Chapter 4: Review

A

What should the dental hygienist do when using a suction toothbrush on a patient?A) Tell the patient the teeth are going to be brushedB) Put bite blocks on both sides of the mouth before brushingC) Have the patient lie on their backD) Use toothpasteE) Refrain from moistening the brush often

A

ADL/IADL (activities of daily living/instrumental activities of daily living) can be defined as which of the following?A) Measure of ability to carry out basic tasks of self-care.B) Identify a medically and/or physically fragile or delicate, or weak person.C) Naming physical, mental, or functional impairment that restricts a major activity.D) Classification of individuals in order to make optimal use of treatment resources.E) End stages of life where there is no hope for a cure.

E

The term "frail elderly" usually refers to peopleA) that have difficulty remembering and learning new thingsB) have a partial or complete functional impairmentC) have a chronic disorder characterized by feelings of sadness and low self-esteemD) requiring intensive care or hospitalizationE) older than 80 years

A

What is the most common cause of xerostomia in the residence-bound?A) MedicationsB) Immune DiseaseC) SmokingD) AlcoholismE) Fungal Infection

E

How often should a visual inspection be done of the oral cavity of the person who is in a hospice program?A) YearlyB) MonthlyC) WeeklyD) BiweeklyE) Daily

C

When designing a strategy for the treatment of increased risk of caries in patients with poor oral status, which strategy applies?A) Educate regarding sips of water or ice chipsB) Educate about emergency care for oral injuryC) Educate about reducing intake of fermentable carbohydratesD) Educate about the signs and symptoms of mucosal infectionsE) Educate regarding oral status and potential for compromised nutritional status

B

Which is NOT an example of a community-based setting for alternative dental hygiene practice?A) Homeless shelterB) Private residenceC) Elementary schoolD) Day care centerE) Activity center for disabled individuals

C

A person who has difficulty concentrating or making decisions that affect everyday life is consideredA) chronically illB) critically illC) cognitively impairedD) depressedE) nonambulatory

E

Instruction in personal oral prevention procedures impacts which of the following for all people including the residence-bound?A) Quality of lifeB) ComfortC) Systemic healthD) None of theseE) All of these

D

What percentage of hospice patients that wear dentures report having difficulty wearing them?A) Fewer than 10 percentB) About 25 percentC) About 50 percentD) More than 70 percentE) More than 95 percent

B

Which strategy is used for patients with candidiasis?A) Monitoring the patient for signs of physical abuseB) Educating the patient about the signs and symptoms of infectionsC) Providing dietary analysisD) Recommending antibacterial treatmentE) Assessing the patient's emotional status

D

_______________ is the model of health care delivery that uses web-based technology to send electronic information such as digital radiographs and patient history between on-site and off-site dental practitioners.A) Mid-level ModelB) Public Health ModelC) Collaborative Practice ModelD) Teledentistry ModelE) Interdisciplinary Team Model

E

What is the suction toothbrush designed to prevent?A) CariesB) Periodontal DiseaseC) Bacterial InfectionD) Viral InfectionE) Aspiration

B

Where should the dental hygienist provide treatment when treating a patient in a wheelchair in the patient's residence?A) BedroomB) KitchenC) HallwayD) Living room or denE) Whichever room is the largest

D

In the residence-bound, periodontal infections, lack of daily personal oral care, need for routine dental check-ups, difficulty biting and chewing, loose teeth, loose uncomfortable dentures, or lost dentures are significant for which of the following reasons?A) They are significant general health issues.B) They are all related to heart disease.C) They are systemic conditions.D) They are common oral problems.E) They indicate that the patient is cognitively impaired.

E

Which of the following oral conditions are frequently found on clinical examination of terminally ill patients?A) MucositisB) Denture problemsC) Candidiasis infectionD) XerostomiaE) All of these

A

1) All dental hygiene assessment and treatment can be provided at home for the residence-bound patient. (2) The exception is radiographs; they cannot be performed in the home setting.A) The first statement is true; the second statement is false.B) Both statements are true.C) The first statement is false; the second statement is true.D) Both statements are false.

A

Prolonged illness, suffering, effects of inactivity, and monotonous confinement can contribute to which of the following?A) DepressionB) PsychosisC) AnxietyD) HalitosisE) Candidiasis

C

What is the most important factor to teach the terminally ill patient about oral care?A) Do not eat sugary snacks between meals.B) Dentifrice should never be used with terminally ill patients.C) A clean mouth contributes to a better quality of life.D) A suction brush provides better care than a standard toothbrush.E) Select food and snacks that are cariogenic.

B

1) Active oral lesions are cared for in the terminally ill. (2) The reason for this is the lesions may cause extreme discomfort when talking or eating, and can present an opportunity for secondary infection.A) The first statement is true; the second statement is false.B) Both statements are true.C) The first statement is false; the second statement is true.D) Both statements are false.

A

When designing a strategy for the treatment and prevention of oral trauma in patients with poor oral status living in nursing homes, which strategy applies?A) Educate regarding protocols for oral injury emergency careB) Provide professional fluoride applicationC) Recommend the use of over-the-counter saliva substitutesD) Train caregivers to give oral inspections to identify infectionsE) Provide oral hygiene aids

D

What is the name of the matter that forms on the lips teeth and oral mucosa in the presence of low fevers or dehydration?A) BiofilmB) Food particlesC) DebrisD) SordesE) Crust

D

What equipment is essential to deliver dental hygiene care for the residence-bound patient who has defective swallowing?A) Hospital bedB) Hand held x-rayC) AutoclaveD) Toothbrush with suction attachmentE) Ultrasonic scaler

D

What is the best lighting for home treatment?A) Overhead lightB) Bathroom lightC) Natural lightD) LED headlampE) Reading lamp

C

When can candida become life threatening?A) In the hospital settingB) In the nursing homeC) In immunocompromised individualsD) In the terminally ill patientE) In patients with xerostomia

A

A person with a condition or disease that persists for a long period of time is consideredA) chronically illB) critically illC) cognitively impairedD) disabledE) functionally dependent

E

What is a common barrier to access for the residence-bound population?A) Lack of suitable transportationB) Limited insurance coverageC) Lack of on-site dental clinics in residential facilitiesD) Limited availability of direct access allied oral health providersE) All of these

D

The dental hygienist who collaborates autonomously with members of interdisciplinary teams to provide dental hygiene services in a variety of settings is using which type of practice model?A) Web-based Communication ModelB) Mid-level ModelC) Public Health ModelD) Collaborative Practice ModelE) Dependent Model

B

Over-the-counter saliva substitutes are recommended for the treatment of which condition?A) Dental cariesB) XerostomiaC) Oral traumaD) CandidiasisE) Mucositis

B

In the dentulous unconscious patient, it is recommended to clean the patient's mouth. All of the following are best practice except one. Which is the EXCEPTION?A) Removing biofilm at least twice a day.B) Wipe the mouth with swabs and sponges.C) Use a power toothbrush or suction toothbrush.D) Place a mouth prop.E) Use a soft manual toothbrush

D

What percent of terminally ill patients have cultures of Candida albicans?A) 8 percentB) 23 percentC) 46 percentD) 79 percentE) 98 percent

C

What is the usual hospital policy concerning removable prosthesis, if they are present?A) Use a mouth prop to stabilize in the unconscious patientB) Limit dental care to approved mouth rinsesC) Remove dentures in the unconscious patientD) Clean dentures every few daysE) Store dentures by wrapping them in a paper towel and setting them on the nightstand

D

What do U.S. federal regulations mandate of residential facilities, such as nursing homes, that receive Medicaid or Medicare funding?A) Payment for dental servicesB) Payment for extractionsC) Payment for dental crownsD) Contract with qualified dental personnelE) Contract with the State for services

A

When designing a strategy for the treatment of inadequate biofilm removal in patients with poor oral status, which strategy applies?A) Educate regarding the role of biofilm in the oral cavityB) Educate about reducing intake of fermentable carbohydratesC) Educate about the effects of oral disease on systemic healthD) Educate about the signs and symptoms of mucosal infectionsE) Educate regarding sips of water or ice chips

C

What is the most likely reason that a denture would not fit in the terminally ill patient?A) InfectionB) XerostomiaC) Severe weight lossD) UlcerationE) Denture sore

D

Communication with a residence-bound patient who is relatively helpless, disabled, or ill can be an adjustment for the dental hygienist. Which of the following communication skills would be helpful in working with the residence-bound patient? Select the most successful approach.A) Communicate with the caregiver instead of the patientB) Project an indifferent attitudeC) Project an oversolicitous attitudeD) Be direct and gently firm

D

In one study, what percent of hospice patients had pathologic changes in the oral mucosa that could be observed?A) 15 percentB) 25 percentC) 50 percentD) 75 percentE) 100 percent

E

What virtue is most applicable to caring for the terminally ill and should be exhibited by the dental team?A) AutonomyB) FrugalityC) AmbitionD) IndustryE) Compassion

A

Documentation of dental hygiene treatment in alternative settings includes key concepts that include all that are listed. Which one is directly related to the categorizing of ADL?A) Assess functional abilityB) Describe current health statusC) Summarize oral health dataD) Specific recommendations for oral care and aidsE) Details for services provided

B

When choosing a lamp to use while delivering care in the home setting, you should NOT select aA) lamp with adequate wattageB) lamp with a wide, diffuse beamC) headlampD) goosneck lampE) photography spotlight

E

When designing a strategy for the treatment of xerostomia in patients with poor oral status, which strategy applies?A) Identify medications with potential of causing xerostomiaB) Eliminate the use of products containing alcoholC) Eliminate the use of products containing glycerinD) Recommend the use of nonsucrose-containing candies or gumsE) All of these apply

B

What objective of care is not the focus for the patient who has a terminal illness?A) Provide care that emphasizes patient comfortB) Provide preventive and restorative aspects of careC) Provide relief of painful or aggravating symptomsD) Prevent aspiration of debris and oral microorganismsE) Provide clean mouth environment to reduce odorD

D

What is the meaning of palliative?A) State of unconsciousnessB) Brain deathC) Affected with comaD) Affording reliefE) Cure

B

When designing a strategy for the treatment of periodontal infection in patients with poor oral status, which strategy applies?A) Evaluate inadequate chewing functionB) Provide oral hygiene aidsC) Facilitate the reline or replacement of poor fitting denturesD) Eliminate the use of products with alcoholE) Provide dietary analysis

D

What is an objective of the dental hygienist when treating the unconscious patient?A) Motivate the caregiverB) Plan an in-service for the staffC) Perform extractionsD) Prevent pneumoniaE) Restore caries

D

In one study, what percent of terminally ill patients reported soreness in conjunction with signs of pathologic change?A) 8 percentB) 17 percentC) 28 percentD) 42 percentE) 68 percent

B

The following is an example of documentation: Month, Day, Year. Routine nursing home visit for visual inspection and oral hygiene. Patient comfortable and alert; arm strength weak, she can no longer support toothbrush for daily oral care. Nurse aid caregiver trying to assist. Extensive biofilm on facial surfaces of maxillary molars. Supervised caregiver in following biofilm removal with soft child-sized toothbrush. Follow-up visit scheduled with patient and caregiver in 2 weeks. What is the description that indicates current health status?A) Month, Day, YearB) Patient comfortable and alertC) Routine nursing home visitD) Nurse aid trying to assistE) Biofilm removal with soft brush

A

Which special procedure for the unconscious patient must be pursued when the injury or illness involves the oral cavity? Choose the best answer.A) Follow the advice of the physician or oral surgeonB) Train the caregiver in special methodsC) Motivate the caregiverD) Plan an in-service for the staffE) Educate nursing staff on techniques

B

Survival of the patient is at stake when he or she isA) chronically illB) critically illC) cognitively impairedD) disabledE) functionally dependent

A

Where is the mouth prop placed during tooth brushing for the residence-bound patient?A) On one side of the mouth while the other side is being brushedB) On both sides of the mouth at once while brushingC) On the retracted side of the mouth with the opposite side being brushedD) On the side being brushed

D

When treating patients in alternative settings, the procedure for the safe handling of instruments includes which of the following?A) Open sterile packets in front of the patientB) Use instruments directly from sterile packs or cassettesC) Place sterile instruments on a small trayD) Transport dirty instruments in a tub labeled for contaminated instrumentsE) Transport sterile instruments in sealed packages

E

What is the most important objective of care for the residence-bound patient who has a shortened life span due to a terminal illness?A) Consult on surgical optionsB) Assist in performing standard activities of daily livingC) Recommend a course of action for providing restorative careD) Remind caregivers not to neglect their own oral careE) Provide palliative care

D

What should the dental hygienist instruct caregivers to do to alleviate the discomfort of xerostomia?A) Brush the patient's teeth with dentifriceB) Swab the mucosa with lemon and glycerinC) Swab the mouth with mouth rinseD) Use frequent ice chipsE) Apply antifungal medication

A

A patient is considered __________ if he or she is unable to perform one or more ADL without help.A) functionally dependentB) cognitively impairedC) critically illD) chronically illE) terminally ill

E

______________ is the interdisciplinary program that provides a continuum of home and inpatient palliative and supportive care to meet the physical, emotional, spiritual, social, and economic needs experienced by terminally ill individuals and their families during the final stages of illness and dying and bereavement.A) MedicareB) MedicaidC) HospiceD) NursingE) Triage

B

Why do dental hygiene procedures lend themselves to the treatment of residence-bound patients?A) Most dental hygiene treatment can be completed quickly with ultrasonic instrumentation.B) Most dental hygiene treatment can be completed with manual instruments.C) Most dental hygiene treatment can be completed with teledentistry.D) Most dental hygiene treatment can be completed with the valscope.E) Most dental hygiene treatment can be completed with air polishing.

B

1) Studies indicate that individuals residing in nursing homes generally have poor oral health status. (2) They also indicate that these individuals do not receive adequate daily oral care.A) The first statement is true; the second statement is false.B) Both statements are true.C) The first statement is false; the second statement is true.D) Both statements are false.

D

During a general procedure in an alternative setting, the dental hygienist shouldA) allow the patient's visitors to remain in the room during treatmentB) refrain from socializing with the patientC) perform all scaling during a single appointment, regardless of the amount of scaling requiredD) request that the caregiver be present to assist as neededE) speak to the patient only when answering his or her questions