A cs The brown circular discoloration in the gingiva above teeth numbers 10 & 11, is most likely a: A. Nevus B. Melanin pigmentation C. Melanoma D. Kaposi's sarcoma - ✔ B
Based on the patient's plaque score and bleeding index, the BEST course of action the dental hygienist should plan is: A. Reducing the stress level at the dental visit B. Assisting in a tobacco cessation intervention C. Demonstrating proper toothbrushing and interproximal care D. Demonstrating the proper technique for water irrigation - ✔ C (Clopidogrel bisulfate) Plavix® is prescribed for the patient based on what medical condition? A. Osteoporosis B. GERD C. Elevated cholesterol D. Cerebrovascular accident - ✔ D There are visible bilateral radio-opacities in front of tooth numbers 22 & 28. Upon intraoral inspection, you find some interesting rounded projections in those regions lingually which you classify as: A. Salivary gland tumors B. Mandibular tori C. Bone cancer D. Fibromas - ✔ B 81 mg aspirin is for - ✔ heart attack (Omeprazole) Prilosec® is for - ✔ GERD
(Lovastatin) Mevacor® is for - ✔ high cholesterol (Atenolol) Tenormin®, (Ramipril) Altace® are for - ✔ HBP (Clopidogrel bisulfate) Plavix® is for - ✔ heart attack (Risedronate sodium) Actonel® is for ********* - ✔ OSTEOPOROSIS AND PAGET'S DISEASE what is a normal hba1c for non diabetics - ✔ 4 - 5.9% what is hb1ac for diabetics uncontrolled usually at and whats target - ✔ above 7% target for diabetics is below 7% and less than 180 What is HbA1c, how often is it taken - ✔ Hemoglobin A1c levels correlate with average levels of glucose in the blood over an approximately three-month time what is the blood glucose target range before meals - ✔ 80 - 130 what is the blood glucose target range after meals - ✔ less than 180 cs 3
C. Stage IV, Grade B D. Stage IV, Grade C - ✔ D What is the primary factor that influenced your decision for the Staging in the above diagnosis? A. Tooth loss due to periodontitis B. Radiographic Bone Loss C. Pocket Depth D. Amount of CAL - ✔ A Which of the following factors most influenced your Grading choice for your periodontal diagnosis? A. Presence of risk factors B. Molar/incisor pattern of bone loss C. Destruction commensurate with amount of biofilm D. Pocket depths - ✔ B After reviewing brushing and flossing techniques with her, what home care recommendations would you make for the patient to address her bleeding gums? A. Consider purchasing an electric toothbrush; use a proxabrush on posterior teeth & furcations; use a stannous fluoride toothpaste B. Use a mouth rinse that contains Zinc; ensure that her toothpaste contains sodium fluoride; use a soft bristled toothbrush C. Purchase a hard bristled toothbrush; use a toothpick to cleanse the furcations; use a mouthrinse containing cetyl pyridinium chloride (CPC) D. Prescribe a 0.12% chlorhexidine rinse to replace her salt water rinses; continue using her manual brush as demonstrated; use a fluoridated toothpaste that contains a whitening agent -
✔ A
One of the patient's prescription medications is Glucophage® (Metformin HCL). Which of the following conditions is this medication prescribed for? A. Diverticulitis B. GERD C. Diabetes D. Stomach ulcers - ✔ C The patient has reported intense stomach pain as well as excessive tiredness lately. These symptoms may be a side effect of which of her current medications? A. (Nizatidine) Axid® B. (Ceterizine) Zyrtec® C. (Metformin hydrochloride) Glucophage® D. (Rosuvastatin calcium) Crestor® - ✔ C Based on the new American Heart Association/American College of Cardiology Blood Pressure Guidelines (2017), how would you classify this patient's blood pressure status? A. Normal B. Elevated C. Stage 1 D. Stage 2 - ✔ C When examining the radiographs, what would be the BEST description for the furcation involvements that appear on all of the mandibular molars? A. Greater than 1mm of bone loss B. Some exposure with bone remaining between roots
A white circular lesion was noted on the lateral border of the tongue. She indicated it was painful upon palpation. - ✔ What MOST likely is the reason for the gingival appearance around the facial of #10, #11? A. Traumatic habit B. Food debris C. Erosion D. Plaque Biofilm - ✔ a All of the following would be plausible inclusions in a differential diagnosis for the white circular lesion present on the lateral border of her tongue EXCEPT: A. Lipoma B. Apthous Ulcer C. Fibroma D. Hyperkeratosis due to chronic irritation - ✔ b Given the patient's clinical and radiographic and historical findings, what would be the best diagnosis for her periodontal condition based on the 2018 AAP Classification of Periodontal and Peri-implant diseases? A. Stage 2, Grade B B. Stage 2, Grade C C. Stage 3, Grade B D. Stage 3, Grade C - ✔ D To address the patient's recent smoking habit, the four A's designed for a cessation initiative follow what order?
A. Ask, Advise, Arrange, Assist B. Ask, Assist, Ask, Arrange C. Ask, Advise, Assist, Arrange D. Advise, Ask, Arrange, Assist - ✔ c Following the new American Heart Association/American College of Cardiologists blood pressure guidelines, how would you categorize this patient's blood pressure? A. Normal B. Elevated C. Stage 1 D. Stage 2 - ✔ c The following microorganisms will MOST likely be identified in this patient's microflora except one. What is the EXCEPTION? A. P. gingivalis B. C. albicans C. T. forsythia D. F. alosis - ✔ b Using the patient's height and weight, her BMI calculation was 25.7. How would you categorize this? A. Underweight B. Normal C. Overweight D. Obese - ✔ c
under her bridge but gets frustrated as the floss often tears and then gets stuck under the bridge. Submandibular and posterior cervical lymph nodes on the left side were palpable. - ✔ What radiographic error(s) is/are evident in the maxillary left posterior periapical radiographs? A. Horizontal angulation & Cone cut B. Elongation & Cone cut C. Overlap & Film placement D. Elongation & Film placement - ✔ b The patient indicates she takes low dose aspirin daily to thin her blood plus Advil for her arthritic/joint pain. What should you indicate to the patient about this combination of over-the-counter medications? A. They could result in stomach ulcers and GI problems B. Higher Ibuprofen dosages have been linked with a higher risk of heart attack C. A & B D. This combination of drugs is perfectly safe - ✔ c According to the latest guidelines recently published by the American Heart Association and the American College of Cardiologists, how would you classify this patient's blood pressure? A. Normal B. Elevated C. Stage 1 D. Stage 2 - ✔ d
thats the answer but thats not accurate With the Patient's concern about her weight gain and also her increased joint pain since her cancer diagnosis, what do you suspect may be the cause of these? A. Stress B. Letrozole C. Hormonal changes D. Lack of exercise - ✔ B Which of the following could constrict the blood vessels sufficiently to reduce gingival bleeding? A. Advil B. Low dose aspirin C. Tobacco D. Letrozole - ✔ c Based on the patient's clinical, radiographic and historical findings, how would you classify this patient's periodontal condition based on the 2018 AAP Classification of Periodontal and Per-implant diseases? A. Stage 2, Grade B B. Stage 3, Grade B C. Stage 3, Grade C D. Stage 4, Grade C - ✔ d dont know how or why In addition to correcting her circular brushing technique and reviewing her flossing technique, what additional recommendations would you make for this patient?
D. Radiation treatment - ✔ a Letrozole is used for - ✔ breast cancer chemotherapy Letrozole Side Effects - ✔ weight gain and joint pain 41 year old caucasian female last seen 2 1/2 yr ago front teeth sensitive to cold The patient reported having a hysterectomy 2 years ago as well as bladder surgery nine years ago. She has a family history of type 2 diabetes. She reports a history of hepatitis B, hypertension and remarked she was frequently thirsty. She was prescribed an anti- anxiety medication after the birth of her last child 3 years ago. Her medications include: (Escitalopram oxalate) Lexapro®, (Enalapril maleate) Vasotec® and a daily 81 mg aspirin. Her blood pressure was recorded at 145/92; Pulse: 75 bpm; respirations: 16 bpm. She has had extensive dental work in the past as she has numerous restorations, 2 bridges and root canals. She claims she lost her 2 front teeth when she was 15 after falling off a horse. She also indicates that she had her 4 wisdom teeth removed when she was 18 years old as they were impacted uses a medium bristled toothbrush and was embarrassed to tell you that she does not floss. Her toothpaste is fluoridated but she is not sure what type of fluoride it contains. She occasionally rinses her mouth with a mouth rinse containing zinc if she feels she has bad breath. She indicates she was a former smoker, but quit 10 years ago - ✔
According to Angle's classification of malocclusion, the BEST classification for this patient is: A. Class I B. Class II, Division I C. Class II, Division II D. Class III - ✔ B Which of the following characteristics describes the alveolar bone around the mandibular right second premolar? A. Vertical bone loss B. Horizontal bone loss C. Normal, no bone loss D. Both vertical and horizontal bone loss - ✔ a Based on the clinical, radiographic and historical findings, how would you classify the periodontal condition of this patient according to the 2018 AAP Classification of Periodontal and Peri-Implant diseases? A. Stage II, Grade B B. Stage III, Grade B C. Stage III, Grade C D. Stage IV, Grade C - ✔ b When determining the "Grade" for the above question, all of the following criteria should have been taken into consideration EXCEPT: A. Presence or absence of risk factors B. Amount of tooth loss due to periodontal disease C. Amount of radiographic bone loss D. Rate of progression -
B. Your blood pressure reading indicates you have Stage II Hypertension and you should see a physician for a possible medication adjustment C. Your blood pressure reading is high, however it is most likely due to "white coat syndrome" and should be taken again at your next appointment D. Your blood pressure reading is normal for people your age - ✔ b What potential side effects might the patient experience from her prescribed medications? A. Insomnia and increased salivary flow B. Weight gain and decreased salivary flow C. Fatigue and headache D. Xerostomia and increased plaque retention - ✔ d Taking into consideration, the patient's current blood pressure, her BMI, frequent thirst and family history, which of the following conditions do you believe she is at highest risk for? A. Type II Diabetes B. Heart attack C. Stroke D. Mental illness - ✔ a 65 yr old caucasian male he patient reports having a stroke eight years ago and now suffers with slurred speech and a reduction in salivary flow. Up until then, he said he had been in perfect health. His recovery from the stroke has been very good with the exception of his speech. He visits his physician regularly for check-ups and is currently on: (Enalapril) Vasotec; (Warfarin) Coumadin®; and (Atorvastatin) Lipitor®. His blood pressure was recorded at 130/80; Pulse was 72 BPM; Respirations were 18 bpm. He claims his last INR reading was 2.5.
He was a smoker for over 40 years but was able to quit 2 years ago. He claims he feels much better now, although he does still miss smoking particularly if he has a drink. He indicates he brushes twice daily with a hard toothbrush using a back and forth scrubbing motion and only flosses occasionally. He occasionally uses a mouthrinse but he hates the burning sensation. - ✔ Using Angle's classification of malocclusion, the patient's occlusal status can BEST be described as: A. Class II, Division II B. Class I C. Class II, Division I D. Class III - ✔ b The patient complains of a loss of taste which could be related to his dry mouth. Which of his medications might this loss of taste be attributed to? A. Lipitor B. Enalapril C. A & B D. Coumadin - ✔ c Based on the client's chief complaint, the dental hygienist should recommend all the following EXCEPT: A. Encourage salivary stimulants B. Physician consultation C. Increase fluid intake D. Increase saturated fats in diet - ✔ d
