Test Bank Darby & Walsh Dental Hygiene Theory and Practice, 4th Edition

Test Bank Darby & Walsh Dental Hygiene Theory and Practice, 4th Edition Table of Contents PREFACE ............................................................................................................................................. 3 Chapter 01: The Dental Hygiene Profession ................................................................................... 4 Chapter 02: Human Needs Theory and Dental Hygiene Care .................................................... 14 Chapter 03: Evidence-Based Decision Making .............................................................................. 23 Chapter 04: Health and Health Promotion .................................................................................... 31 Chapter 05: Changing Behaviors ................................................................................................... 40 Chapter 06: Cultural Competence ................................................................................................. 47 Chapter 08: The Dental Hygiene Care Environment .................................................................... 52 Chapter 10: Medical Emergencies ................................................................................................. 58 Chapter 11: Ergonomics ................................................................................................................. 67 Chapter 12: The Health History ..................................................................................................... 71 Chapter 13: Vital Signs ................................................................................................................... 78 Chapter 14: Pharmacologic History ............................................................................................... 84 Chapter 15: Extraoral and Intraoral Clinical Assessment ............................................................ 94 Chapter 16: Dentition Assessment .............................................................................................. 101 Chapter 17: Oral Hygiene Assessment: Soft and Hard Deposits.............................................. 110 Chapter 18: Dental Caries Management by Risk Assessment .................................................. 115 Chapter 19: Periodontal and Risk Assessment ........................................................................... 119 Chapter 20: Potential Impact of Periodontal Infections on Overall General Health ................ 127 Chapter 21: Dental Hygiene Diagnosis ....................................................................................... 138 Chapter 22: Dental Hygiene Care Plan, Evaluation, and Documentation ................................. 147 Chapter 23: Toothbrushing .......................................................................................................... 158 Chapter 24: Mechanical Oral Biofilm Control: Interdental and Supplemental Self-Care Devices ........................................................................................................................................................ 164 Chapter 25: Dentifrices ................................................................................................................ 177 Chapter 26: Hand-Activated Instrumentation ............................................................................. 183 Chapter 27: Ultrasonic Instrumentation ..................................................................................... 192 Chapter 28: Root Morphology and Instrumentation Implications ........................................... 199 Chapter 29: Stain Management and Tooth Whitening ............................................................... 206 Chapter 30: Decision Making Related to Nonsurgical Periodontal Therapy ............................ 213 Chapter 31: Chemotherapy for the Control of Periodontal Disease ........................................ 226 Chapter 32: Acute Gingival and Periodontal Conditions, Lesions of Endodontic Origin, and Avulsed Teeth ................................................................................................................................ 232 Chapter 33: Fluorides, Chlorhexidine, Amorphous Calcium Phosphate, and Xylitol ............. 235 Chapter 34: Pit and Fissure Sealants ........................................................................................... 241 Chapter 35: Nutritional Counseling ............................................................................................ 245 Chapter 36: Tobacco Cessation ................................................................................................... 252 1Chapter 37: Impressions, Study Casts, and Oral Appliances .................................................... 260 Chapter 38: Restorative Therapy ................................................................................................. 266 Chapter 39: Dentinal Hypersensitivity Management ................................................................. 274 Chapter 40: Local Anesthesia ....................................................................................................... 281 Chapter 41: Nitrous Oxide–Oxygen Analgesia ........................................................................... 288 Chapter 42: Persons with Disabilities.......................................................................................... 295 Chapter 43: Cardiovascular Disease ............................................................................................ 303 Chapter 44: Diabetes Mellitus ...................................................................................................... 312 Chapter 45: Oral Care of Persons with Cancer ........................................................................... 320 Chapter 46: Human Immunodeficiency Virus Infection ............................................................. 330 Chapter 47: Persons with Neurologic and Sensory Deficits ...................................................... 339 Chapter 48: Persons with Autoimmune Diseases ...................................................................... 347 Chapter 49: Renal Disease and Organ Transplantation ............................................................. 356 Chapter 50: Respiratory Diseases ................................................................................................ 364 Chapter 51: Cognitively and Developmentally Challenged Persons ........................................ 371 Chapter 52: Alcohol and Substance Abuse Problems ................................................................ 379 Chapter 53: Eating Disorders ....................................................................................................... 384 Chapter 54: Women’s Health and the Health of Their Children ............................................... 391 Chapter 55: The Older Adult ........................................................................................................ 401 Chapter 56: Persons with Fixed and Removable Dental Prostheses ........................................ 409 Chapter 57: Orofacial Clefts and Fractured Jaw ......................................................................... 416 Chapter 58: Osseointegrated Dental Implants ........................................................................... 423 Chapter 59: Persons with Orthodontic Appliances .................................................................... 430 Chapter 60: Abuse and Neglect ................................................................................................... 439 Chapter 61: Palliative Oral Care ................................................................................................... 448 Chapter 62: Practice Management ............................................................................................... 456 Chapter 63: Career Planning and Job Searching ........................................................................ 464 2PREFACE TEST BANK with Complete Questions and Solutions. To clarify, this is the TEST BANK, not the textbook. You get immediate access to download your test bank. You will receive a complete test bank; in other words, all chapters shown in the table of contents in this preview will be there. Test banks come in PDF format; therefore, you do not need specialized software to open them. 3Chapter 01: The Dental Hygiene Profession MULTIPLE CHOICE 1. What is the discipline of dental hygiene? a. The study of teeth and their supporting structures b. Brushing and flossing one’s teeth and rinsing with an antimicrobial mouth rinse twice a day, morning and night c. The study of preventive oral healthcare, including the management of behavior to prevent oral disease and promote health d. The study of those procedures that dental hygienists provide to clients ANS: C The study of teeth and their supporting structures. This answer is wrong because the discipline of dental hygiene covers much more information than the study of teeth and supporting structures. Dental hygiene focuses on the preventive measures that the teeth and supporting structures must receive, in addition to other oral healthcare steps that must be taken to promote one’s health. Brushing and flossing one’s teeth and rinsing with an antimicrobial mouth rinse twice a day, morning and night. This answer is wrong because this statement describes only one procedure within the discipline of dental hygiene. Dental hygiene is a much larger and general field of study than this simple preventive action. The study of preventive oral healthcare including the management of behavior to prevent oral disease and promote health. This answer is correct because this is the direct definition of dental hygiene. The definition can be broken down into smaller, specified divisions to further develop the discipline of dental hygiene. The study of those procedures that dental hygienists provide to clients. This answer is wrong because dental hygienists play many interrelated roles, such as clinician, educator, administrator or manager, advocate, and researcher. Although each of these roles is created to assist in dental hygiene, the discipline is not centered on the actions and procedures of the dental hygienist. REF: What is Dental Hygiene? | 1 2. Who is the professional dental hygienist? a. A licensed preventive oral health professional who has graduated from a Commission on Dental Accreditation, accredited, entry level dental hygiene program b. A licensed person who has learned on the job via a preceptorship program, such as the Alabama Dental Hygienists Program c. A dentist who has graduated from a Commission on Dental Accreditation, accredited, dental school program d. A person who has graduated from a Commission on Dental Accreditation, accredited, dental assisting program ANS: A A licensed preventive oral health professional who has graduated from a Commission on Dental Accreditation, accredited, entry level dental hygiene program. This answer is correct because to be eligible as a professional dental hygienist, the person must have graduated from an accredited dental hygiene program. A licensed person who has learned on the job via a preceptorship program, such as the Alabama Dental Hygienists Program. This answer is wrong because a dental hygienist cannot learn on the job to become a professional. Rather, they must pass 4written examinations and graduate from an accredited dental hygiene program. A dentist who has graduated from a Commission on Dental Accreditation, accredited, dental school program. This answer is wrong because a dentist has a higher degree than a dental hygienist and therefore, generally, works above a dental hygienist. It is not necessary for a dental hygienist to receive an education from a dental school. A person who has graduated from a Commission on Dental Accreditation, accredited, dental assisting program. This answer is wrong because a person graduating from an accredited dental assisting program would only be licensed as a dental assistant. REF: Who Is the Dental Hygienist? | 1 3. All of these services are provided by the majority of dental hygienists in the clinical setting except one. Which one is the exception? a. Perform periodontal maintenance care. b. Implement interventions to direct a person back to oral wellness. c. Provide fluoride varnish treatment. d. Place and remove restorations. ANS: D Perform periodontal maintenance care. This is a service provided in the clinical setting. The clinical setting allows for application of preventive and therapeutic agents related to periodontal disease. For example: subgingival sustained-release delivery systems containing chlorhexidine. Implement interventions to direct a person back to oral wellness. This is a service provided in the clinical setting. The main goal of a dental hygienist is to prevent oral disease and promote health. Therefore, if the state of an individual’s oral health changes, the dental hygienist (within the scope of the clinical setting) can provide some degree of intervention to direct the individual back to oral wellness. Provide fluoride varnish treatment. This is a service provided in the clinical setting. The clinical setting allows for application of preventive and therapeutic agents related to dental caries. Fluoride varnish treatments prolong fluoride exposure on the tooth surface for safe and effective caries control. Place and remove restorations. This service is not provided by the majority of dental hygienists in the clinical setting. Only a few dental hygienists have the certification to place restorations, while many others do not. Also, the removal of restorations is not a given action of a dental hygienist in the clinical setting. REF: Clinician | 3 4. Which of the following is a key behavior within the dental hygiene process of care? a. Observation b. Diagnosis c. Communication skills d. Client care ANS: B Observation. This answer is wrong because dental hygienists must go further than simply observing the client. The hygienist must assess the client by thoroughly collecting data. Diagnosis. This answer is correct because identifying the diagnosis is the focal point for establishing goals in the dental hygiene care plan. The client’s dental hygiene needs are determined so that specific interventions can be 5implemented. Communication skills. This answer is wrong because the communication skills are not a key behavior and are not necessary to complete the dental hygiene process. Client care. This answer is wrong because client care is not one of the steps in dental hygiene care. However, proper client care is the goal being achieved through the key behaviors. REF: What Is the Dental Hygiene Process of Care? | 1 5. Which of the following is not an environmental factor that the dental hygienist takes into account in the Human Needs Model? a. Age b. Attitudes c. Lifestyles d. Weight ANS: D Age. This answer is an environmental factor that must be taken into account because age plays a large role in the development of an individual’s oral health. Attitudes. This answer is an environmental factor that must be taken into account because it can have an effect on the dental hygiene process. Lifestyles. This answer is an environmental factor that must be taken into account because an individual’s oral health can be affected by lifestyle choices. Weight. This answer is not an environmental factor that must be taken into account because an individual’s weight does not affect their oral health. The diet choices that go along with a person’s particular weight may affect oral health, but the overall weight of an individual does not. REF: What Is the Dental Hygiene Process of Care? | 1 6. Which of the following is not one of the seven roles of a dental hygienist? a. Clinician b. Public Health c. Interpreter d. Researcher ANS: C The seven roles of a dental hygienist are clinician, public health, researcher, educator, administrator, and entrepreneur. REF: Chapter One, Table 1-1 Seven Roles of the Dental Hygienist | 4 7. What is a paradigm? a. A widely accepted worldview of a discipline that shapes the knowledge of its practitioners, educators, administrators, and researchers b. Decision-making skills that are used worldwide c. A school of thought within a discipline d. A widely accepted worldview of a discipline that shapes the direction and methods of its practitioners, educators, administrators, and researchers ANS: D A widely accepted worldview of a discipline that shapes the knowledge of its practitioners, educators, administrators, and researchers. This answer is incorrect because a paradigm does not shape the knowledge but shapes the direction and 6methods of practitioners, etc. Decision-making skills that are used worldwide. This answer is incorrect because a paradigm does not focus on decision-making skills that are accepted worldwide. A school of thought within a discipline. This answer is incorrect because it is the definition of a conceptual model. A widely accepted worldview of a discipline that shapes the direction and methods of its practitioners, educators, administrators, and researchers. This answer is correct because practitioners, educators, administrators, and researchers all accept this paradigm or worldview of discipline in major concepts selected for study and statements about major statements that define them in a global matter. REF: Dental Hygiene’s Paradigm | 5 8. Which of the following is not one of the four major concepts of paradigm for the dental hygiene discipline? a. Client b. Health and oral health c. Environment d. Nutrition ANS: D Client. This answer is a major concept of paradigm because the client is the recipient of dental hygiene care. Health and oral health. This answer is a major concept of paradigm because the discipline of dental hygiene exists to promote oral health, which influences overall health. Environment. This answer is a major concept of paradigm because factors other than dental hygiene actions affect the client’s attainment of optimal oral health. Nutrition. This answer is not a major concept of paradigm because nutrition does not identify the phenomena central to the discipline of dental hygiene in an abstract global manner. REF: BOX 1-3: Four Major Concepts of the Dental Hygiene Paradigm | 6 9. The importance of a conceptual model is to provide philosophic and practical perspectives about dental hygiene’s paradigm concepts. Dental hygiene’s paradigm is operationalized via the Human Needs Conceptual Model. a. Both statements are true. b. The first statement is true, and the second statement is false. c. The first statement is false, and the second statement is true. d. Both statements are false. ANS: A Both statements are true. Conceptual models do provide philosophic and practical perspectives about dental hygiene’s paradigm concepts; however, the models can explain dental hygiene from different perspectives as well. Also, the Human Needs Conceptual Model defines the paradigm concepts. The first statement is true; the second statement is false. Both statements are true. The first statement is false; the second statement is true. Both statements are true. Both statements are false. Both statements are true. REF: Conceptual Models | 6 10. What occurs when individuals with differing strengths and areas of expertise work 7together as equal partners to achieve better outcomes than each would achieve working alone? a. Implementation b. Collaboration c. Determination d. Concentration ANS: B Implementation. This answer is incorrect because by definition implementation is the act of putting something into effect. Implementing something can be done individually. Collaboration. This answer is correct and is demonstrated in the Collaborative Practice Model, which assumes that dentists and dental hygienists work together as colleagues. Determination. This answer is incorrect because determination does not require partners of differing strengths. Determination can be achieved individually by staying focused on the task at hand. Concentration. This answer is incorrect because concentration is just maintaining a strong focus on the task at hand. Collaboration can be done more efficiently if the partners are concentrated but is not required. REF: Collaborative Practice Model | 6 11. What is the collaborative practice conceptual model? a. Dentist and dental hygienist work together as colleagues, each offering professional expertise for the goal of providing optimum oral healthcare to the public b. Model describing the best methods of dentist and dental hygienist to work as a team c. Model showing how collaboration produces better work d. Dental hygienists and other healthcare professionals work together as colleagues, each offering professional expertise for the goal of providing optimum oral healthcare to the public ANS: A Dentist and dental hygienists work together as colleagues, each offering professional expertise for the goal of providing optimum oral healthcare to the public. Model describing the best methods of dentist and dental hygienist to work as a team. This answer is incorrect because the focus and main goal of the model is to provide optimum oral healthcare to the public, not to learn to work as a team. Model showing how collaboration produces better work. This answer is incorrect because the model focuses on providing optimum oral healthcare to the public. Collaboration between a dentist and dental hygienist is just an assisting factor to reach optimum oral healthcare. Dental hygienists and other healthcare professionals work together as colleagues, each offering professional expertise for the goal of providing optimum oral healthcare to the public. This answer is incorrect because the collaboration must be between a dentist and a dental hygienist. This plays a key role in establishing a co- therapist relationship within the Collaborative Practice Conceptual Model. REF: Collaborative Practice Model | 6-7 12. Which is not one of the five interrelated roles of a professional dental hygienist? a. Educator b. Manager 8c. Researcher d. Clients ANS: D Educator. This is one of the five interrelated roles of a professional dental hygienist. An educator explains concepts regarding oral health and disease, and their relationship to general health; demonstrates oral self-care procedures; determines client understanding; motivates behavior change; reinforces learning or desired behavior; and evaluates the client’s progress in learning. Manager. This is one of the five interrelated roles of a professional dental hygienist. A manager’s position is to guide and direct the work of others. They do this by planning, making decisions, organizing, staffing, directing, and controlling. Researcher. This is one of the five interrelated roles of a professional dental hygienist. A researcher tests the assumptions of clinical practice. Clients. This is not one of the five interrelated roles of a professional dental hygienist. The client is the individual receiving oral healthcare from the dental hygienist. REF: Roles | 2-5 13. According to the Occupational Model, the dental hygienist: a. uses a process of care to assess needs, diagnose dental hygiene problems, and plan, implement, evaluate, and document dental hygiene care. b. works together with the dentist, each offering professional expertise for the goal of providing optimum oral healthcare to the public. c. is a dental auxiliary who implements treatment plans and carries out isolated duties as directed by the supervising dentist. d. explains dental hygiene from different perspectives. ANS: C The Occupational Model5 presents the concept of dental hygiene actions as technically based. According to this model the dental hygienist is a dental auxiliary who implements treatment plans and carries out isolated duties as directed by the supervising dentist. REF: Chapter One, Conceptual Models | 6 14. Which of the following is not a setting for a dental hygiene researcher? a. Clinical practice b. Research institutions c. Hospitals d. Oral healthcare industry e. Public school programs ANS: C Clinical practice. This is a setting for a dental hygiene researcher because researchers are testing assumptions from clinical practices. Researchers may go to the clinical practice to assess the area of study. Research institutions. This is a setting for a dental hygiene researcher because this is a place where research is the prime goal and source of employment. Researchers gather together here and are able to collaborate with one another if necessary. Hospitals. This is not a setting for a dental hygiene researcher because a hospital is not primarily focused on oral healthcare, rather it is focused on the overall health of an individual. A researcher would not have the information or materials needed to do 9their studies. Oral healthcare industry. This is a setting for a dental hygiene researcher because the oral healthcare industry is the field that they are studying or researching. By working within the oral healthcare industry, the researchers can make evidence- based decisions. Public school programs. This is a setting for a dental hygiene researcher because this is a place where the researcher can transmit current concepts of health promotion and disease prevention to individuals and groups, and evaluate the educational outcomes. REF: Researcher | 3 15. The three responsibilities of the dental hygiene clinician are: a. preventive, therapeutic, educational. b. manager, educator, researcher. c. planner, organization of appointments, billing. d. communicator, planner, researcher. ANS: A Preventive, therapeutic, educational. This answer is correct because a dental hygiene clinician is expected to fulfill these areas. Preventive methods are created to promote health and prevent oral disease. Therapeutic methods are created to arrest or control oral disease. Educational methods are created to reinforce learning, evaluate understanding, demonstrate self-care techniques, determine ability to perform desired behavior, and explain oral disease and health concepts. Manager, educator, researcher. This answer is incorrect because these are not responsibilities; instead they are roles that can be played by dental hygienists based on the degree of education. Planner, organization of appointments, billing. This answer is incorrect because these are the responsibilities of an administrator or manager. Communicator, planner, researcher. This answer is incorrect because these are the responsibilities of a researcher. REF: BOX 1-2: Responsibilities of the Dental Hygiene Clinician | 3 16. What is an administrator or manager not doing when referring to dental hygiene? a. Planning b. Staffing c. Financial work d. Directing ANS: C Planning. This is done by an administrator to acknowledge priorities and decide on appropriate continuing care intervals and self-care measures. Staffing. This is done by an administrator to create a knowledgeable and stable staff, and to determine the line of authority and responsibilities of each co-worker. Financial work. This is not done by an administrator because financial work does not relate to the job of an administrator, which is to guide and direct the work of others. Directing. This is done by an administrator while managing a professional educational program and possibly serving as a dean for various schools. REF: Administrator | 5 1017. When considering the key roles of a dental hygienist, what does the client advocate most refer to? a. A dental hygienist who is working with the state legislature to change the dental practice act b. Dental hygienist’s role in protecting and supporting clients’ rights and well-being c. A person whose official position is to guide and direct the work of others d. A dental hygiene educator who is employed as a full-time faculty member ANS: B A dental hygienist who is working with the state legislature to change the dental practice act. This answer is incorrect because it does not directly relate to the client. Dental hygienist’s role in protecting and supporting clients’ rights and well-being. This is correct because the definition directly links to the client’s best interests. A person whose official position is to guide and direct the work of others. This is incorrect because this is the key role of an administrator or manager. A dental hygiene educator who is employed as a full-time faculty member. This is incorrect because this is a role of an educator. REF: What Is the Dental Hygiene Process of Care? | 1-2 18. A dental hygienist keeps up-to-date with the rapidly changing art and science of dental hygiene by doing all of the following, except one. Which one is the exception? a. Discussing updated techniques with other dental hygienists b. Making evidence-based decisions c. Using multiple research skills d. Practicing at least part-time as a dental hygienist ANS: A Discussing updated techniques with other dental hygienists. This is not done to stay up-to-date with the art and science of dental hygiene. Although discussing with other dental hygienists will draw conversation to new changes, further research and analyzing must be done to fully understand the rapid changes in the art and science of dental hygiene. Making evidence-based decisions. This is done to stay up-to-date with the art and science of dental hygiene. By looking in-depth at scientific evidence, client preferences or values, clinical client circumstances, and experiences and judgment, dental hygienists can draw conclusions and remain up-to-date in the discipline of dental hygiene. Using multiple research skills. This is done to stay up-to-date with the art and science of dental hygiene. Multiple research skills should be used to find relevant evidence and critical appraisal skills to rapidly evaluate and sort out what is valid and useful. Practicing at least part-time as a dental hygienist. This is done to stay up-to-date with the art and science of dental hygiene. By staying involved in the discipline of dental hygiene, more and more information can be learned. There are many different roles that a professional can play as a dental hygienist; any of these roles will keep a dental hygienist up-to-date with the rapid changes. REF: Researcher | 3 19. What is accreditation? a. The process of explaining the concepts of oral health and their 11relationship to general health b. The process of guiding and directing of the work of others so that they can become certified c. The process of researching a specific topic and analyzing it d. A formal, voluntary nongovernmental process that establishes a minimum set of national standards that promotes and ensures quality in education ANS: D The process of explaining the concepts of oral health and their relationship to general health. This answer is incorrect because this statement is explaining the role of an educator. The process of guiding and directing of the work of others so that they can become certified. This answer is incorrect because guiding and directing the work of others is a role played by an administrator. The process of researching a specific topic and analyzing it. This answer is incorrect because this process is performed by a dental hygienist researcher. A formal, voluntary nongovernmental process that establishes a minimum set of national standards that promotes and ensures quality in education. This answer is correct because accreditation is given to institutions or programs to ensure that the education being taught is proper and accurate. REF: Accreditation | 8 20. What professional organization promotes the profession of dental hygiene globally? a. ADHA b. NDHA c. CDHA d. IFDH ANS: D ADHA. This answer is incorrect because the professional organization is limited to the United States. NDHA. This answer is incorrect because the professional organization specifically focuses on minority professionals. CDHA. This answer is incorrect because the professional organization is limited to Canada. IFDH. This answer is correct because the professional organization includes several countries and focuses on worldwide issues of dental hygiene. REF: International Federation of Dental Hygienists | 9-10 21. What is the one most important reason why state dental practice laws were established? a. To regulate the practice of dental hygiene and dentistry b. To regulate the amount of education one must have to practice dentistry c. To ensure the best overall service to the general public d. To protect the health and welfare of the public ANS: A To regulate the practice of dental hygiene and dentistry. This answer is correct because regulating the practice will ensure all criteria are met and education is fulfilled properly. The practice will be able to run smoothly in each state, ensuring beneficial service to the public. To regulate the amount of education one must have to practice dentistry. This answer is incorrect because the amount of education one must have to practice dentistry is similar for all states so that relocating can be more 12easily accomplished. To ensure the best overall service to the general public. This answer is incorrect because it is not the most important reason. If the practice of dental hygiene and dentistry is regulated, the best overall service will be given to the general public. To protect the health and welfare of the public. This answer is incorrect because it is not the most important reason. If the practice of dental hygiene and dentistry is regulated, the health and welfare of the public will be protected. REF: Practice Acts and Licensure | 8 22. Which one of these is most descriptive of licensure? a. The process of becoming a dentist or dental hygienist b. The process of graduating from an accredited dental hygiene program and then practicing dental hygiene c. The process by which a government agency certifies that individuals are minimally qualified to practice within its jurisdiction d. All of the above ANS: C The process of becoming a dentist or dental hygienist. This answer is incorrect because the description of licensure is very broad and undetailed. The process of graduating from an accredited dental hygiene program and then practicing dental hygiene. This answer is incorrect because licensure does not require oneself to immediately begin practicing dental hygiene. This statement is also not the most descriptive. The process by which a government agency certifies that individuals are minimally qualified to practice within its jurisdiction. This answer is correct because the description is full and gives a complete idea of licensure. All of the above. This answer is incorrect because each statement is not equally descriptive so they cannot all be the most descriptive of licensure. REF: Practice Acts and Licensure | 8 23. The Canadian Dental Hygienist’s Association (CDHA) Board’s actions are directed toward attaining: a. Direct access to dental hygiene care b. Recognition by the Canadian public c. Supportive public policy and a strong national voice d. All of the above ANS: D The CDHA Board’s actions are directed toward attaining specific measurable outcomes, including the following: direct access to dental hygiene care, recognition by the Canadian public, supportive public policy and a strong national voice, interprofessional practice, professional identity and professional standards, knowledge and research, business success and workplace well-being, and leadership development. REF: Chapter One, Professional Dental Hygiene Organizations | 9 24. The dental hygienist must be in the jurisdiction in which they practice. a. licensed b. certified 13c. accredited d. educated ANS: A Licensed. This answer is correct because licensing examinations are created in each jurisdiction and must be passed by dental hygienists to receive a license to practice. Certified. This answer is incorrect because certifications are usually voluntary. Licenses are required to become a professional while certifications usually are not. Accredited. This answer is incorrect because accreditation can only be given to an institution or program, not an individual such as a dental hygienist. Educated. This answer is incorrect because dental hygienists must pass certain written examinations to practice in the jurisdiction. A simple education does not meet the standard. REF: Practice Acts and Licensure | 8 Chapter 02: Human Needs Theory and Dental Hygiene Care MULTIPLE CHOICE 1. Examples of human needs related to dental hygiene care include all of the following except one. Which one is the exception? a. Freedom from fear and stress b. Protection from health risks c. Freedom from head and neck pain d. Love and belong needs e. Wholesome facial image ANS: D Love and belonging needs is not an example of the specific eight human needs related to dental hygiene care in the Human Needs Conceptual Model of Dental Hygiene. Freedom from fear and stress, protections from health risks, freedom from head and neck pain, and a wholesome facial image are all examples of the specific eight human needs related to dental hygiene care in the Human Needs Conceptual Model of Dental Hygiene. REF: Dental Hygiene’s Eight Human Needs | 18-31 2. Protection from health risks is the need to avoid medical contraindications related to dental hygiene care and to be free from harm or danger involving the integrity of the body structure and environment around the person. With advances in thermoplastic material, boil and bite mouth guard have good retention and cover all posterior teeth. a. Both statements are true. b. Both statements are false. c. The first statement is true, and the second statement is false. d. The first statement is false, and the second statement is true. 14ANS: C The definition for the human need for protection from health risks is correct. However, boil and bite mouth guards have poor retention and do not cover all posterior teeth. The other choices are incorrect. REF: Protection From Health Risks | 18-19 3. What is the term for a tension within a person? a. Self-tolerance b. Human need c. Facial image stressors d. Immunosuppression ANS: B Human need is the term for tension within a person. Self-tolerance is the unique ability to recognize the difference between “self” and “foreign” antigens and is an incorrect choice. Facial image stressors are related to the human need for wholesome facial image and is an incorrect answer. Immunosuppression refers to the inhibition of the formation of antibodies to antigens that may be present; it is used in transplantation procedures to prevent rejection of the transplanted organ or tissue. It is an incorrect choice. REF: Background | 14 4. Human need theory was selected as the conceptual framework for the Dental Hygiene Human Needs Model because human needs transcend age, culture, gender, and nationality. a. Both the statement and the reason are correct, and they are related. b. Both the statement and the reason are correct, but they are not related. c. The statement is correct, but the reason is not. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: A Human need theory is the conceptual framework for the Dental Hygiene Human Needs Model. It was selected because human needs transcend age, culture, gender, and nationality. The other choices are incorrect. REF: Human Needs Conceptual Model of Dental Hygiene | 15 5. Which type of medications helps meet the human need for a biologically sound dentition? a. Fluoride b. NSAIDs c. Penicillamine d. Cyclosporine e. Antimalarials ANS: A Fluoride helps meet the human need for a biologically sound dentition. NSAIDs, penicillamine, cyclosporine, and antimalarials are incorrect choices. REF: Implications for Dental Hygiene Care | 29 156. Which of the following represents a human need deficit in the need for a biologically sound dentition? a. Gingival bleeding b. No dental examination in the last 2 years c. Vital signs outside of normal limits d. Mucogingival problems e. Concern about confidentiality ANS: B No dental examination in the last 2 years is a sign of a human need deficit in the need for a biologically sound dentition. Gingival bleeding, vital signs outside of normal limits, mucogingival problems, and concerns about confidentiality are incorrect choices. REF: Assessment | 27-29 7. Periodontal disease is epidemic in the United States and elsewhere. The human need for skin and mucous membrane integrity of the head and neck is usually unmet in clients seeking dental hygiene care. a. Both statements are true. b. Both statements are false. c. The first statement is true, and the second statement is false. d. The first statement is false, and the second statement is true. ANS: A Over 80% of the population in the United States and elsewhere has some form of periodontal disease. Therefore, the human need for skin and mucous membrane integrity of the head and neck is usually unmet in clients seeking dental hygiene care. The other choices are incorrect. REF: Implications for Dental Hygiene Care | 26 8. Which human need is associated with dissatisfaction with facial profile? a. Protection from health risks b. Biologically sound and functional dentition c. Wholesome facial image d. Freedom from stress ANS: C Dissatisfaction with one’s facial profile is associated with a deficit in the human need for a wholesome facial image. Protection from health risks, biologically sound and functional dentition, and freedom from stress are not associated with dissatisfaction with one’s facial profile. REF: Wholesome Facial Image | 23 9. Pockets greater than 4 mm, attachment loss greater than 4 mm, and bleeding on probing are all signs of a deficit in which human need? a. Wholesome facial image b. Protection from health risks c. Biologically sound and functional dentition d. Skin and mucous membrane integrity of head and neck e. Chronic cutaneous lupus erythematosus ANS: D 16Pockets greater than 4 mm, attachment loss greater than 4 mm, and bleeding on probing are signs of a deficit in the human need for skin and mucous membrane integrity of the head and neck. The other choices are incorrect. REF: Assessment | 24 10. Which of the following is the most common concern associated with the human need for freedom from head and neck pain? a. Concerns about disease transmission b. Concerns about fluoride toxicity c. Report of pain d. Concern about radiation exposure e. Has questions about oral disease ANS: C Report of pain is the most common symptom associated with the human need for freedom from pain. The other choices are incorrect. REF: Assessment | 21 11. The dental hygienist should not evaluate clients with a deficit in protection from health risks because the domain of the dental hygienist is only the oral cavity. a. Both the statement and the reason are correct, and they are related. b. Both the statement and the reason are correct, but they are not related. c. The statement is correct, but the reason is not. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: E Patients with a deficit in protection from health risks must be evaluated by the dental hygienist to avoid medical contraindications related to dental hygiene care and to be free from harm or danger involving the integrity of the body’s structure. The domain of dental hygiene is represented by the eight human needs related to dental hygiene care. The other choices are incorrect. REF: Assessment | 18-19 12. Using a human needs assessment tool for dental hygiene care is an appropriate way for dental hygienists to diagnose human need deficits related to dental hygiene care. Patients having human need deficits should be referred for further medical evaluation. a. Both statements are true. b. Both statements are false. c. The first statement is true, and the second statement is false. d. The first statement is false, and the second statement is true. ANS: C Using a risk assessment tool for dental hygiene care is an appropriate way for dental hygienists to diagnose human need deficits related to dental hygiene care. However, not all human need deficits require referral of the client for further medical evaluation. The other choices are incorrect. REF: Concept 4: Dental Hygiene Actions | 15-17 13. Most clients with deficits in the human need for protection from health 17risks require prophylactic antibiotics before dental and dental hygiene treatment because they are immunosuppressed and prone to infection. a. Both the statement and the reason are correct, and they are related. b. Both the statement and the reason are correct, but they are not related. c. The statement is correct, but the reason is not. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: E Many clients with deficits in the human need for protection from health risks do not require prophylactic antibiotics before dental and dental hygiene treatment. Prophylactic antibiotics are recommended when clients have a condition (e.g., complete hip replacement surgery within the past 2 years) that places them at risk for serious infection such as endocarditis. The other choices are incorrect. REF: Protection From Health Risks | 18-19 14. Which human need most often presents with bleeding on probing? a. Wholesome facial image b. Protection from health risks c. Biologically sound and functional dentition d. Skin and mucous membrane integrity of the head and neck e. Freedom from head and neck pain ANS: D Skin and mucous membrane integrity of the head and neck has a deficit that most often presents with bleeding on probing. The other choices are incorrect. REF: Assessment | 24 15. Daily fluoride therapy is often recommended for clients with a deficit in the need for a biologically sound and functional dentition because they are prone to xerostomia. a. Both the statement and the reason are correct, and they are related. b. Both the statement and the reason are correct, but they are not related. c. The statement is correct, but the reason is not. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: A Daily fluoride therapy is often recommended for clients with a deficit in the need for a biologically sound and functional dentition autoimmune disease because treatment of incipient carious lesions (such as white spots) with fluoride will remineralize them. The other choices are incorrect. REF: Biologically Sound and Functional Dentition | 27-29 16. Power toothbrushes are recommended for clients who present with biofilm removal challenges. Which human need that, if in deficit, would suggest the need for this oral health device? a. Protection from health risks b. Freedom from head and neck pain c. Freedom from stress d. Responsibility for oral health 18e. Wholesome facial image f. Biologically sound dentition ANS: D A deficit in the human need for responsibility for oral health would be inadequate plaque biofilm control. Power toothbrushes are recommended for clients who present with biofilm removal challenges. The other choices are incorrect. REF: Implications for Dental Hygiene Care | 31 17. Medical consultation often is recommended for clients with a deficit in their human need for protection from health risks. The need for medical treatment may supersede the oral treatment planned. a. Both statements are true. b. Both statements are false. c. The first statement is true, and the second statement is false. d. The first statement is false, and the second statement is true. ANS: A Medical consultation often is recommended for clients with a deficit in their human need for protection from health risks to avoid medical contraindications related to dental hygiene care. The need for medical treatment may supersede the oral treatment planned to be free from harm or danger involving the integrity of the body structure. The other choices are incorrect. REF: Implications for Dental Hygiene Care | 19 18. Regular maintenance intervals of no more than 3 months are recommended for clients with a deficit in skin and mucous membrane integrity of the head and neck because they are not motivated to maintain oral health at home. a. Both the statement and the reason are correct, and they are related. b. Both the statement and the reason are correct, but they are not related. c. The statement is correct, but the reason is not. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: C Regular maintenance intervals of no more than 3 months are recommended for clients with a deficit in skin and mucous membrane integrity of the head and neck. However, clients may be highly motivated to maintain oral health at home, but may be unable to do a thorough job of reducing the effects of pathogenic oral bacteria for a period greater than 2 to 3 months. The other choices are incorrect. REF: Implications for Dental Hygiene Care | 24-27 19. A deficit in the need for a wholesome facial image is a dissatisfaction with the appearance of one’s teeth. This need is in deficit only if the client reports dissatisfaction. a. Both statements are true. b. Both statements are false. c. The first statement is true, and the second statement is false. d. The first statement is false, and the second statement is true. ANS: A A deficit in the need for a wholesome facial image is a dissatisfaction with the appearance of one’s teeth. This need is in deficit only if the client reports 19dissatisfaction rather than basing the deficit on the clinician dissatisfaction. The other choices are incorrect. REF: Wholesome Facial Image | 23 20. How many human needs have been identified in the Dental Hygiene Human Needs Conceptual Model as being related to dental hygiene care? a. 20 b. 11 c. 14 d. 8 e. Over 30 ANS: D Currently, eight human needs have been identified in the Dental Hygiene Human Needs Conceptual Model as being related to dental hygiene care; 20, 11, 14, and over 30 are incorrect. REF: Concept 4: Dental Hygiene Actions | 15-17 21. All of the following are signs that the client’s human need for a biologically and functional dentition is in deficit except one. Which one is the exception? a. No dental evaluation in the last 2 years b. Missing teeth c. Need for prophylactic antibiotics d. Teeth with erosion e. Ill-fitting dentures ANS: C A need for prophylactic antibiotics is not a sign of a deficit in the client’s human need for a biologically sound and functional dentition. No dental evaluation in the last 2 years, missing teeth, teeth with erosion, and ill-fitting dentures are all examples of deficits in the human need for a biologically sound and functional dentition. REF: Assessment | 27-29 22. Local anesthesia and nitrous oxide-oxygen sedation are recommended for a client who has a deficit in the human need for freedom from head and neck pain because these modalities help to prevent a medical emergency. a. Both the statement and the reason are correct, and they are related. b. Both the statement and the reason are correct, but they are not related. c. The statement is correct, but the reason is not. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: C Local anesthesia and nitrous oxide sedation are recommended for clients who are deficient in the need for freedom from head and neck pain. However, the rationale is that they block or decrease one’s appreciation for the severity of pain, not because these modalities help to prevent a medical emergency during dental hygiene care. The other choices are incorrect. REF: Implications for Dental Hygiene Care | 21-23 23. From the following list, select those that should be part of documentation of the 20dental hygiene appointment with clients who have a deficit in the need for a wholesome facial image. a. Process b. Outcomes c. Extent to which goals are met d. Client’s response to care e. Referrals needed f. Adverse reactions g. Future treatment h. All of the above ANS: H All of the choices should be part of documentation of the dental hygiene appointment with all clients who have a deficit in any of the eight human needs related to dental hygiene care. REF: Concept 4: Dental Hygiene Actions | 15-17 24. Prophylactic antibiotics are often required in clients with a deficit in protection from health risk because they report a history of a heart murmur resulting from rheumatic fever. a. Both the statement and the reason are correct, and they are related. b. Both the statement and the reason are correct, but they are not related. c. The statement is correct, but the reason is not. d. The statement is not correct, but the reason is correct. e. Neither the statement nor the reason is correct. ANS: A Patients who report a history of a heart murmur resulting from rheumatic fever have a deficit in protection from health risks. Such clients often require prophylactic antibiotics because they are more susceptible to developing endocarditis. The other choices are incorrect. REF: Assessment | 18-19 25. Which human need is characterized by the need to feel safe, be free from emotional discomfort in the oral healthcare environment, and to receive appreciation, attention, and respect from others? a. Conceptualization and understanding b. Freedom from head and neck pain c. Freedom from stress d. Responsibility for oral health e. Wholesome facial image ANS: C The human need for freedom from stress is characterized by the need to feel safe, be free from emotional discomfort in the oral healthcare environment, and to receive appreciation, attention, and respect from others. Conceptualization and understanding, freedom from head and neck pain, responsibility for oral health, and wholesome facial image are incorrect answers. REF: Freedom from Fear and Stress | 19 26. Which human need is characterized by the need to be exempt from physical 21discomfort in the head and neck area? a. Conceptualization and understanding b. Freedom from head and neck pain c. Freedom from stress d. Responsibility for oral health e. Wholesome facial image ANS: B The human need for freedom from head and neck pain is characterized by the need to be exempt from physical discomfort in the head and neck area. Conceptualization and understanding, freedom from stress, responsibility for oral health, and wholesome facial image are incorrect answers. REF: Freedom from Pain | 21 MULTIPLE RESPONSE 1. Select the four paradigm concepts related to the dental hygiene human needs theory. a. Client b. Environment c. Patient d. Community e. Infection f. Dental hygiene actions g. Total client care h. Health/oral health ANS: A, B, F, H Client, environment, dental hygiene actions, and health/oral health are the four paradigm concepts related to the dental hygiene human needs theory. Patient, community, infection, and total client care are not paradigm concepts related to the dental hygiene human needs theory. REF: Human Needs Conceptual Model of Dental Hygiene | 15-17 2. Select the signs and symptoms of a deficit in skin and mucous membrane integrity of the head and neck. a. Gingival inflammation b. Bleeding on probing c. Probing depths greater than 4 mm d. Anemia e. Xerostomia f. Clinical attachment loss greater than 4 mm g. Tinnitus h. Extraoral tenderness or swelling ANS: A, B, C, F, H Gingival inflammation, bleeding on probing, probing depths greater than 4 mm, clinical attachment loss greater than 4 mm, and extraoral tenderness or swelling are all signs and symptoms of a deficit in skin and mucous membrane integrity of the head and neck. Anemia, xerostomia, and tinnitus are incorrect choices. REF: Assessment | 24 223. Select the four deficits in the human need for a biologically sound and functional dentition. a. Missing teeth b. Vital signs outside of normal limits c. Concern about appearance of teeth d. Teeth with signs of disease e. Gingival inflammation f. Ill-fitting dentures g. Chewing difficulties ANS: A, D, F, G Missing teeth, teeth with signs of disease, ill-fitting dentures, and chewing difficulties are four deficits in the human need for a biologically sound and functional dentition. Vital signs outside of normal limits, concern about appearance of teeth, and gingival inflammation are not associated with a deficit in the human need for a biologically sound and functional dentition. REF: Assessment | 27-29 MATCHING For each human need, select the appropriate sign or symptom associated with a deficit in that human need. a. Wholesome facial image b. Skin and mucous membrane integrity of the head and neck c. Biologically sound and functional dentition d. Freedom from stress e. Responsibility for oral health 1. Concern about cost 2. Missing teeth 3. Bleeding on probing 4. Presence of plaque biofilm and calculus 5. Halitosis 1. ANS: E 2. ANS: C 3. ANS: B 4. ANS: A 5. ANS: D REF: Dental Hygiene’s Eight Human Needs | 18-31 REF: Dental Hygiene’s Eight Human Needs | 18-31 REF: Dental Hygiene’s Eight Human Needs | 18-31 REF: Dental Hygiene’s Eight Human Needs | 18-31 REF: Dental Hygiene’s Eight Human Needs | 18-31 Chapter 03: Evidence-Based Decision Making MULTIPLE CHOICE 231. Which of the following components define evidence-based practice? a. Clinical judgment and expertise b. Client values/preferences c. Scientific research d. Both a and c e. Options a, b, and c ANS: E Clinical judgment and expertise, client values/preferences, and scientific research are all components of an evidence-based practice. REF: What is Evidence-Based Decision-Making? | 34 2. The purpose of evidence-based decision-making (EBDM) is to: a. emphasize new research findings. b. close the gap between research and practice. c. defer to clients’ wishes. d. use expert opinions. e. do none of the above. ANS: B The purpose of EBDM is to close the gap between research and practice. Emphasizing new research findings, deferring to clients’ wishes, and use of expert opinions are not part of the stated purpose of EBDM. REF: Competencies | 34 3. Being a good consumer of research literature means you: a. understand what you are reading. b. can identify the level of evidence. c. know how much confidence you can put into the findings. d. Both a and c are correct. e. Options a, b, and c are correct. ANS: E Being a good consumer of research literature means you understand what you are reading, can identify the level of evidence, and know how much confidence you can put into the findings. REF: Competencies | 34 4. Which of the following distinguishes EBDM from traditional decision making? a. Client preferences or values b. Clinical circumstances c. Clinician’s experience and judgment d. Scientific evidence e. All of the above ANS: D The use of scientific evidence distinguishes EBDM from traditional decision making. Client preferences or values, clinical circumstances, and the clinician’s experience and judgment are part of both traditional decision-making and EBDM. REF: Competencies | 34 245. Which of the following can generate questions in practice? a. Client care issues b. Client clinical condition c. Clinical problems d. Clinician’s interest e. All of the above ANS: E Client care issues, the client’s clinical condition, clinical problems, and the clinician’s interest can all generate questions in practice. REF: Principals of Evidence-Based Decision-Making | 34 6. Which of the following is a true statement? a. Evidence alone does not tell practitioners what to do. b. All evidence is equal on the hierarchy. c. The number of studies increase as you move up the hierarchy. d. The clinical relevance of studies decreases as you move up the hierarchy. e. None of the above are true statements. ANS: A Evidence alone does not tell practitioners what to do is a true statement. All of the other statements are incorrect. REF: Principals of Evidence-Based Decision-Making | 34 7. Primary research includes all of the following except: a. experimental studies. b. observational studies. c. systematic reviews. d. case control studies. e. cohort studies. ANS: C Primary research includes experimental studies, observational studies, case control studies, and cohort studies, but it does not include systematic reviews. REF: Evidence Sources and Levels of Evidence | 34-35 8. Characteristics of experimental studies include: a. testing cause and effect. b. describing already existing conditions. c. testing potentially harmful substances. d. both b and c. e. options a, b, and c. ANS: A Characteristics of an experimental study include testing cause and effect. Describing already existing conditions and testing potentially harmful substances are characteristics of observational research. REF: Evidence Sources and Levels of Evidence | 34-35 259. Characteristics of secondary research include the following except: a. filtered, preappraised research. b. meta-analyses. c. systematic reviews. d. case reports. e. research on already conducted research. ANS: D Secondary research includes filtered, preappraised research, meta-analyses, systematic reviews, and research on already conducted research. Case reports are characteristic of primary research. REF: Evidence Sources and Levels of Evidence | 35 10. Characteristics of nonexperimental research include: a. making observations between exposures and diseases. b. ability to conduct studies prospectively. c. ability to conduct studies retrospectively. d. both a and c. e. options a, b, and c. ANS: E Characteristics of nonexperimental research include making observations between exposures and diseases, the ability to conduct studies prospectively, and the ability to conduct studies retrospectively. REF: Figure 3-2: Hierarchy of Research Designs and Levels of Scientific Evidence | 35 11. Which of the following are considered Level 1 evidence? a. RCTs, systematic reviews, case reports b. Systematic reviews, meta-analyses, cohort studies c. RCTs, systematic reviews, meta-analyses d. RCTs, cohort studies, case control studies e. Case series, case control studies, RCTs ANS: C RCTs, systematic reviews, and meta-analyses are considered Level 1 evidence. The remaining choices are mixtures of the levels of evidence. REF: Figure 3-2: Hierarchy of Research Designs and Levels of Scientific Evidence | 35 12. The AHA Guidelines on Prevention of Infective Endocarditis changed most recently because of: a. more people dying from dental procedures. b. quality of evidence. c. dental professionals not following the guidelines. d. client compliance. e. a change in medications available. ANS: B The AHA Guidelines on Prevention of Infective Endocarditis changed most recently because of the quality of evidence. The remaining statements were not stated reasons for the change. REF: Evidence Sources and Levels of Evidence | 36 2613. Which of the following organizations is solely dedicated to producing systematic reviews? a. American Academy of Pediatric Dentistry b. American Academy of Periodontology c. American Dental Association d. Centers for Disease Control and Prevention e. Cochrane Collaboration ANS: E The sole purpose of the Cochrane Collaboration is to produce systematic reviews. Systematic reviews are not the sole purpose of the American Academy of Pediatric Dentistry, American Academy of Periodontology, American Dental Association, or the Centers for Disease Control and Prevention. REF: Evidence Sources and Levels of Evidence | 36 14. EBDM is now possible due primarily to which factor(s)? a. Scientific databases b. Computer access c. Information explosion d. Both a and b e. Both a and c ANS: D EBDM is now possible due primarily to scientific databases and computer access. The explosion of information is a reason why EBDM is needed, but not a factor in making it possible. REF: EBDM Process and Skills: A Practical Application | 37 15. The first step in the EBDM process is: a. finding the best evidence. b. applying the results to client care. c. asking a good clinical question. d. evaluating the resu