Test Bank for Modern Dental Assisting, 13th Edition, Doni Bird, Debbie Robinson

Test Bank for Modern Dental Assisting, 13th Edition, Doni Bird, Debbie Robinson Acute chemical toxicity results from high levels of exposure over a short period. The victim feels the effects immediately and may show symptoms of dizziness, fainting, headache, nausea, or vomiting. A chronic chemical toxicity involves repeated exposures over a long period. Chemical resistance refers to a material that prevents the hazardous chemical from being in contact with the tissue. Neoprene or nitrile gloves are examples of materials that are chemical resistant. Dizziness, headache, nausea, and vomiting are not considered symptoms of a mild exposure. When dealing with hazardous chemicals, any exposure can be considered serious. DIF: Comprehension REF: p. 334 OBJ: 2 TOP: CDA, CG, VII. Office Operations 4. Which of the following is a form of toxicity that can be caused by chronic benzene exposure? a. Headache b. Dizziness c. Unconsciousness d. Leukemia ANS: D Leukemia, a cancer of white blood cells, represents an example of toxicity caused by chronic exposure to low levels of benzene. A single exposure to a high concentration of benzene (acute toxicity) can cause dizziness, headache, and unconsciousness. DIF: Comprehension REF: p. 334 OBJ: 2 TOP: CDA, CG, VII. Office Operations 5. Latex gloves worn during patient care do not provide adequate protection when handling chemicals because: a. they are likely to tear. b. the latex in the gloves degrades when exposed to chemical disinfectants. c. they have many pinholes that are responsible for leaks. d. they will chemically react and create toxic fumes. ANS: B Latex gloves worn during patient care do not provide adequate protection when handling chemicals, because the latex in the gloves degrades when exposed to chemical disinfectants. This creates a wicking action that will actually pull contaminants and chemicals through the glove. DIF: Comprehension REF: p. 334 OBJ: 2 TOP: CDA, CG, VII. Office Operations 6. If a small mercury spill occurs in the dental office, the assistant should: a. call the HAZ-MAT team. b. call the EPA. c. get the mercury spill kit, a mask, and utility gloves. d. make a report and tell the dentist. ANS: C A dental practice working with amalgam should have a mercury spill kit, and the assistant should wear a mask and utility gloves when cleaning up a mercury spill. A trained dental assistant should be capable of responding to and controlling a mercury spill. The dentist should be informed of the incident, but a report is not required. DIF: Comprehension REF: p. 335 OBJ: 2 TOP: CDA, CG, VII. Office Operations 7. Eyewash units: a. must be wall mounted. b. irrigate the eyes with a strong, narrow flow of water, to bathe away contaminants. c. must be flushed yearly to reduce microbial content in the waterline, according to some manufacturers. d. must be installed in every workplace where chemicals are used, according to OSHA regulations. ANS: D Eyewash units must be installed in every workplace where chemicals are used, according to OSHA regulations. The standard eyewash unit attaches directly to existing faucets for emergencies but still allows normal faucet use. The wall-mounted eyewash station is an alternative to the sink-mounted style. The units irrigate eyes with a soft, wide flow of water. Some manufacturers of eyewash units recommend a weekly 3-minute flushing to reduce microbial content in the waterline. DIF: Comprehension REF: p. 335 OBJ: 2 TOP: CDA, CG, VII. Office Operations 8. Wastes are classified as hazardous if they are: a. ignitable. b. ingestible. c. ultrasonic. d. plastic. ANS: A A waste is classified as hazardous if it is ignitable. Ingestible, ultrasonic, and plastic are not characteristics of hazardous waste. DIF: Comprehension REF: p. 336 OBJ: 2 TOP: CDA, CG, VII. Office Operations 9. The Hazard Communication Standard requires employers to inform their employees about the of chemicals that they use in the workplace. a. identity and hazards b. manufacturing process c. chemical structure d. natural and synthetic origins ANS: A The Hazard Communication Standard requires employers to inform their employees about the identity and hazards of chemicals that they use in the workplace. It does not address the manufacturing process or require that employees be informed of the chemical structure (although the chemical structure may be found on MSDS sheets) or require that employees be informed of the natural and synthetic origins. DIF: Recall REF: p. 337 OBJ: 3 TOP: CDA, CG, VII. Office Operations 10. The written program portion of the Hazard Communication Program: a. must identify all the employers in the office who are exposed to hazardous chemicals. b. describes how to respond to chemical emergencies. c. is not a requirement for an office with fewer than 15 employees. d. describes employer, but not staff, training. ANS: B The written program portion of the Hazard Communication Program describes how to respond to chemical emergencies such as spills or exposures. The written program portion of the Hazard Communication Program must identify, by name, all the employees, rather than employers, in the office who are exposed to hazardous chemicals. The written program portion of the Hazard Communication Program does not specify a minimum number of employees. The written program portion of the Hazard Communication Program describes staff training. If several dentists work in one clinic or practice, all employers must be aware of hazards and protective measures so that they can train their employees. DIF: Comprehension REF: p. 337 OBJ: 3 TOP: CDA, CG, VII. Office Operations 11. Which of the following is true of Safety Data Sheets (SDS)? a. They are supplied by the Occupational Safety and Health Administration (OSHA). b. The SDS should be organized in binders so that employees can locate a particular SDS. c. They should be attached to each product that is associated with that particular SDS. d. The SDS should be retained for 5 years. ANS: B The manufacturer of a product that contains chemicals is required to supply the dental office with an SDS for the product. SDS often are enclosed in the package with the product and usually can be downloaded from the manufacturer’s website as well. These sheets should be organized in binders so that employees have ready access to them and can easily locate a particular SDS. DIF: Comprehension REF: p. 337 OBJ: 3 TOP: CDA, CG, VII. Office Operations 12. For continuing employees, Hazard Communication Program training is required: a. only at the time of initial hiring. b. once a month. c. twice a year. d. once a year. ANS: D Hazard Communication Program training is required once a year for all continuing employees. Hazard Communication Program training is required when a new employee is hired, when a new chemical product is added to the office, and once a year for all continuing employees. DIF: Recall REF: p. 339 OBJ: 3 TOP: CDA, CG, VII. Office Operations 13. When a chemical is transferred to a different container, the new container must be labeled with: a. an official label obtained from the manufacturer of the chemical product. b. an official label obtained from the EPA. c. any label, providing the labeling system is easy to use and all employees are properly trained to understand and read the label. d. a reduced size photocopy of the label from the original container. ANS: C When a chemical is transferred to a different container, the new container can be labeled with any label, providing the labeling system is easy to use and all employees are properly trained to understand and read the label. Manufacturers provide the MSDS; however, they do not provide an official label. The EPA does not provide labels. It is impossible to reduce the size of the label from the original container enough to fit some of the secondary containers and still be legible. DIF: Application REF: pp. 339-340 OBJ: 3 TOP: CDA, CG, VII. Office Operations 14. An example of regulated waste that requires special disposal is: a. human tissue. b. food. c. saliva-soaked gauze. d. a used patient bib. ANS: A Human tissue is considered regulated waste and requires special disposal. Food, saliva-soaked gauze, or a used patient bib are not considered regulated waste. DIF: Comprehension REF: p. 342 OBJ: 4 TOP: CDA, CG, VII. Office Operations 15. All waste containers that hold potentially infectious materials must: a. have a red bag. b. be labeled with the biohazard symbol. c. have special disposal. d. be labeled as infectious waste. ANS: B All waste containers that hold potentially infectious materials must be labeled with the biohazard symbol. As long as the bag has the international biohazard symbol, it does not have to be red. Regulated waste requires special disposal, but “potentially infectious materials” are considered nonregulated and do not need to have special disposal. The label for infectious waste is the international biohazard symbol. DIF: Recall REF: p. 342 OBJ: 4 TOP: CDA, CG, VII. Office Operations 16. Scrap dental amalgam should be collected and stored in a designated airtight container: a. under photographic developer solution. b. under photographic fixer solution. c. under water. d. that is dry. ANS: D Scrap dental amalgam should be collected and stored in a designated, dry, airtight container. Storing scrap dental amalgam in an airtight container under photographic developer, fixer or water is not an accepted protocol. DIF: Recall REF: p. 342 OBJ: 4 TOP: CDA, CG, VII. Office Operations 17. Lead foil from the radiographic film package should be: a. recycled as scrap metal in the same container as scrap dental amalgam. b. recycled as scrap metal in a designated, separate container. c. sterilized in an autoclave and then disposed in the regular trash. d. disposed in the regular trash without any treatment prior to disposal. ANS: B Lead foil from radiographic film packages is easily recyclable and should not be disposed of in the regular trash. Eastman Kodak offers a mail-in service to recycle this material. Because lead is considered a hazardous material, it is unacceptable to dispose of lead foil in the regular trash. DIF: Comprehension REF: p. 343 OBJ: 4 TOP: CDA, CG, VII. Office Operations 18. The government agency responsible for enforcing rules regarding the disposal of regulated waste is the: a. OSHA. b. EPA. c. CDC. d. FDA. ANS: B The EPA enforces the disposal of regulated waste. The OSHA regulates the health and safety of American workers. The CDC protects the health and safety of people at home and abroad. The FDA regulates the manufacturing and labeling of medical devices. DIF: Comprehension REF: p. 343 OBJ: 4 TOP: CDA, CG, VII. Office Operations 19. Used radiographic fixer: a. should be flushed down the toilet. b. requires offsite treatment. c. can be managed on site with the installation of a silver recovery system. d. is nonhazardous; however, used radiographic developer is hazardous. ANS: C Used radiographic fixer can be managed on site with installation of a silver recovery system. Used radiographic fixer is considered a hazardous waste because of its high silver content. It can be managed with onsite treatment requiring installation of a silver recovery system or off site through contracting with a disposal company for pickup. Used radiographic developer can exceed the pH standard set by the local wastewater treatment plant. DIF: Comprehension REF: p. 343 OBJ: 4 TOP: CDA, CG, VII. Office Operations 20. Which of the following is the classification for waste that is infectious and requires special handling, neutralization, and disposal? a. Contaminated waste b. Hazardous waste c. Regulated waste d. Nonregulated waste ANS: C Regulated waste is infectious waste that requires special handling, neutralization, and disposal. Contaminated waste items may contain the potentially infectious body fluids of patients. Hazardous waste is waste that poses a risk to humans. Nonregulated waste includes contaminated waste materials but does not require special disposal. DIF: Recall REF: p. 342 OBJ: 1 TOP: CDA, CG, VII. Office Operations 21. OSHA requires a sharps container to be all of the following except: a. leak-proof. b. puncture-resistant. c. labeled with the dental practice name. d. closable. ANS: C According to OSHA, a sharps container must be closable, leak-proof, puncture-resistant, labeled with the biohazard symbol, and color coded. DIF: Comprehension REF: p. 342 OBJ: 4 TOP: CDA, CG, VII. Office Operations 22. Radiographic fixer is considered a hazardous waste because it has a high: a. silver content. b. mercury index. c. lead level. d. acid reading. ANS: A A radiographic fixer is considered a hazardous waste because it has a high silver content. Radiographic fixer does not contain mercury or lead. Radiographic fixer is acid based, but that is not the reason it is classified as a hazardous waste. DIF: Recall REF: p. 343 OBJ: 4 TOP: CDA, CG, VII. Office Operations 23. All of the following are true about handling extracted teeth except extracted teeth: a. are considered potentially infectious. b. containing amalgam restorations should be heat sterilized to prevent the release of mercury vapors. c. are regulated waste. d. can be heat sterilized for educational purposes. ANS: B Extracted teeth that contain amalgam restorations should never be heat sterilized because the high temperature can create toxic mercury vapors. Extracted teeth are considered potentially infectious; therefore, they are regulated waste and cannot be returned to the patient. Virgin extracted teeth can be heat sterilized and used for educational purposes. DIF: Application REF: p. 342 OBJ: 4 TOP: CDA, CG, VII. Office Operations 24. All of the following are considered a regulated waste except: a. blood-soaked gauze. b. human tissue. c. saliva-soaked gauze. d. scalpel blade. ANS: C Saliva-soaked gauze is considered contaminated waste; therefore, it is not considered to be regulated waste and require special disposal. Blood-soaked gauze, human tissue, and scalpel blades (sharps) are all considered to be regulated waste and require special disposal. DIF: Application REF: p. 342 OBJ: 4 TOP: CDA, CG, VII. Office Operations 25. In the National Fire Protection Association (NFPA) labeling system, the color yellow indicates: a. health hazard. b. reactivity. c. flammability. d. special health hazards. ANS: B According to the NFPA, the color yellow indicates the product’s reactivity data. According to the NFPA, the color blue indicates health hazard; the color red indicates flammability; and the color white indicates special health hazards. DIF: Comprehension REF: p. 341 OBJ: 3 TOP: CDA, CG, VII. Office Operations 26. All of the following information is required on a SDS except: a. cost of product. b. hazard identification. c. accidental release measures. d. composition/information on ingredients. ANS: A The cost of the product is not required information on an SDS. Hazard identification, accidental release measures, and composition/information on ingredients are required. DIF: Comprehension REF: p. 339, Box 23.1 OBJ: 3 TOP: CDA, CG, VII. Office Operations 27. The section of a SDS that describes proper methods of containment and cleanup is: a. Section 5—Fire-fighting measures. b. Section 6—Accidental release measures. c. Section 1—Identification. d. Section 3—Composition/information on ingredients. ANS: B Section 6—Accidental release measures lists emergency procedures; protective equipment; chemical hazards from fire. Section 5—Fire-fighting measures lists suitable extinguishing techniques; equipment; chemical hazards from fire. Section 1—Identification includes product identifier; manufacturer or distributor name, address, phone number; emergency phone number; recommended use; restrictions on use. Section 3—Composition/information on ingredients includes information on chemical ingredients; trade secret claims. DIF: Comprehension REF: p. 340, Table 23.1 OBJ: 3 TOP: CDA, CG, VII. Office Operations 28. All of the following are considered hazardous waste except: a. human tissue. b. scrap amalgam. c. lead foil. d. radiographic processing solution. ANS: A Human tissue is infectious waste and is capable of causing infectious disease. Scrap amalgam, lead foil, and radiographic solution are hazardous wastes because they are toxic chemicals. DIF: Comprehension REF: p. 341 OBJ: 4 TOP: CDA, CG, VII. Office Operations 29. Training regarding the dental office hazard communication program is required for continuing employees every: a. month. b. 6 months. c. year. d. 3 years. ANS: C Staff training is required once a year for all continuing employees. It is also required for a new employee when they are hired, and when a new chemical product is introduced to the office. A chemical training program for employees must provide information that includes the use of hazardous chemicals, required PPE, and safe handling and disposal methods. DIF: Comprehension REF: p. 339 OBJ: 3 TOP: CDA, CG, VII. Office Operations 30. What is the purpose of the Globally Harmonized System of Classification and Labeling of Chemicals (GHS)? a. A central warehouse for purchasing chemicals on the worldwide, global market. b. Uniformity in classifying and labeling of a chemical regardless of where it is manufactured or used. c. A computerized database containing an SDS for every chemical product found worldwide. d. A consortium for identifying chemicals, particularly “designer drugs.” ANS: B The Occupational Safety and Health Administration (OSHA) revised the Hazard Communication Standard in 2012 and adopted GHS. Under the international GHS, each chemical will be classified and labeled the same regardless of where in the global market the chemical is manufactured or used. It will end confusion and eliminate the need for different labels. DIF: Comprehension REF: p. 337 OBJ: 3 TOP: CDA, CG, VII. Office Operations 31. The written program of the Hazard Communication Program must include all of the following information except: a. the names of all employees who are exposed to hazardous chemicals. b. the identity the individual responsible for the program. c. employee phone numbers. d. a description of staff training. ANS: C Employee phone numbers are not included in the written program of the Hazard Communication Program. The written program of the Hazard Communication Program includes the names of all employees exposed to hazardous chemicals, identifies the individual responsible for the program, and describes the staff training. DIF: Application REF: p. 337 OBJ: 3 TOP: CDA, CG, VII. Office Operations 32. The product that does not need to be listed on the chemical inventory is: a. dental film. b. phosphoric acid etch. c. amalgam. d. composite. ANS: A Dental film does not contain chemicals requiring listing on the chemical inventory. Phosphoric acid etch, amalgam, and composite contain chemicals requiring listing on the chemical inventory. DIF: Application REF: pp. 337, 339 OBJ: 3 TOP: CDA, CG, VII. Office Operations 33. The section of the SDS listing precautions for storage incompatibilities is: a. Section 2—Hazard(s) identification. b. Section 8—Exposure control/personal protection. c. Section 3—Composition/information on ingredients. d. Section 7—Handling and storage. ANS: D Section 7—Handling and storage lists precautions for safe handling and storage, including incompatibilities. Section 2—Hazard(s) identification includes all hazards regarding the chemical; required label elements. Section 8—Exposure control/personal protection lists OSHA’s Permissible Exposure Limits (PELs); Threshold Limit Values (TLVs); appropriate engineering controls; personal protective equipment (PPE). Section 3—Composition/information on ingredients includes information on chemical ingredients; trade secret claims. DIF: Comprehension REF: p. 340, Table 23.1 OBJ: 3 TOP: CDA, CG, VII. Office Operations 34. According to OSHA, how often do eyewash stations need to be inspected to ensure proper function? a. Daily b. Weekly c. Monthly d. Not required by OSHA ANS: C OSHA requires that eyewash stations be inspected monthly to ensure proper function. DIF: Comprehension REF: p. 335 OBJ: 2 TOP: CDA, CG, VII. Office Operations 35. The protocol recommended by manufacturers of eyewash units to reduce microbial content in the waterline is a -minute flushing . a. 6; weekly b. 3; weekly c. 3; monthly d. 2; daily ANS: B Manufacturers of eyewash units recommend a 3-minute flushing weekly to reduce microbial content in the waterline. DIF: Comprehension REF: p. 335 OBJ: 2 TOP: CDA, CG, VII. Office Operations 36. All of the following areas in a dental environment require good ventilation except the: a. laboratory. b. sterilization area. c. darkroom. d. reception area. ANS: D The reception area would not require special ventilation because there is no type of chemical used in that area of a dental office. DIF: Comprehension REF: p. 335 OBJ: 2 TOP: CDA, CG, VII. Office Operations 37. When using chemicals, dental assistants must wear: a. utility gloves, mask, and eye protection. b. latex gloves, eye protection, and mask. c. overgloves and eye protection only. d. mask and eye protection only. ANS: A When using chemicals, dental assistants must wear utility gloves for hand protection, a proper face mask for inhalation protection, and eye protection to protect eyes from fumes and splashes. DIF: Application REF: p. 334 OBJ: 2 TOP: CDA, CG, VII. Office Operations 38. Chronic chemical toxicity results from generally levels of the chemical over a much time period than acute chemical toxicity. a. higher; shorter b. higher; longer c. lower; shorter d. lower; longer ANS: D Chronic chemical toxicity results from many repeated exposures, generally to lower levels of the chemical, over a much longer time period than acute chemical toxicity. Possible effects include liver disease, brain disorders, cancer, and infertility. Acute chemical toxicity results from high levels of exposure over a short period of time. DIF: Comprehension REF: p. 334 OBJ: 2 TOP: CDA, CG, VII. Office Operations 39. Each of the following is a symptom of acute chemical toxicity except one. Which one is the EXCEPTION? a. Headache b. Dizziness c. Nausea d. Cancer ANS: D Acute chemical toxicity can cause dizziness, fainting, headache, nausea, and vomiting. Chronic chemical toxicity results from many repeated exposures. Many effects of chronic toxicity are possible, including liver disease, brain disorders, cancer, and infertility. DIF: Comprehension REF: p. 334 OBJ: 2 TOP: CDA, CG, VII. Office Operations 40. In addition to chemical exposure directly damaging the lungs, the organs that can also be affected are: a. heart, brain, and thyroid gland. b. kidneys, brain, and liver. c. brain, heart, and stomach. d. heart, brain, and bladder. ANS: B Inhalation of some gases, vapors, or dusts of chemicals may not affect the lungs but can be absorbed by them and sent through the blood to the brain, liver, and kidneys. DIF: Comprehension REF: p. 333 OBJ: 2 TOP: CDA, CG, VII. Office Operations 41. Failure to wash hands that are contaminated with chemicals before eating a sandwich is an example of: a. inhalation. b. absorption. c. ingestion. d. inflation. ANS: C Common ways of ingesting harmful chemicals in the workplace include eating lunch in an area where chemicals are used or eating with hands that are contaminated with chemicals. DIF: Recall REF: p. 333 OBJ: 2 TOP: CDA, CG, VII. Office Operations 42. Products that have outlived their expiration date should be: a. used first. b. used as needed. c. kept as back-up supplies. d. disposed of immediately. ANS: D Products that have outlived their expiration date should be disposed of immediately. DIF: Recall REF: p. 336 OBJ: 2 TOP: CDA, CG, VII. Office Operations 43. All of the following metals are considered toxic forms of waste except: a. lead. b. barium. c. gold. d. chromium. ANS: C Toxic chemicals could contain arsenic, barium, chromium, mercury, lead, silver, and certain pesticides. Gold is used for restoring teeth. DIF: Application REF: p. 336 OBJ: 2 TOP: CDA, CG, VII. Office Operations 44. All of the following are included in the Hazard Communication Program except: a. SDS with a specified 16-section format. b. a chemical inventory of products in the office that contain hazardous chemicals. c. a supply list. d. employee training documentation. ANS: C A supply list of products used in a dental office would not be included in the Hazard Communication Program. The Hazard Communication Program includes SDS for every chemical, an inventory of hazardous chemicals, and documentation of employee training. DIF: Application REF: pp. 337, 339 OBJ: 3 TOP: CDA, CG, VII. Office Operations Chapter 24: Dental Unit Waterlines Bird & Robinson: Modern Dental Assisting, 13th Edition MULTIPLE CHOICE 1. Within 5 days of installation, research has shown that microbial counts in new dental unit waterlines (DUWLs) can reach CFUs/mL. a. b. c. d. 10 500 1000 200,000 ANS: D Research has shown that microbial counts in new dental unit waterlines can reach 200,000 CFUs/mL within 5 days of installation. Counts greater than 1,000,000 CFUs/ml have been reported. DIF: Recall REF: p. 345 OBJ: 2 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 2. The type of plaque that develops inside DUWLs, consisting of bacterial cells and other microbes, is called: a. the infective layer. b. microfilm. c. biofilm. d. slime. ANS: C Biofilm consists of bacterial cells and other microbes that adhere to surfaces and form a protective slime layer. Microfilm is not a term used to describe the accumulation of microorganisms in the DUWL. The slime layer refers to the accumulation of the biofilm. DIF: Comprehension REF: p. 346 OBJ: 2 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 3. The bacteria in the biofilm are more resistant to chemical germicides than planktonic bacteria by a factor of: a. b. c. d. 3. 5. 100. 1500. ANS: D The bacteria in the biofilm are up to 1500 times more resistant to chemical germicides than planktonic bacteria. DIF: Comprehension REF: p. 347 OBJ: 2 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 4. Methods of reducing the level of bacterial contamination in waterlines include all of the following except: a. yearly replacement of all waterlines. b. chemical treatment regimens. c. self-contained water reservoirs. d. microfiltration. ANS: A Yearly replacement of all waterlines has not been suggested. Methods of reducing the level of bacterial contamination in waterlines include chemical treatment regimens, self-contained water reservoirs, microfiltration, and daily draining and drying of lines. DIF: Comprehension REF: p. 348, Box 24.1 OBJ: 3 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 5. The advantages of self-contained water reservoirs include which of the following? a. They are less expensive to use than tap water from the delivery unit. b. Dental personnel can select the quality of water used. c. Use of sterile water in the reservoir guarantees delivery of sterile water to the patient. d. The quality of water will contain fewer than 500 CFU/ml regardless of maintenance. ANS: B Having the ability to maintain self-contained reservoir systems and select the quality of water are advantages over other systems. Self-contained water reservoirs are an additional expense above and beyond purchase of a delivery unit for handpieces and suction. Failure to maintain the self-contained water reservoir may cause the water to become contaminated with even higher than normal counts of waterborne pathogens. DIF: Comprehension REF: p. 348 OBJ: 3 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 6. Disposable inline microfiltration cartridges should be changed: a. according to the manufacturer’s recommendations. b. between patients. c. once a week. d. twice a day. ANS: A Inline microfiltration cartridges should be replaced according to the manufacturer’s recommendations on each line. DIF: Recall REF: p. 348 OBJ: 3 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 7. To reduce the microbial count temporarily and to help clean the handpiece waterlines, DUWLs should be flushed: a. at the beginning of the day for several minutes and for 20 to 30 seconds between patients. b. At the beginning of the day for several minutes but not between patients. c. For 20 to 30 seconds between patients but not at the beginning of the day. d. only after the water has been allowed to become stagnant, such as over a weekend. ANS: A DUWLs should be flushed every morning for several minutes and after each patient for 20 to 30 seconds to reduce the microbial count temporarily and to help clean the handpiece waterlines. DIF: Comprehension REF: p. 349 OBJ: 3 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 8. Reduction of exposure of the dental unit water for the dental team include all of the following except: a. the HVE. b. a dental dam. c. masks. d. protective eyewear and/or face shields. ANS: B Using the dental dam protects the patient, not the dental team. The dental team can reduce exposure to dental unit water spray and aerosols by using the HVE and wearing PPE, including protective eyewear, masks, and face shields. Using the HVE, masks, protective eyewear, and face shields is a correct method of reducing exposure, but this is not the only correct choice. DIF: Comprehension REF: p. 349 OBJ: 4 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 9. Backflow from low-volume saliva ejectors can occur when a patient: a. is positioned in a reclined position in the dental chair. b. closes his or her lips around the tip of a saliva ejector. c. first turns on the saliva ejector. d. has been using a saliva ejector for more than 10 minutes. ANS: B Backflow from low-volume saliva ejectors occurs when the patient closes his or her lips around the tip of a saliva ejector. DIF: Comprehension REF: p. 349 OBJ: 4 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 10. Planktonic bacteria are: a. unable to survive in DUWLs. b. prevented from entering DUWLs by use of antiretraction valves. c. free floating in the water. d. in the biofilm attached to DUWL walls. ANS: C Planktonic bacteria are free floating in the water. The other community of bacteria in DUWLs exists in the biofilm attached to DUWL walls. Planktonic bacteria are able to survive in DUWLs. Antiretraction valves are intended to prevent saliva from being retracted back into the waterlines during treatment. DIF: Comprehension REF: pp. 345-346 OBJ: 1 | 2 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 11. Biofilm can contain many types of bacteria: a. fungi, algae, and protozoa. b. fungi and algae but not protozoa. c. fungi and protozoa but not algae. d. algae and protozoa but not fungi. ANS: A Biofilm can contain many types of bacteria, fungi, algae, and protozoa. DIF: Recall REF: p. 347 OBJ: 2 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 12. Which of the following statements is true about dental unit waterlines? a. Viruses cannot multiply in the DUWL. b. The use of sterile water in the self-contained water reservoir ensures that water will be sterile at the point of delivery. c. Microfilters reduce the bacterial contamination of water and destroy the biofilms that colonize the DUWLs. d. Flushing for 20 to 30 seconds after each patient will remove biofilms from the lines. ANS: A Viruses cannot multiply in the DUWL. The use of sterile water in the self-contained water reservoir does not ensure that water will be sterile at the point of delivery. Microfilters reduce the bacterial contamination of water but do not destroy the biofilms that colonize the DUWLs. Flushing for 20 to 30 seconds after each patient will not remove biofilms from the lines. DIF: Application REF: p. 347 OBJ: 2 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 13. The number of waterborne bacteria in community water is kept below colony-forming units (CFUs) per milliliter. a. 1 b. 50 c. d. 100 500 ANS: D It is kept below 500 colony-forming units (CFUs) per milliliter. Water from air-water syringes and dental handpieces frequently has levels that are hundreds or thousands of times greater than are permissible in drinking water. DIF: Recall REF: p. 345 OBJ: 2 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 14. Which of the following types of water will likely have the highest bacterial colony-forming unit (CFU) count? a. Tap water from the sink. b. Distilled water purchased in a plastic container. c. Water from a drinking fountain. d. Water from an air-water syringe. ANS: D Dental unit water lines (DUWLs) have a narrow tube. Smaller diameter tubes collect more biofilm. Biofilm forms on the inside of the DUWLs as water flows through the unit. DIF: Comprehension REF: p. 347 OBJ: 2 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 15. Factors contributing to the formation of bacteria in DUWLs include all of the following except: a. stagnant water. b. water heating. c. well water. d. backflow from a saliva ejector. ANS: C Stagnant water left in waterlines in between patients, overnight, and over the weekend, heating the water and a backflow of contaminants can increase bacterial count. DIF: Comprehension REF: p. 347 OBJ: 2 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 16. Water from municipal lines can be harmful to a patient because it may contain a biofilm with: a. human immunodeficiency virus (HIV). b. bacterial cells. c. chlorine. d. fluoride. ANS: B Some bacteria already present in municipal water can be carried from the dental waterlines and handpiece into the patient’s oral cavity. Because dental unit waterlines (DUWLs) have a narrow tube biofilm forms on the inside of the tube as water flows through the unit. Viruses, such as the human immunodeficiency virus, cannot multiply within the DUWL. Chlorine is added to reduce the growth of bacteria. Fluoride is added to prevent caries. DIF: Comprehension REF: p. 346 OBJ: 2 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 17. Advantages of using self-contained water reservoirs include: a. increasing the amount of biofilm in waterlines. b. the ability to sterilize that inside parts of the dental unit. c. giving the dental office control over quality of water used. d. complete elimination of biofilms and bacteria from dental waterlines. ANS: C The use of optional self-contained water reservoir systems helps to control water quality, whether it be distilled water, tap water, or sterile water. Bacteria are reduced by chemical treatment or by flushing waterlines. Failure to properly maintain a self-contained water reservoir can lead to even higher than normal counts of waterborne pathogens. The inside parts of the dental unit cannot be sterilized. Complete elimination of biofilms and bacteria would be the ideal solution; however, this is not possible. DIF: Comprehension REF: p. 348 OBJ: 3 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 18. When choosing a chemical agent to give dental unit waterlines a “shock” treatment, care should be taken to: a. scrub out all the dental unit water lines with a fine-bristled brush. b. check with the manufacturer to determine the recommended chemical product and protocol for maintenance. c. use the chemical agent no more than once a month. d. replace all dental unit waterlines on a yearly basis. ANS: B Take care in selecting the best product, because some chemicals can cause damage to the dental units. Always check the recommendation from the manufacturer to avoid causing any damage to dental units with chemicals. Periodic or “shock” treatment with chemical agents should be done regularly, usually once a week, to help minimize bacteria in dental water units. Dental unit water lines are not scrubbed out. Dental unit water lines are not replaced at a specific frequency according to time. DIF: Comprehension REF: p. 349 OBJ: 3 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 19. The type of water used during surgery where bone is exposed should be: a. heated municipal water. b. distilled water from a self-contained system. c. only sterile water delivered in a sterile syringe. d. any type of water can be used. ANS: C Only sterile water should be used during surgery where bone is exposed. The use of sterile syringes should be used for irrigation of the surgical area. Municipal water contains bacteria and is not sterile. Distilled water is not bacteria free when used in the self-contained reservoir system. DIF: Comprehension REF: p. 349 OBJ: 4 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 20. An option for independent verification of the quality of dental unit water cleaning is: a. none; there is no availability for testing of the dental waterline cleaning. b. using a commercial testing service. c. using an in-office test kit. d. checking to see if any patients become ill following dental treatment. ANS: B Two options are available for testing dental unit water. One option is to send out samples to a commercial testing service. The other option is an in-office testing kit; however, this method does not provide for independent verification of dental unit water quality. DIF: Comprehension REF: p. 349 OBJ: 4 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 21. Flushing the dental unit waterlines (DUWLs) for several minutes at the beginning of the treatment day and for 20 to 30 seconds between patients will help to: a. reduce prep time between dental patients. b. reduce the microbial count of bacteria in the dental unit waterlines. c. eliminate bacterial biofilm from the dental unit waterlines. d. clean the dental unit water that is used for surgery involving exposure of bone. ANS: B Flushing the DUWLs for several minutes each morning and at least 20 to 30 seconds in between patients will help to reduce the microbial count in the waterlines. Flushing DUWLs is necessary; however, it increases prep time between patients. Flushing will not remove biofilm from the lines. Dental unit water should not be used as an irrigant for surgery involving exposure of bone. DIF: Comprehension REF: p. 349 OBJ: 4 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission 22. Which of the following techniques in dentistry has been shown to be a potential source of cross-contamination as a result of backflow into a patient’s mouth? a. Hand scaling with periodontal curettes. b. Use of an ultrasonic or piezo scaler to clean accretions from teeth. c. Low-volume saliva ejectors. d. Use of a high-speed handpiece for cavity preparation. ANS: C No adverse health effects have been reported with backflow from saliva ejectors; however, when a patient closes his or her lips around the tip of a saliva ejector, a partial vacuum is created, which can cause backflow to occur. DIF: Comprehension REF: p. 350 OBJ: 4 TOP: CDA, ICE, II. Standard/Universal Precautions and the Prevention of Disease Transmission Chapter 25: Ergonomics Bird & Robinson: Modern Dental Assisting, 13th Edition MULTIPLE CHOICE 1. The goal of ergonomics is to help people: a. adapt the human body to the work environment. b. increase their range of twisting and reaching motions. c. establish sequences of repetitive motions to reduce work strain. d. stay healthy while performing their work more effectively. ANS: D The goal of ergonomics is to help people stay healthy while performing their work more effectively. Ergonomics deals with adaptation of the work environment to the human body rather than adaptation of the human body to the work environment. The ideal way to work is from a neutral position. Unfortunately, the dental assistant tends to deviate from the neutral position. Such deviations include leaning forward, twisting, bending the back too much, and reaching. Repetitive motions can significantly increase the risk for cumulative trauma disorders. DIF: Recall REF: p. 352 OBJ: 2 TOP: CDA, CG, VII. Office Operations 2. All of the following factors contribute to musculoskeletal disorders (MSDs) except: a. posture. b. repetition. c. twisting. d. force. ANS: C Twisting is not one of the categories of risk factors that contribute to MSDs. The three categories of risk factors that contribute to MSDs are posture, repetition, and force. DIF: Comprehension REF: p. 353 OBJ: 2 TOP: CDA, CG, VII. Office Operations 3. The ideal working position for a dental assistant is: a. a neutral position sitting upright with body weight evenly distributed. b. standing chairside. c. seated, leaning forward supported by the stool arm. d. knees and feet together. ANS: A The ideal way to work is from a neutral position, sitting upright with your weight evenly distributed. Sitting chairside is generally less fatiguing than standing. Leaning forward and using the stool arm for support do not allow the body’s weight to be distributed evenly, which is a goal of the neutral position. Your legs should be separated with your feet flat on the floor when you are working as an operator—or they should be flat on the footrest of the assistant’s stool when you are assisting.