Simulated National Board Dental Hygiene
Examinations: TEST 2 With complete solutions |
latest update 2026/2027
Which of the following is a measure of the energy needed to maintain life while at rest and
without food? - Ans BMR
RATIONALE: Energy for basal metabolism is referred to as the basal metabolic rate (BMR), which
is a measure of energy. The specific dynamic energy (SDE) is a measure used during metabolism
of food. Protein energy malnutrition (PEM), a potentially fatal protein deficit, is prominent in
anorexic individuals, as well as those in later stages of HIV infection. Coronary heart disease
(CHD), is a disease state, not a measure of energy.
During the intraoral examination, a translucent-to-whitish irregular film on the buccal mucosa is
noted. The film is not removable with gauze. Which of the following conditions is MOST likely
present? - Ans Hyperkeratinization
RATIONALE: Hyperkeratinization can result from constant low-grade irritations such as cheek
biting, which causes an abnormal layer of keratin to develop. The client needs to be questioned
regarding parafunctional oral habits. Hyperplasia is an increase in the number of cells whereas
linea alba presents as a whitish, horizontal, elevated line on the buccal mucosa at the height of
the occlusal plane. Also whitish in appearance, leukoplakia is characterized as white patches
that sometimes appear fissured, may cause discomfort, cannot be scraped off and are
considered precancerous.
When comparing permanent and primary molars, which of the following statements is TRUE? -
Ans Primary molars have larger pulp chambers.
,RATIONALE: The pulp chambers of primary molars are larger than those of the permanent
molars. Second primary molars, not first primary molars, have anatomy similar to that of the
first permanent molars. Primary molars have the same number of roots as permanent molars;
note that neither primary molars nor permanent molars are classified as succedaneous teeth. A
succedaneous tooth is a permanent tooth that replaces a primary tooth. Thus, permanent
incisors are succedaneous, but permanent molars are not. The root trunks of primary molars
are very short in comparison with those of permanent molars
John Jeffry, a 45-year-old man, calls the dental office to request an appointment for an oral
examination. After discovering that he has cerebral palsy, the office manager tells Mr. Jeffry that
he cannot be treated in the office due to his condition. Which of the following BEST describes
the behavior being demonstrated by the office manager? - Ans This behavior is an
example of discrimination according to the Americans with Disabilities Act.
RATIONALE: This illegal behavior is an example of discrimination according to the Americans
with Disabilities Act (ADA). Based upon the ADA, dental practices can neither refuse treatment
based on a client's disability nor can they prescreen clients to determine whether they will
provide care. Although the Equal Rights Amendment affords important protection to all citizens,
it has no bearing on the provision of dental treatment.
Which of the following correctly ranks the tissues in order of MOST sensitive to LEAST sensitive
to ionizing radiation? - Ans Reproductive, lymphatic, endocrine, digestive, nervous
RATIONALE: In general, younger cells with a high rate of metabolism, an increased proliferation
and growth rate, and a decrease in specialization are more susceptible to radiation-induced
biologic changes. Therefore, reproductive organs represent tissue with cells that are most
radiosensitive, whereas the nervous system is composed of cells considered to be the most
radioresistant. In descending order of radiosensitivity are lymphatic, endocrine, and digestive
tissues. An important concept, tissues that are less sensitive to radiation-induced biological
changes will be more specialized, have lower rates of metabolism and decreased proliferation
and growth rates.
,Which of the following describes a dental implant that is placed on the surface of the bone
beneath the periosteum? - Ans Subperiosteal
RATIONALE: A subperiosteal implant is placed on the surface of the bone beneath the
periosteum. Periosseous is not a term associated with a type of dental implant. An endosseous
implant is placed into the alveolar bone whereas a transosteal implant is placed through the
alveolar bone.
Studies of the natural history of periodontal disease have shown which of the following to be
TRUE? - Ans Periodontal therapy and oral self-care will slow the rate of attachment loss in
periodontitis.
RATIONALE: In studies of Sri Lanka tea workers, comparison of untreated groups with regular
dental care attendees from Norway documented that periodontal therapy and self-care slow
the rate of clinical attachment loss (0.3 and 0.1 mm, respectively). Because plaque and calculus
are common in treated and untreated clients, incidence of periodontitis is not affected by the
amount these accretions. Regarding patterns of disease progression, gingivitis will not
necessarily progress to periodontitis, nor does untreated periodontal disease rapidly progress.
Acidic agents, such as acidulated phosphate fluoride (APF) gels and foams, can inadvertently
dissolve ceramic phases on all of the following surfaces EXCEPT one. Which one is the
EXCEPTION? - Ans Pit and fissure sealants
RATIONALE: Inadvertent dissolution of a ceramic phase is not a concern with pit and fissure
sealants because sealants do not contain a ceramic phase that is vulnerable to dissolution.
When a client's treatment plan includes an acidulated phosphate fluoride gel or foam, the
dental hygienist must first assure that damage from the low pH (acidity) of the solution will not
damage any existing dental restorations. Hybrid composites have glass fillers that can be
dissolved by APF. Porcelain fused-to-metal (PFM) restorations can be partially dissolved by APF
as can CAD/CAM ceramics which are etched during the bonding procedures by hydrofluoric
acid. Also vulnerable to dissolution by APF are porcelain veneers.
, The eruption sequence for maxillary permanent teeth is: central incisors, lateral incisors, first
molars, canines, first premolars
In general, maxillary permanent teeth erupt prior to mandibular permanent teeth. -
Ans Both statements are FALSE.
RATIONALE: The eruption sequence for maxillary permanent teeth is first molars (age 6 to 7);
central incisors (age 7 to 8); lateral incisors (age 8 to 9); first premolars (age 10 to 11); canines
(age 11 to 12). In general, the mandibular permanent (as well as deciduous) teeth erupt prior to
their maxillary counterparts.
Congenital heart disease is associated with anomalies of the heart structure.
Anomalies of the heart structure occur in utero during weeks 15 through 20. - Ans The
first statement is TRUE, the second is FALSE.
RATIONALE: Congenital heart disease is associated with anomalies of the heart structure, which
occur in the first 9 weeks in utero.
The surfaces used to determine the terminus or terminal plane of the primary dentition is the -
Ans distal surface of a mandibular second primary molar.
RATIONALE: Distal surfaces of second primary molars are considered to be end vertical planes or
termini of the primary dentition. A terminus refers to the end of a structure; neither the first
primary molar nor its mesial surface is the endpoint of a primary dentition. Similarly, the distal
surface of a mandibular first primary molar is not the end point of a primary dentition. In the
same logic pattern, the mesial surface of a second primary molar is not the termination of a
primary dentition.
Plaque-induced gingivitis will always progress to chronic periodontitis if left untreated.
Examinations: TEST 2 With complete solutions |
latest update 2026/2027
Which of the following is a measure of the energy needed to maintain life while at rest and
without food? - Ans BMR
RATIONALE: Energy for basal metabolism is referred to as the basal metabolic rate (BMR), which
is a measure of energy. The specific dynamic energy (SDE) is a measure used during metabolism
of food. Protein energy malnutrition (PEM), a potentially fatal protein deficit, is prominent in
anorexic individuals, as well as those in later stages of HIV infection. Coronary heart disease
(CHD), is a disease state, not a measure of energy.
During the intraoral examination, a translucent-to-whitish irregular film on the buccal mucosa is
noted. The film is not removable with gauze. Which of the following conditions is MOST likely
present? - Ans Hyperkeratinization
RATIONALE: Hyperkeratinization can result from constant low-grade irritations such as cheek
biting, which causes an abnormal layer of keratin to develop. The client needs to be questioned
regarding parafunctional oral habits. Hyperplasia is an increase in the number of cells whereas
linea alba presents as a whitish, horizontal, elevated line on the buccal mucosa at the height of
the occlusal plane. Also whitish in appearance, leukoplakia is characterized as white patches
that sometimes appear fissured, may cause discomfort, cannot be scraped off and are
considered precancerous.
When comparing permanent and primary molars, which of the following statements is TRUE? -
Ans Primary molars have larger pulp chambers.
,RATIONALE: The pulp chambers of primary molars are larger than those of the permanent
molars. Second primary molars, not first primary molars, have anatomy similar to that of the
first permanent molars. Primary molars have the same number of roots as permanent molars;
note that neither primary molars nor permanent molars are classified as succedaneous teeth. A
succedaneous tooth is a permanent tooth that replaces a primary tooth. Thus, permanent
incisors are succedaneous, but permanent molars are not. The root trunks of primary molars
are very short in comparison with those of permanent molars
John Jeffry, a 45-year-old man, calls the dental office to request an appointment for an oral
examination. After discovering that he has cerebral palsy, the office manager tells Mr. Jeffry that
he cannot be treated in the office due to his condition. Which of the following BEST describes
the behavior being demonstrated by the office manager? - Ans This behavior is an
example of discrimination according to the Americans with Disabilities Act.
RATIONALE: This illegal behavior is an example of discrimination according to the Americans
with Disabilities Act (ADA). Based upon the ADA, dental practices can neither refuse treatment
based on a client's disability nor can they prescreen clients to determine whether they will
provide care. Although the Equal Rights Amendment affords important protection to all citizens,
it has no bearing on the provision of dental treatment.
Which of the following correctly ranks the tissues in order of MOST sensitive to LEAST sensitive
to ionizing radiation? - Ans Reproductive, lymphatic, endocrine, digestive, nervous
RATIONALE: In general, younger cells with a high rate of metabolism, an increased proliferation
and growth rate, and a decrease in specialization are more susceptible to radiation-induced
biologic changes. Therefore, reproductive organs represent tissue with cells that are most
radiosensitive, whereas the nervous system is composed of cells considered to be the most
radioresistant. In descending order of radiosensitivity are lymphatic, endocrine, and digestive
tissues. An important concept, tissues that are less sensitive to radiation-induced biological
changes will be more specialized, have lower rates of metabolism and decreased proliferation
and growth rates.
,Which of the following describes a dental implant that is placed on the surface of the bone
beneath the periosteum? - Ans Subperiosteal
RATIONALE: A subperiosteal implant is placed on the surface of the bone beneath the
periosteum. Periosseous is not a term associated with a type of dental implant. An endosseous
implant is placed into the alveolar bone whereas a transosteal implant is placed through the
alveolar bone.
Studies of the natural history of periodontal disease have shown which of the following to be
TRUE? - Ans Periodontal therapy and oral self-care will slow the rate of attachment loss in
periodontitis.
RATIONALE: In studies of Sri Lanka tea workers, comparison of untreated groups with regular
dental care attendees from Norway documented that periodontal therapy and self-care slow
the rate of clinical attachment loss (0.3 and 0.1 mm, respectively). Because plaque and calculus
are common in treated and untreated clients, incidence of periodontitis is not affected by the
amount these accretions. Regarding patterns of disease progression, gingivitis will not
necessarily progress to periodontitis, nor does untreated periodontal disease rapidly progress.
Acidic agents, such as acidulated phosphate fluoride (APF) gels and foams, can inadvertently
dissolve ceramic phases on all of the following surfaces EXCEPT one. Which one is the
EXCEPTION? - Ans Pit and fissure sealants
RATIONALE: Inadvertent dissolution of a ceramic phase is not a concern with pit and fissure
sealants because sealants do not contain a ceramic phase that is vulnerable to dissolution.
When a client's treatment plan includes an acidulated phosphate fluoride gel or foam, the
dental hygienist must first assure that damage from the low pH (acidity) of the solution will not
damage any existing dental restorations. Hybrid composites have glass fillers that can be
dissolved by APF. Porcelain fused-to-metal (PFM) restorations can be partially dissolved by APF
as can CAD/CAM ceramics which are etched during the bonding procedures by hydrofluoric
acid. Also vulnerable to dissolution by APF are porcelain veneers.
, The eruption sequence for maxillary permanent teeth is: central incisors, lateral incisors, first
molars, canines, first premolars
In general, maxillary permanent teeth erupt prior to mandibular permanent teeth. -
Ans Both statements are FALSE.
RATIONALE: The eruption sequence for maxillary permanent teeth is first molars (age 6 to 7);
central incisors (age 7 to 8); lateral incisors (age 8 to 9); first premolars (age 10 to 11); canines
(age 11 to 12). In general, the mandibular permanent (as well as deciduous) teeth erupt prior to
their maxillary counterparts.
Congenital heart disease is associated with anomalies of the heart structure.
Anomalies of the heart structure occur in utero during weeks 15 through 20. - Ans The
first statement is TRUE, the second is FALSE.
RATIONALE: Congenital heart disease is associated with anomalies of the heart structure, which
occur in the first 9 weeks in utero.
The surfaces used to determine the terminus or terminal plane of the primary dentition is the -
Ans distal surface of a mandibular second primary molar.
RATIONALE: Distal surfaces of second primary molars are considered to be end vertical planes or
termini of the primary dentition. A terminus refers to the end of a structure; neither the first
primary molar nor its mesial surface is the endpoint of a primary dentition. Similarly, the distal
surface of a mandibular first primary molar is not the end point of a primary dentition. In the
same logic pattern, the mesial surface of a second primary molar is not the termination of a
primary dentition.
Plaque-induced gingivitis will always progress to chronic periodontitis if left untreated.
