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DH102 Final Review Part 2

A medical professional administering local anesthesia in a dental office, with educational materials and dental equipment in the background.

DH102 Final Review Part 2 Quiz

Test your knowledge and prepare for your DH102 Final examination with our comprehensive review quiz! This quiz contains 105 challenging questions covering local anesthesia, techniques, and patient management.

Multiple-choice format
Instant feedback on your answers
Perfect for students and practitioners alike

105 Questions26 MinutesCreated by InjectingKnowledge321

Where the excretion of local anesthetics and their metabolites occur?

Kidney

Liver

Pancreas

Lungs

Smaller-gauge needles provide LESS tissue deflection during deep injection penetration.

True

False

Tachyphylaxis is defined as:

Decreased tolerance to a local anesthetic

Increased tolerance to a drug that is administered repeatedly

Immunity to any type of local anesthetic

Increased heart rate under local anesthesia

What is the proper length of time to allow topical anesthetic to remain on the tissue at the injection site?

1 to 2 minutes

2-4 minutes

5-6 minutes

Until patient reports that he/she is numb

All of the following is true regarding mepivacaine 3% plain, except:

Provides LONG-acting pulpal anesthesia

Provides similar duration of anesthesia as lidocaine 2% with epi 1:200,000

Makes it easier to reach MRD than lidocaine 2% ith epi 1: 100,000

Contains 50% more local anesthetic in a cartridge than lidocaine 2% with epi 1:100,000

Cardiovascular signs of toxicity of local anesthetic solution include which of the following?

Myocardial depression

Cardiac dysrhythmias

Cardiotoxicity in pregnancy

All options listed

When there is mild toxic overdose, the proper treatment should be to protect the patients, monitor the vitals and give oxygen.

True

False

For what kind of patient should the MRD of local anesthetic agents be decreased?

Children

Elderly

Medically compromised

All options listed

Which anesthetic/vasoconstrictor combination is most likely to limit the anesthetic drug?

Lidocaine 2% 1:50,000 epinephrine

Lidocaine 2% 1:100,000 epinephrine

Mepivacaine 3% 1:20,000 levonordefrin

All options listed

A moderate level of sedation is referred to

Minimal sedation

General sedation

Maximmum sedation

Conscious sedation

Children between the ages of 6 to 9 may receive effective pain control, equivalent to the IA block, from buccal supraperiosteal infiltrations. Some extraction procedures can be accomplished utilizing mandibular supraperiosteal injections.

Both statements are true.

Both statements are false.

The first statement is true; the second statement is false. The first statement is false; the second statement is true.

The first statement is true; the second statement is false. The first statement is true; the second statement is false.

Sheath needle before and immediately after injection WILL NOT help prevent infection when administering local anesthetic.

True

False

Which of the following could be cause for pain during injection?

Dull needle

Barbed needle

Rapid deposition

All options listed

If one has to estimate the amount of local anesthetic solution that was administered from one cartridge, the width of the rubber stopper would represent how much?

2 mL of solution

0.2 mL of solution

0.02 mL of solution

Never estimate

All of the following are true of topical anesthetics used in dentistry, EXCEPT one;

Lidocaine may contain preservatives such as the parabens that could induce an allergic response.

Topical anesthetics are possible allergens.

Benzocaine is a commonly used amide topical anesthetic that can contribute to an allergic reaction.

Tetracaine can contribute to an allergic response.

What is the formula for calculating how many milligrams of anesthetic solution were administered?

Subtract the MRD from the absolute MRD.

Multiply the percent concentration of local anesthetic agent by 10 mg.

Multiply the number of cartridges administered by the milligrams of anesthetic in each cartridge.

Multiply the milligrams of anesthetic in each cartridge by the patient’s weight.

Which of the following could result if local anesthetic solution is inadvertently deposited in the parotid gland?

Incomplete anesthesia of teeth

Hematoma

Facial paralysis

All options listed

To prevent paresthesia when administering an IA block the clinician should

Consider the risks verses the benefits of using a 0.5% solution.

Consider the risks verses the benefits of using a 2% solution.

Consider the risks verses the benefits of using a 3% solution.

Consider the risks verses the benefits of using a 4% solution.

What is phentolamine mesylate?

Alpha-adrenergic receptor agonist

Beta-adrenergic receptor agonist

Alpha-adrenergic receptor antagonist

Beta-adrenergic receptor antagonist

Which of describes a primary complication?

Is experienced at the time of injection.

Is apparent after the injection is completed.

May seem severe at the time of observance but will eventually resolve without leaving any residual effects.

Will leave a residual effect.

What documentation about local anesthesia should be recorded in the patient’s chart?

Postanesthetic instructions given to patient

Type and dose of drug/drugs administered

Patient’s response to anesthesia

Appropriate consultations or referrals

All options listed

Local anesthetic drug amounts are expressed in ______ while vasoconstrictor amounts, such as epinephrine are expressed in ______.

Percentages, ratios

Ratios, percentages

Ratios, ratios

Percentages, percentages

Most adverse drug reactions occur within 5 to 10 minutes of injection. Local anesthesia systemic toxicity initially manifests as excitation followed by depression of the cardiovascular system and to a lesser extent of the central nervous system.

Both statements are true.

Both statements are false.

The first statement is true; the second statement is false.

The first statement is false; the second statement is true.

Which of the following agents is indicated for the reversal of soft tissue anesthesia?

Local anesthetic buffering agents

Phentolamine mesylate

Oraqix

Mepivacaine 3% plain

Which of the following is helpful during dental procedures when nitrous oxide is used?

Diminish gag reflex

Facilitate taking radiographs

Facilitate taking impressions

All options listed

What does a pulse oximeter measure?

Pulse rate

Blood pressure

Oxygen saturation of the circulating blood

All options listed

All of the following are strategies for when the clinician encounters exostosis EXCEPT one. Which one is the EXCEPTION?

Increase retraction

Move the needle injection site more superior

Utilize the palatal injections

Keep needle parallel to the bone

Practices to avoid when administering local anesthetic include which of the following?

Not using enough for patient comfort and hemostatic control

Overadministering of anesthesia

Administering anesthesia to a larger treatment area than can be completed in one visit

All options listed

What usually causes the discomfort associated with the IA block?

Lingual shock

Injecting slowly

The needle insertion

Gently contacting bone

Numbness or tingling of the lower lip is a reliable indicator that profound anesthesia has occurred. It is also an indicator that the inferior alveolar nerve has been initially anesthetized.

Both statements are true

Both statements are false

The first statement is true; the second statement is false.

The first statement is false; the second statement is true.

When two quadrants of anesthesia are needed, what is the correct order for administering the injections for the right

Rt. PSA, Gow-Gates, B

Rt. Mental, IA, ASA, PSA

Rt. PSA, MSA, ASA, IA, B

Rt. IA, B, PSA, MSA, ASA

When administering the IA block, what other nerve may inadvertently be anesthetized if bone is not contacted?

PSA

Facial nerve

Lingual nerve

Mandibular nerve

Lingual shock may occur when needle passes by the __________ during the inferior alveolar (IA) block.

Inferior alveolar nerve

Mylohyoid nerve

Lingual nerve

Mental nerve

The PSA nerve innervates maxillary second and third molars and the maxillary tuberosity is one landmark for the injection on this nerve.

Both statements are true

Both statements are false

The first statement is true, the second is false

The first statement is false, the second is true

The incisive foramen is located palatal to the maxillary incisors.

True

False

All of the following injections require a long needle, EXCEPT which one?

Inferior Alveolar Block Injection

Infraorbital Block injection

Gow Gates Block injection

Long Buccal Block injection:

Posterior Superior Alveolar injection

Long needles are required for inferior alveolar block Gow-Gates and infraorbital injections.

True

False

Different manufacturers have consistent color-coding of the needle length and gauge. There are no uniform guidelines for the color of needle sheaths (caps).

Both statements are true

Both statements are false.

The first statement is true; the second statement false

The first statement is false; the second statement is true.

The _________ is the weakest part of the needle and where the most needle breakage occurs.

Bevel

Shaft

Hub

Gauge

All of the following are commonly used needle lengths for intraoral injections, EXCEPT one;

Long

Short

Extra-short

Extra-long

The routine maintenance of the reusable syringe includes thorough cleaning and sterilization

True

False

The standard local anesthetic cartridge contains ______ of solution

1.7 ml

3 ml

1.8 ml

2 ml

For local anesthetic containing vasconstrictors, the MRD is determined by the drug that reaches the MRD FIRST (limiting factor)

True

False

The MRD depends on the patient's health

True

False

_________ is responsible for making sure that dental hygienists maintain professional competency, credentials, and continuing education requirement fulfillments.

Dentist

Dental hygienist

Dental assistants

Office management

What details of the incident report should be included for a percutaneous injury?

1. The depth of the wound

2. The gauge of the needle

3. Whether the fluid was injected

4. The time of the incident

1, 2 ,3

2, 3, 4

1, 2

1 only

The bone in the mandibular anterior teeth is less dense than the posterior teeth. Therefore, a supraperiosteal injection may be more successful on the anterior than the posterior.

True

False

With the PDL injection, multirooted teeth DO NOT require an injection for each root.

True

False

If a patient has a history of allergic reactions to an LA containing a vasoconstrictor, then it would be an absolute contraindication to administer. A vasoconstrictor is an absolute contraindication for uncontrolled hyperthyroidism.

Both statements are true.

Both statements are false.

The first statement is true; the second statement is false.

The first statement is false; the second statement is true.

Benzocaine exists almost entirely in its base form making the absorption into circulation________.

Slow

Fast

A patient comes back the day after a dental treatment stating that he has some swelling on his face. You should tell your patient that this is not related to the dental anesthesia because any complications or adverse effects happen ONLY at the moment of the injection.

True

False

Anbesol with benzocaine, an over-the-counter product CANNOT be safely used by all family members.

True

False

_________ is a buffer that creates an anesthetic solution isotonic.

Sodium bisulfite

Sodium chloride

Potassium chloride

None of the above

The most commonly used anesthetic in dentistry is __________

Lidocaine

Articaine

Bupivacaine

Mepivacaine

The higher the pka of an anesthetic, the ____________ the onset of action

Slower

Faster

The incidence of occupational exposure is NOT reduced for the experienced clinician.

True

False

A clinical sign of syncope is ___________.

Pallor

Red face

Bradycardia

None of the above

In which scenario will the PSA injection be needed in children?

The thick zygomatic process may overlie the buccal roots of the second primary and first permanent molars.

All permanent dentition are present and PSA is highly reccomended

The medical condition of the child requires a stronger dose of anesthesia

All of the above

Which mandibular supplemental injections enter the alveolar bone?

Periodontal Ligament

Intraosseous: uses a 'pecking motion' into the bone

Intraseptal

All of the above

If there is a DOUBLE mandibular canal on the x-ray, the injection site for the IA block should be INFERIOR to the usual anatomic landmark.

True

False

PSA can injection can be used in recare appointments because the maxillary molars are the first teeth that can get periodontal disease.

True

False

All of the following are best practices to avoid when giving local anesthesia, except;

Giving anesthesia to a larger treatment area than can be completed in one visit

Over-administering of anesthesia

Not using enough anethesia for treatment comfort and hemostatic control

All of the above are best practices

All of the following are acceptable fulcrums when administering local anesthesia, EXCEPT;

Arm-to-body support

Extraoral fulcrum, ie patient's chin

Other fingers and thumbs

Patient's arm

Depositing anesthetic solution slowly is a safety factor and improves patient comfort.

Both statements are true

Both statements are false

First statement is true, and second is false

First statement is false and second is true

The pterygoid venous plexus is an area of concern when administering PSA because it is highly vascular.

True

False

After initial negative aspiration, the clinician should rotate the syringe 45 degrees to aspirate a second time. This is to ensure that the needle is not located within a blood vessel, and possibly abutting the vessel wall causing a false-negative aspiration.

Both statements are true

Both statements are false

First statement is true and the second is false

First statement is false and the second is true

A common mistake that beginners make when first learning giving local anesthesia is_________________

Not performing aspiration at appropriate intervals

Overexaggerating the pulling back of thumb ring, pulling the needle away from penetration site

Allowing the thumb ring to slip down to the bottom of the thumb making it harder to aspirate.

There is usually no mistakes made by beginners

_____________ aspiration is the term when there is a presence of a CLEAR air bubble or NO return after backward of rubber stopper.

Positive

Negative

Backwards

Regular

The PSA nerve innervates maxillary second and third molars and the maxillary tuberosity is one landmark for the injection on this nerve.

Both statements are true

Both statements are false

The first statement is true, the second is false

The first statement is false, the second is true

The first division of the trigeminal nerve is the ophthalmic nerve

True

False

The sensory information for the teeth and associated tissues is provided by the trigeminal (V) nerve.

True

False

The __________ is the opening between the mandibular premolar apices.

Lingual foramen

Mandibular canal

Incisive foramen

Mental foramen

The majority of health conditions ABSOLUTELY contraindicate the administration of vasoconstrictors.

True

False

____________ is a inherited syndrome that is triggered by the exposure of certain drugs for general anesthesia and the neuromuscular blocking agent succinylcholine.

Cancer

Cirrhosis

Malignant hyperthermia

None of the above

All of the following are best practices to reduce patient's anxiety about dental treatment, except:

Consider appointment length and time of day

Do not call the patient after treatment

Administer adequate pain control during treatment

Administer adequate pain control after treatment

The collection of preanesthetic data guides the hygienist in determining the need of medical consultation, modification of dental care plan and appropriateness of administering local anesthetic.

True

False

_____________ is when a drug should NOT be administered to a patient under any circumstances.

Absolute contraindication

Drug to drug interaction

Relative contraindication

None of the above

Oraqix is in liquid form in the cartridge. It will gel when it is inside the periodontal pocket.

Both statements are true

Both statements are false

First statement is true; second is false

First statement is false; second is true

What is the maximum recommended dose of Oraqix in one dental session?

10 cartridges

3 cartridges

4 cartridges

5 cartridges

Possible localized adverse effects of topical anesthetics are_______

Convulsions, sloughing tissue and stinging at site of application

Cardiovascular depression, coma and disorientation

Sloughing tissue, tissue discoloration, and stinging at site of application

Hematoma, stinging at site of application and muscle twitching

To obtain the most benefit from topical anesthetics, a fairly substantial amount of it should be places on the cotton tip applicator. It should stay for 5-10 minutes on the area where local anesthesia will be administered.

Both statements are true

Both statements are false

The first statement is true; second is false

The first statement is false; second is true

1:50,000 is safer than 1:200,000 of epinephrine for a patient who is cardiovasculary compromised.

True

False

An undesirable side effect of epinephrine is/are_____________

Reduce rate of heart contractions

Increase rate and force of heart contractions

Dilate bronchi

Reduce force of heart contractions

The stimulation of Beta 2 receptors relax bronchial smooth muscles causing the bronchi to dilate.

True

False

Epinephrine helps to reduce systemic toxicity and increased the duration of anesthetic because it reduces the rate of absorption.

Both the statement and reason are correct and related

Both the statement and reason are correct BUT not related.

The statement is not correct BUT the reason is correct

Neither the statement nor the reason is correct.

The__________ renders the molecule water soluble, the___________ determines if the molecule is an ester or amide, and the ______________ improves the lipid solubility of the molecule.

Hydrophilic amino group, intermediate hydrocarbon chain, the lipophilic aromatic ring

Lipophilic aromatic ring, hydrophilic amino group, intermediate hydrocarbon chain

Intermediate hydrocarbon chain, lipophilic aromatic ring, hydrophilic amino group

Intermediate hydrocarbon chain, hydrophilic amino group, lipophilic aromatic ring

After absorption of local anesthetics into bloodstream, they are distributed throughout the body. Highly vascular organs (heart, kidneys, etc.) have higher concentrations of anesthetics.

Both statements are true

Both statements are false

First statement is true; second is false

First statement is false; second is true

The concentration gradient is the relationship between relative amounts of ions inside and outside the membrane

True

False

The axon is made up of cytoplasm and surrounded by multiple lipid membrane.

True

False

Local anesthetics inhibit ___________ to prevent nerve cell stimulation

Sodium influx

Chloride influx

Potassium influx

All of the above

Membrane potential is the difference between the electrical charge on the outside and inside of the cell.

True

False

The cell body of the ______ neurons are located at the terminal arborization.

Motor

Sensory

Efferent

Afferent

An anesthetic has frozen when there are bubbles larger than 2 mm inside the cartridge.

True

False

All local anesthetic used same colors and there is a uniform guidelines for the color of needle shields.

Both statements are true

Both statements are false

First statement is true; second is false

First statement is false; second is true

The qualified health care provider corresponds directly with the exposed health care worker as not to violate HIPPA

True

False

Local anesthetics with vasoconstrictor are ABSOLUTE contraindication for a patient that experienced an allergic reaction in the past.

True

False

Benzocaine is a commonly used ESTER topical anesthetic.

True

False

The MRD of epinephrine for a cardiac patient is ______and levonordefrin for the same patient is __________

0.2 mg and 0.04 mg

0.04 mg and 0.2 mg

0.2 mg for both

0.04 mg for both

What is the best way to avoid systemic toxicity when administering a local anesthetic solution?

Reduce the amount of vasoconstrictor.

Inject slowly.

Use disposable needles.

Aspirate before injection

Which of the following best practices will help to prevent infection caused by the administration of local anesthetic?

Wipe needle with disinfectant.

Store anesthetic cartridges in disinfectant solutions.

Sheath needle before and immediately after injection

All options listed

What is the formula for calculating how many milligrams of
anesthetic solution were administered?

Subtract the MRD from the absolute MRD.

Multiply the percent concentration of local anesthetic agent by 10 mg.

Multiply the number of cartridges administered by the milligrams of anesthetic in each cartridge.

Multiply the milligrams of anesthetic in each cartridge by the patient’s weight.

Which of the following is considered a transient complication?

Burning on injection

Nerve damage

Hematoma

Anaphylaxis

Which of the following must be document in the patient’s record following the administration of nitrous oxide?

Health history

Vital signs

Oxygen saturation

All of the above

The preanesthetic patient assessment is the most important measure the dental hygienist can complete to prevent an allergic reaction. Patients who report they are susceptible to asthma, hay fever, and allergies to foods have an increased potential to develop an allergic response to medications.

True

False

Which of the following are preventive measures to decrease the occurrences of soft tissue injury?

Selection of agent with appropriate duration of action.

Advise parent/caregiver about possible injury due to biting the lip, tongue, or cheek.

Place cotton rolls in vestibule and warning stickers on the patient’s head.

Advise parent/caregiver to delay meals and hot drinks.

All options listed

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