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Chapter 01: Patient Evaluation and Risk Assessment
Test Bank Little: Dental Management of the Medically
Compromised Patient, 10th Edition All Chapters 1 to 30
MULTIPLE CHOICE
1. Elective dental care should be deferred for patients with severe,
uncontrolled hypertension, meaning that the blood pressure is greater
than or equal to mm Hg.
a.
200/140
b.
180/140
c.
180/110
d.
160/110
ANSWER: C
Elective dental care should be deferred for patients with severe,
uncontrolled hypertension, which is blood pressure greater than or
equal to 180/110 mm Hg, until the condition can be brought under
control.
2. The American Heart Association currently recommends antibiotic
prophylaxis for a patient with which of the following cardiac conditions?
a.
Mitral valve prolapse
b.
Prosthetic heart valve
c.
Rheumatic heart disease
d.
Pacemakers for cardiac arrhythmias
ANSWER: B
Previously, the American Heart Association (AHA) recommended antibiotic
prophylaxis for many patients with heart murmurs caused by valvular
disease (e.g., mitral valve prolapse, rheumatic heart disease) in an effort
to prevent infective endocarditis; however, current guidelines omit this
recommendation on the basis of accumulated scientific evidence. If a
murmur is due to certain specific cardiac conditions (e.g., previous
endocarditis, prosthetic heart valve, complex congenital cyanotic heart
disease), the AHA continues to recommend antibiotic prophylaxis for most
dental procedures.
3. One consequence of chronic hepatitis (B or C) or cirrhosis of the liver is
decreased ability of the body to certain drugs, including local
anesthetics and analgesics.
a.
absorb
b.
distribute
c.
metabolize
d.
excrete
ANSWER: C
Patients also may have chronic hepatitis (B or C) or cirrhosis, with
impairment of liver function. This deficit may result in prolonged
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bleeding and less efficient metabolism of certain drugs, including
local anesthetics and analgesics.
4. Which of the following symptoms and signs is most consistent with allergy?
a.
Heart palpitations
b.
Itching
c.
Vomiting
d.
Fainting
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ANSWER: B
Symptoms and signs consistent with allergy include itching, urticaria
(hives), rash, swelling, wheezing, angioedema, runny nose, and tearing
eyes. Isolated signs and symptoms such as nausea, vomiting, heart
palpitations, and fainting generally are not of an allergic origin but rather
are manifestations of drug intolerance, adverse side effects, or
psychogenic reactions.
5. Which of the following is true of the patient with a history of tuberculosis?
a.
A positive result on skin testing means that the person has active TB.
b.
Most patients who become positive skin testers develop active disease.
c.
Patients with acquired immunodeficiency syndrome (AIDS) have
a high incidence of tuberculosis.
d.
A diagnosis of active TB is made by a purified protein derivative (PPD)
skin test.
ANSWER: C
The potential coexistence of tuberculosis and acquired immunodeficiency
syndrome (AIDS) should be explored because patients with AIDS have a
high incidence of tuberculosis. A positive result on skin testing means
specifically that the person has at some time been infected with TB, not
necessarily that active disease is present. Most patients who become
positive skin testers do not develop active disease. A diagnosis of active
TB is made by chest x-ray, imaging, sputum culture, and clinical
examination.
6. Vasoconstrictors should be avoided in patients who cocaine or
methamphetamine users because these agents may precipitate .
a.
severe hypotension
b.
severe hypertension
c.
respiratory depression
d.
cessation of intestinal peristalsis
ANSWER: B
Vasoconstrictors should be avoided in patients who are cocaine or
methamphetamine users because the combination may precipitate
arrhythmias, MI, or severe hypertension.
7. It has been shown that the risk for occurrence of a serious perioperative
cardiovascular event (e.g., MI, heart failure) is increased in patients who
are unable to meet a -MET (metabolic equivalent of task) demand during
normal daily activity.
a.
4
b.
6
c.
8
d.
10
ANSWER: A
Daily activities requiring 4 METs include level walking at 4 miles/hour or
climbing a flight of stairs. Activities requiring greater than 10 METs include
swimming and singles tennis. An exercise capacity of 10 to 13 METs
indicates excellent physical conditioning.
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8. Which of the following alterations in the fingernails is associated with
cirrhosis?
a.
Yellowing
b.
Clubbing
c.
White discoloration
d.
Splinter hemorrhages
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Chapter 01: Patient Evaluation and Risk Assessment
Test Bank Little: Dental Management of the Medically
Compromised Patient, 10th Edition All Chapters 1 to 30
MULTIPLE CHOICE
1. Elective dental care should be deferred for patients with severe,
uncontrolled hypertension, meaning that the blood pressure is greater
than or equal to mm Hg.
a.
200/140
b.
180/140
c.
180/110
d.
160/110
ANSWER: C
Elective dental care should be deferred for patients with severe,
uncontrolled hypertension, which is blood pressure greater than or
equal to 180/110 mm Hg, until the condition can be brought under
control.
2. The American Heart Association currently recommends antibiotic
prophylaxis for a patient with which of the following cardiac conditions?
a.
Mitral valve prolapse
b.
Prosthetic heart valve
c.
Rheumatic heart disease
d.
Pacemakers for cardiac arrhythmias
ANSWER: B
Previously, the American Heart Association (AHA) recommended antibiotic
prophylaxis for many patients with heart murmurs caused by valvular
disease (e.g., mitral valve prolapse, rheumatic heart disease) in an effort
to prevent infective endocarditis; however, current guidelines omit this
recommendation on the basis of accumulated scientific evidence. If a
murmur is due to certain specific cardiac conditions (e.g., previous
endocarditis, prosthetic heart valve, complex congenital cyanotic heart
disease), the AHA continues to recommend antibiotic prophylaxis for most
dental procedures.
3. One consequence of chronic hepatitis (B or C) or cirrhosis of the liver is
decreased ability of the body to certain drugs, including local
anesthetics and analgesics.
a.
absorb
b.
distribute
c.
metabolize
d.
excrete
ANSWER: C
Patients also may have chronic hepatitis (B or C) or cirrhosis, with
impairment of liver function. This deficit may result in prolonged
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bleeding and less efficient metabolism of certain drugs, including
local anesthetics and analgesics.
4. Which of the following symptoms and signs is most consistent with allergy?
a.
Heart palpitations
b.
Itching
c.
Vomiting
d.
Fainting
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ANSWER: B
Symptoms and signs consistent with allergy include itching, urticaria
(hives), rash, swelling, wheezing, angioedema, runny nose, and tearing
eyes. Isolated signs and symptoms such as nausea, vomiting, heart
palpitations, and fainting generally are not of an allergic origin but rather
are manifestations of drug intolerance, adverse side effects, or
psychogenic reactions.
5. Which of the following is true of the patient with a history of tuberculosis?
a.
A positive result on skin testing means that the person has active TB.
b.
Most patients who become positive skin testers develop active disease.
c.
Patients with acquired immunodeficiency syndrome (AIDS) have
a high incidence of tuberculosis.
d.
A diagnosis of active TB is made by a purified protein derivative (PPD)
skin test.
ANSWER: C
The potential coexistence of tuberculosis and acquired immunodeficiency
syndrome (AIDS) should be explored because patients with AIDS have a
high incidence of tuberculosis. A positive result on skin testing means
specifically that the person has at some time been infected with TB, not
necessarily that active disease is present. Most patients who become
positive skin testers do not develop active disease. A diagnosis of active
TB is made by chest x-ray, imaging, sputum culture, and clinical
examination.
6. Vasoconstrictors should be avoided in patients who cocaine or
methamphetamine users because these agents may precipitate .
a.
severe hypotension
b.
severe hypertension
c.
respiratory depression
d.
cessation of intestinal peristalsis
ANSWER: B
Vasoconstrictors should be avoided in patients who are cocaine or
methamphetamine users because the combination may precipitate
arrhythmias, MI, or severe hypertension.
7. It has been shown that the risk for occurrence of a serious perioperative
cardiovascular event (e.g., MI, heart failure) is increased in patients who
are unable to meet a -MET (metabolic equivalent of task) demand during
normal daily activity.
a.
4
b.
6
c.
8
d.
10
ANSWER: A
Daily activities requiring 4 METs include level walking at 4 miles/hour or
climbing a flight of stairs. Activities requiring greater than 10 METs include
swimming and singles tennis. An exercise capacity of 10 to 13 METs
indicates excellent physical conditioning.
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8. Which of the following alterations in the fingernails is associated with
cirrhosis?
a.
Yellowing
b.
Clubbing
c.
White discoloration
d.
Splinter hemorrhages
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