Deck 7: Preanesthetic Assessment

Question 1

Patients who report an allergy to sulfites should be given the vasoconstrictor levonordefrin.

Answer 1

False

Question 2

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

Answer 2

False

Question 3

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

Answer 3

Prilocaine

Question 4

Usual doses of amide local anesthetic do not pose any additional risk for patients with renal dysfunction.

Question 5

Which of the following are best practices to use to reduce a dental patient's level of anxiety about dental treatment?

A) Consider appointment length and time of day.
B) Administer adequate pain control during treatment and after the operation.
C) Telephone the patient after treatment
D) All options listed

Question 6

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.
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 7

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 8

Best practices include which of the following?

A) Take preanesthetic vital signs to provide a standard of comparison in the event of an emergency.
B) Take preanesthetic blood pressure readings to provide baseline information.
C) Take preanesthetic blood pressure readings to determine whether to use a local anesthetic with a vasoconstrictor.
D) Take preanesthetic vital signs to identify diagnosed or undiagnosed conditions.
E) All options listed

Question 9

Your patient reports taking nonselective beta blockers.If vasoconstrictor is necessary,you should:

A) Limit epinephrine to 0.04 mg per appointment
B) Limit levonordefrin to 0.2 mg per appointment
C) Not use 1:50,000 epinephrine
D) All options listed

Question 10

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

Question 11

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.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.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true;the second statement is false.
D) The first statement is false;the second statement is true.

Question 12

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 options listed

Question 13

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

Question 14

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

Question 15

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

A) Irritability
B) Muscular tension
C) Increased blood pressure
D) All options listed

Question 16

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

Question 17

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) Drug to drug interaction
D) None of the above

Question 18

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 19

Which of the following conditions are absolute contraindications for vasoconstrictors?

A) Myocardial infarction within 6 months
B) Coronary bypass surgery within 6 months
C) Uncontrolled high blood pressure
D) All options listed

Question 20

Vasoconstrictors can increase a patient's blood pressure.

Question 21

Which of the following influences the amount of local anesthetic agent in the systemic circulation?

A) Administration technique
B) Ability of the body to metabolize the drug
C) Ability of kidneys to excrete any unmetabolized drug.
D) All options listed

Question 22

Which of the following should you consider regarding the use of vasoconstrictors for patients who present with hypothyroidism?

A) Uncontrolled hyperthyroidism is an absolute contraindication to vasoconstrictors
B) Patients may be at risk of developing thyrotoxicosis
C) When controlled,cardiac dose of vasoconstrictors is permitted.
D) All options listed

Question 23

Which of the following are signs of anxiety and fear?

A) Increased vital signs
B) Paleness of skin
C) Cold sweats
D) All options listed

Question 24

The most common procedure for assessing the pulse rate is to palpate the brachial artery.Bradycardia is an abnormally elevated heart rate and may be a sign of cardiovascular disease or anxiety.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true;the second statement is false.
D) The first statement is false;the second statement is true.

Question 25

Which of the following describes digitalis glycosides?

A) Used for the treatment of congestive heart failure
B) When combined with epinephrine,the potential for cardiac arrhythmias increases.
C) All options listed
D) None of the options listed

Question 26

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 27

Local anesthetics administered during pregnancy are not teratogenic and pose little danger to the fetus.Pregnant women can receive dental hygiene care with anesthesia in any trimester,in consultation with the patient's physician.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true;the second statement is false.
D) The first statement is false;the second statement is true.

Question 28

Few health conditions absolutely contraindicate the administration of vasoconstrictors.Patients with uncontrolled systemic disease are not normally seen for nonsurgical periodontal therapy.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true;the second statement is false.
D) The first statement is false;the second statement is true.

Question 29

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 options listed

Question 30

Adequate pain control is essential to provide thorough nonsurgical periodontal therapy.Thorough pain control is best accomplished by the administration of local anesthetics.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true;the second is false.
D) The first statement is false;the second is true.

Question 31

All of the following are true regarding phenothiazines EXCEPT one.Which one is the EXCEPTION?

A) Alpha blocker that antagonizes the beta effects of epinephrine
B) May reverse the pressor effect of vasoconstrictors
C) May increase the risk of hypertension
D) When epinephrine is needed,the minimum effective dose should be administered