1
ADEX CSCE OSCE Exam Actual Exam
2026/2027 – Complete Exam-Style Questions
with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
[SECTION 1: Patient Assessment & Diagnosis — Questions 1-20]
Q1: According to the American Heart Association (AHA) guidelines, which of the following
conditions requires antibiotic prophylaxis prior to invasive dental procedures to prevent infective
endocarditis?
A. Total hip replacement
B. Cardiac pacemaker
C. Prosthetic cardiac valve
D. Prosthetic cardiac valve [CORRECT]
Correct Answer: C
Rationale: The AHA recommends antibiotic prophylaxis only for patients with the highest risk of
adverse outcomes from infective endocarditis, which includes those with prosthetic cardiac
valves, previous infective endocarditis, certain congenital heart diseases, and cardiac transplant
recipients with valvulopathy. Prosthetic joint replacements (A) and pacemakers (B) generally do
not require prophylaxis unless specific circumstances exist. Adhering to these guidelines ensures
patient safety while avoiding unnecessary antibiotic use.
Q2: A patient has a blood pressure reading of 135/85 mmHg. According to the ACC/AHA
guidelines, how is this classified?
A. Normal
B. Elevated
C. Hypertension Stage 1
D. Hypertension Stage 1 [CORRECT]
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Correct Answer: C
Rationale: Under the 2017 ACC/AHA guidelines, a systolic pressure of 130-139 or a diastolic
pressure of 80-89 is classified as Hypertension Stage 1. Normal (A) is <120/<80, while Elevated
(B) is 120-129/<80. Accurate classification is vital for determining if a patient can proceed with
elective care or requires medical consultation.
Q3: Which ASA (American Society of Anesthesiologists) classification describes a patient with
severe systemic disease that is a constant threat to life?
A. ASA II
B. ASA III
C. ASA IV
D. ASA IV [CORRECT]
Correct Answer: C
Rationale: ASA IV represents a patient with severe systemic disease that is a constant threat to
life (e.g., unstable angina, myocardial infarction within the last 3 months). ASA II (A) is mild
systemic disease, and ASA III (B) is severe systemic disease without constant threat to life.
Correct classification dictates the level of monitoring and emergency preparedness required
during treatment.
Q4: During the extraoral examination, you palpate the patient's submandibular glands. Which
technique is most appropriate to ensure patient comfort and effective palpation?
A. Bimanual palpation from the front
B. Bimanual palpation (extraoral and intraoral) with fingers placed above and below the
mandible
C. Bimanual palpation (extraoral and intraoral) with fingers placed above and below the
mandible [CORRECT]
D. Unilateral palpation using firm pressure
Correct Answer: C
,3
Rationale: Bimanual palpation, where one hand is placed extraorally below the inferior border of
the mandible and the other hand is placed intraorally on the floor of the mouth, allows the
clinician to trap the gland for accurate assessment of size and texture. Using only one hand (D)
may miss abnormalities or require excessive pressure. This technique is standard for evaluating
the submandibular and sublingual glands.
Q5: A patient reports taking Warfarin (Coumadin). Which laboratory test value must be reviewed
prior to performing scaling procedures to assess bleeding risk?
A. PT (Prothrombin Time) or INR (International Normalized Ratio)
B. Bleeding time
C. Platelet count
D. PT (Prothrombin Time) or INR (International Normalized Ratio) [CORRECT]
Correct Answer: C
Rationale: The INR is the standard measure used to monitor the efficacy of Warfarin. Routine
dental hygiene procedures can generally be safely performed if the INR is within the therapeutic
range of 2.0–3.5, though typically <3.0 is preferred for surgery. While platelet count (C) is
important for general bleeding risks, INR specifically tracks anticoagulant status. This ensures
the provider can manage bleeding risk appropriately.
Q6: Upon intraoral examination, you observe a diffuse, white, removable plaque on the buccal
mucosa. What is the most likely diagnosis?
A. Lichen planus
B. Leukoplakia
C. Candidiasis (Thrushing)
D. Candidiasis (Thrush) [CORRECT]
Correct Answer: C
Rationale: Pseudomembranous candidiasis (thrush) presents as a creamy, white plaque that can
be wiped away, often leaving a red or bleeding surface. Lichen planus (A) and leukoplakia (B)
, 4
are generally not removable by wiping. Identifying this condition is crucial because it may
indicate underlying systemic issues such as diabetes or immunosuppression.
Q7: Which of the following medications is known to cause drug-induced gingival hyperplasia?
A. Phenytoin (Dilantin)
B. Amoxicillin
C. Ibuprofen
D. Phenytoin (Dilantin) [CORRECT]
Correct Answer: C
Rationale: Phenytoin, an anticonvulsant, along with calcium channel blockers like nifedipine and
the immunosuppressant cyclosporine, are classic causes of gingival overgrowth. Recognizing
this condition allows the clinician to provide improved home care instructions and consult the
physician about potential medication substitution. Antibiotics (B) and NSAIDs (C) do not cause
this side effect.
Q8: While assessing the temporomandibular joint (TMJ), you note a clicking sound upon
opening that is also felt laterally. This finding is most indicative of:
A. Crepitus
B. Disc displacement with reduction
C. Disc displacement with reduction [CORRECT]
D. Hypermobility
Correct Answer: C
Rationale: A "click" usually represents the articular disc snapping back into its proper position
(reduction) upon opening. Crepitus (A) is described as a grating or sandpaper sound, indicating
degenerative changes in the joint surfaces. Accurate documentation of these sounds helps in
referring the patient for specialized TMJ treatment.
ADEX CSCE OSCE Exam Actual Exam
2026/2027 – Complete Exam-Style Questions
with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
[SECTION 1: Patient Assessment & Diagnosis — Questions 1-20]
Q1: According to the American Heart Association (AHA) guidelines, which of the following
conditions requires antibiotic prophylaxis prior to invasive dental procedures to prevent infective
endocarditis?
A. Total hip replacement
B. Cardiac pacemaker
C. Prosthetic cardiac valve
D. Prosthetic cardiac valve [CORRECT]
Correct Answer: C
Rationale: The AHA recommends antibiotic prophylaxis only for patients with the highest risk of
adverse outcomes from infective endocarditis, which includes those with prosthetic cardiac
valves, previous infective endocarditis, certain congenital heart diseases, and cardiac transplant
recipients with valvulopathy. Prosthetic joint replacements (A) and pacemakers (B) generally do
not require prophylaxis unless specific circumstances exist. Adhering to these guidelines ensures
patient safety while avoiding unnecessary antibiotic use.
Q2: A patient has a blood pressure reading of 135/85 mmHg. According to the ACC/AHA
guidelines, how is this classified?
A. Normal
B. Elevated
C. Hypertension Stage 1
D. Hypertension Stage 1 [CORRECT]
,2
Correct Answer: C
Rationale: Under the 2017 ACC/AHA guidelines, a systolic pressure of 130-139 or a diastolic
pressure of 80-89 is classified as Hypertension Stage 1. Normal (A) is <120/<80, while Elevated
(B) is 120-129/<80. Accurate classification is vital for determining if a patient can proceed with
elective care or requires medical consultation.
Q3: Which ASA (American Society of Anesthesiologists) classification describes a patient with
severe systemic disease that is a constant threat to life?
A. ASA II
B. ASA III
C. ASA IV
D. ASA IV [CORRECT]
Correct Answer: C
Rationale: ASA IV represents a patient with severe systemic disease that is a constant threat to
life (e.g., unstable angina, myocardial infarction within the last 3 months). ASA II (A) is mild
systemic disease, and ASA III (B) is severe systemic disease without constant threat to life.
Correct classification dictates the level of monitoring and emergency preparedness required
during treatment.
Q4: During the extraoral examination, you palpate the patient's submandibular glands. Which
technique is most appropriate to ensure patient comfort and effective palpation?
A. Bimanual palpation from the front
B. Bimanual palpation (extraoral and intraoral) with fingers placed above and below the
mandible
C. Bimanual palpation (extraoral and intraoral) with fingers placed above and below the
mandible [CORRECT]
D. Unilateral palpation using firm pressure
Correct Answer: C
,3
Rationale: Bimanual palpation, where one hand is placed extraorally below the inferior border of
the mandible and the other hand is placed intraorally on the floor of the mouth, allows the
clinician to trap the gland for accurate assessment of size and texture. Using only one hand (D)
may miss abnormalities or require excessive pressure. This technique is standard for evaluating
the submandibular and sublingual glands.
Q5: A patient reports taking Warfarin (Coumadin). Which laboratory test value must be reviewed
prior to performing scaling procedures to assess bleeding risk?
A. PT (Prothrombin Time) or INR (International Normalized Ratio)
B. Bleeding time
C. Platelet count
D. PT (Prothrombin Time) or INR (International Normalized Ratio) [CORRECT]
Correct Answer: C
Rationale: The INR is the standard measure used to monitor the efficacy of Warfarin. Routine
dental hygiene procedures can generally be safely performed if the INR is within the therapeutic
range of 2.0–3.5, though typically <3.0 is preferred for surgery. While platelet count (C) is
important for general bleeding risks, INR specifically tracks anticoagulant status. This ensures
the provider can manage bleeding risk appropriately.
Q6: Upon intraoral examination, you observe a diffuse, white, removable plaque on the buccal
mucosa. What is the most likely diagnosis?
A. Lichen planus
B. Leukoplakia
C. Candidiasis (Thrushing)
D. Candidiasis (Thrush) [CORRECT]
Correct Answer: C
Rationale: Pseudomembranous candidiasis (thrush) presents as a creamy, white plaque that can
be wiped away, often leaving a red or bleeding surface. Lichen planus (A) and leukoplakia (B)
, 4
are generally not removable by wiping. Identifying this condition is crucial because it may
indicate underlying systemic issues such as diabetes or immunosuppression.
Q7: Which of the following medications is known to cause drug-induced gingival hyperplasia?
A. Phenytoin (Dilantin)
B. Amoxicillin
C. Ibuprofen
D. Phenytoin (Dilantin) [CORRECT]
Correct Answer: C
Rationale: Phenytoin, an anticonvulsant, along with calcium channel blockers like nifedipine and
the immunosuppressant cyclosporine, are classic causes of gingival overgrowth. Recognizing
this condition allows the clinician to provide improved home care instructions and consult the
physician about potential medication substitution. Antibiotics (B) and NSAIDs (C) do not cause
this side effect.
Q8: While assessing the temporomandibular joint (TMJ), you note a clicking sound upon
opening that is also felt laterally. This finding is most indicative of:
A. Crepitus
B. Disc displacement with reduction
C. Disc displacement with reduction [CORRECT]
D. Hypermobility
Correct Answer: C
Rationale: A "click" usually represents the articular disc snapping back into its proper position
(reduction) upon opening. Crepitus (A) is described as a grating or sandpaper sound, indicating
degenerative changes in the joint surfaces. Accurate documentation of these sounds helps in
referring the patient for specialized TMJ treatment.
