LITTLE AND FALACE'S DENTAL MANAGEMENT OF THE MEDICALLY COMPROMISED PATIENT
9TH EDITION TEST BANK ISBN-978-0323443555
1. Question: Elective dental care should be deferred for patients with severe, uncontrolled
hypertension, meaning that the blood pressure is greater than or equal to what mm Hg?
o Answer: c. 180/110
2. Question: Which cardiac condition currently requires antibiotic prophylaxis according to the
American Heart Association?
o Answer: b. Prosthetic heart valve
3. Question: A consequence of chronic hepatitis (B or C) is decreased ability of the body to do
which of the following?
o Answer: c. metabolize
4. Question: What symptom is most consistent with an allergy?
o Answer: b. Itching
5. Question: What is true about a patient with a history of tuberculosis?
o Answer: c. Patients with acquired immunodeficiency syndrome (AIDS) have a high incidence of
tuberculosis.
6. Question: Why should vasoconstrictors be avoided in patients who are cocaine or
methamphetamine users?
o Answer: b. severe hypertension
7. Question: A serious perioperative cardiovascular event risk increases in patients unable to
meet what MET demand?
o Answer: a. 4
8. Question: What alteration in fingernails is associated with cirrhosis?
o Answer: c. White discoloration
9. Question: When placing a blood pressure cuff, when should it be inflated until?
o Answer: b. the radial pulse disappears and then inflated an additional 20 to 30 mm Hg.
10. Question: What does ASA III classify a patient with?
o Answer: b. Patient’s disease has significant impact on daily activity.
Infective Endocarditis
11. Question: Which statement is true about infective endocarditis?
o Answer: d. Accumulating evidence questions the validity of antibiotic prophylaxis.
12. Question: What is the most common underlying condition predisposing to infective
endocarditis?
o Answer: c. Mitral valve prolapse
13. Question: What is the leading cause of death due to infective endocarditis?
o Answer: b. heart failure
14. Question: How soon do symptoms of infective endocarditis typically onset after the presumed
initiating bacteremia?
o Answer: b. 2 weeks
15. Question: Where are Janeway lesions typically located?
, LITTLE AND FALACE'S DENTAL MANAGEMENT OF THE MEDICALLY COMPROMISED PATIENT
9TH EDITION TEST BANK ISBN-978-0323443555
o Answer: b. Palms of the hands and soles of the feet
16. Question: What is true regarding the magnitude of bacteremia needed to cause infective
endocarditis?
o Answer: b. Cases of IE caused by oral bacteria probably result from frequent exposure to low
inocula.
17. Question: Is visible bleeding during a dental procedure a reliable predictor of bacteremia?
o Answer: b. Both statements are false.
18. Question: What conclusion have investigators drawn about the efficacy of antibiotic
prophylaxis for IE?
o Answer: d. Investigators have concluded that dental or other procedures probably only caused
a small fraction of cases of IE.
19. Question: Before dental treatment, which cardiac condition requires antibiotic prophylaxis?
o Answer: c. Prosthetic cardiac valve
20. Question: What antibiotic is suitable for a patient already taking penicillin requiring
premedication before dental treatment?
o Answer: b. Clindamycin
Hypertension
21. Question: What are the diastolic pressure ranges for prehypertension?
o Answer: a. 80 to 89
22. Question: Who can diagnose hypertension and decide on treatment?
o Answer: a. Physician
23. Question: Which group is most likely to have hypertension according to the prevalence in
America?
o Answer: d. Its prevalence is similar among men and women.
24. Question: Approximately what percentage of all blood pressure-related deaths due to coronary
heart disease occurs in prehypertensive persons?
o Answer: c. 15
25. Question: What is the first-line drug category for treating hypertension when lifestyle changes
are ineffective?
o Answer: b. Diuretics, thiazide diuretics, and others.
26. Question: When should elective dental care be deferred?
o Answer: d. 180/110 mm Hg or greater
27. Question: Which method is recommended for stress management in hypertensive dental
patients?
o Answer: c. Nitrous oxide plus oxygen for inhalation sedation.
28. Question: Why should chair position changes be avoided during dental treatment for
hypertensive patients?
o Answer: b. They tend to produce orthostatic hypotension as a side effect.
, LITTLE AND FALACE'S DENTAL MANAGEMENT OF THE MEDICALLY COMPROMISED PATIENT
9TH EDITION TEST BANK ISBN-978-0323443555
29. Question: How many cartridges of 2% lidocaine with 1:100,000 epinephrine is considered safe
for hypertensive patients?
o Answer: a. 2
30. Question: What happens if a dental anesthetic containing a vasoconstrictor is given to a
patient on nonselective β-blockers?
o Answer: b. Hypertension
Continued Medical Management and Procedures
31. Question: For what blood pressure reading should a dental patient be referred for evaluation
within one week?
o Answer: d. 180/110
32. Question: What impact does poor oral hygiene have on bacteremia levels after dental
procedures?
o Answer: b. Quality of oral hygiene has an appreciable effect.
33. Question: When assessing a patient with a history of heart conditions, what specific
symptoms should dentists look for?
o Answer: Chest pain, shortness of breath, and fatigue.
34. Question: What adjunctive treatment can manage anxiety for a patient undergoing dental
procedures?
o Answer: Short-acting benzodiazepines.
35. Question: Which dietary changes are recommended to help manage hypertension?
o Answer: Reducing salt intake and increasing fruit and vegetable consumption.
36. Question: When taking blood pressure, what is the importance of patient positioning?
o Answer: Proper positioning helps ensure an accurate reading.
37. Question: In dental treatment, what is a recommended approach for patients with a history of
myocardial infarction?
o Answer: Consult their physician before treatment.
38. Question: What should be done for patients undergoing dental procedures with a history of
heart valve replacement?
o Answer: Provide antibiotic prophylaxis as per AHA guidelines.
39. Question: Which condition requires you to review a patient’s medical history in detail before
providing dental care?
o Answer: Infective endocarditis
40. Question: How has the prevalence of hypertension in the U.S. population changed over recent
decades?
o Answer: It has been steadily increasing.
Additional Scenarios and Considerations
41. Question: Which medications can affect the metabolism of local anesthetics?
o Answer: Anticoagulants and certain antihypertensives.
, LITTLE AND FALACE'S DENTAL MANAGEMENT OF THE MEDICALLY COMPROMISED PATIENT
9TH EDITION TEST BANK ISBN-978-0323443555
42. Question: For patients with controlled hypertension, what dental procedures are typically
authorized?
o Answer: Both surgical and nonsurgical treatments may proceed.
43. Question: How can a history of severe allergic reactions affect dental treatment plans?
o Answer: It may require the use of alternative medications or procedures.
44. Question: How should dental professionals prepare for patients with a history of major
cardiovascular conditions?
o Answer: Develop a care plan in collaboration with their healthcare provider.
45. Question: In the context of dental emergency procedures, what protocols should be in place
for patients with uncontrolled hypertension?
o Answer: Immediate referral to a physician and stabilization prior to any treatment.
46. Question: What information should be documented in a patient's chart regarding their cardiac
health?
o Answer: History of conditions, any medications they are taking, and past procedures.
47. Question: What dietary recommendations can be provided to patients struggling with
hypertension?
o Answer: Encourage a Mediterranean diet rich in fruits, vegetables, whole grains, and healthy
fats.
48. Question: How should a dental professional handle a patient exhibiting signs of anxiety during
treatment?
o Answer: Offer reassurance, allow breaks, and adjust treatment speed accordingly.
49. Question: What should patients with known bleeding disorders do before dental procedures?
o Answer: Inform their dentist and possibly consult a hematologist.
50. Question: What lifestyle modifications can significantly contribute to hypertension
management?
o Answer: Regular exercise, decreased alcohol consumption, and smoking cessation.
Medical History and Patient Assessment
51. Question: What is the purpose of obtaining thorough medical histories from dental patients?
o Answer: To identify contraindications for dental procedures and medications.
52. Question: If a patient presents with symptoms of possible endocarditis, what immediate
actions should the dental professional take?
o Answer: Referral to a physician for evaluation and possibly necessary testing.
53. Question: Why is it important to monitor blood pressure in patients receiving dental care?
o Answer: To prevent complications associated with uncontrolled hypertension.
54. Question: In the presence of anaphylactic reactions, what emergency medications should be
available in the dental office?
o Answer: Epinephrine, antihistamines, and corticosteroids.
55. Question: In terms of dental procedure scheduling, what factors can minimize patient stress?
o Answer: Flexibility in appointment times and clear communication prior to procedures.
9TH EDITION TEST BANK ISBN-978-0323443555
1. Question: Elective dental care should be deferred for patients with severe, uncontrolled
hypertension, meaning that the blood pressure is greater than or equal to what mm Hg?
o Answer: c. 180/110
2. Question: Which cardiac condition currently requires antibiotic prophylaxis according to the
American Heart Association?
o Answer: b. Prosthetic heart valve
3. Question: A consequence of chronic hepatitis (B or C) is decreased ability of the body to do
which of the following?
o Answer: c. metabolize
4. Question: What symptom is most consistent with an allergy?
o Answer: b. Itching
5. Question: What is true about a patient with a history of tuberculosis?
o Answer: c. Patients with acquired immunodeficiency syndrome (AIDS) have a high incidence of
tuberculosis.
6. Question: Why should vasoconstrictors be avoided in patients who are cocaine or
methamphetamine users?
o Answer: b. severe hypertension
7. Question: A serious perioperative cardiovascular event risk increases in patients unable to
meet what MET demand?
o Answer: a. 4
8. Question: What alteration in fingernails is associated with cirrhosis?
o Answer: c. White discoloration
9. Question: When placing a blood pressure cuff, when should it be inflated until?
o Answer: b. the radial pulse disappears and then inflated an additional 20 to 30 mm Hg.
10. Question: What does ASA III classify a patient with?
o Answer: b. Patient’s disease has significant impact on daily activity.
Infective Endocarditis
11. Question: Which statement is true about infective endocarditis?
o Answer: d. Accumulating evidence questions the validity of antibiotic prophylaxis.
12. Question: What is the most common underlying condition predisposing to infective
endocarditis?
o Answer: c. Mitral valve prolapse
13. Question: What is the leading cause of death due to infective endocarditis?
o Answer: b. heart failure
14. Question: How soon do symptoms of infective endocarditis typically onset after the presumed
initiating bacteremia?
o Answer: b. 2 weeks
15. Question: Where are Janeway lesions typically located?
, LITTLE AND FALACE'S DENTAL MANAGEMENT OF THE MEDICALLY COMPROMISED PATIENT
9TH EDITION TEST BANK ISBN-978-0323443555
o Answer: b. Palms of the hands and soles of the feet
16. Question: What is true regarding the magnitude of bacteremia needed to cause infective
endocarditis?
o Answer: b. Cases of IE caused by oral bacteria probably result from frequent exposure to low
inocula.
17. Question: Is visible bleeding during a dental procedure a reliable predictor of bacteremia?
o Answer: b. Both statements are false.
18. Question: What conclusion have investigators drawn about the efficacy of antibiotic
prophylaxis for IE?
o Answer: d. Investigators have concluded that dental or other procedures probably only caused
a small fraction of cases of IE.
19. Question: Before dental treatment, which cardiac condition requires antibiotic prophylaxis?
o Answer: c. Prosthetic cardiac valve
20. Question: What antibiotic is suitable for a patient already taking penicillin requiring
premedication before dental treatment?
o Answer: b. Clindamycin
Hypertension
21. Question: What are the diastolic pressure ranges for prehypertension?
o Answer: a. 80 to 89
22. Question: Who can diagnose hypertension and decide on treatment?
o Answer: a. Physician
23. Question: Which group is most likely to have hypertension according to the prevalence in
America?
o Answer: d. Its prevalence is similar among men and women.
24. Question: Approximately what percentage of all blood pressure-related deaths due to coronary
heart disease occurs in prehypertensive persons?
o Answer: c. 15
25. Question: What is the first-line drug category for treating hypertension when lifestyle changes
are ineffective?
o Answer: b. Diuretics, thiazide diuretics, and others.
26. Question: When should elective dental care be deferred?
o Answer: d. 180/110 mm Hg or greater
27. Question: Which method is recommended for stress management in hypertensive dental
patients?
o Answer: c. Nitrous oxide plus oxygen for inhalation sedation.
28. Question: Why should chair position changes be avoided during dental treatment for
hypertensive patients?
o Answer: b. They tend to produce orthostatic hypotension as a side effect.
, LITTLE AND FALACE'S DENTAL MANAGEMENT OF THE MEDICALLY COMPROMISED PATIENT
9TH EDITION TEST BANK ISBN-978-0323443555
29. Question: How many cartridges of 2% lidocaine with 1:100,000 epinephrine is considered safe
for hypertensive patients?
o Answer: a. 2
30. Question: What happens if a dental anesthetic containing a vasoconstrictor is given to a
patient on nonselective β-blockers?
o Answer: b. Hypertension
Continued Medical Management and Procedures
31. Question: For what blood pressure reading should a dental patient be referred for evaluation
within one week?
o Answer: d. 180/110
32. Question: What impact does poor oral hygiene have on bacteremia levels after dental
procedures?
o Answer: b. Quality of oral hygiene has an appreciable effect.
33. Question: When assessing a patient with a history of heart conditions, what specific
symptoms should dentists look for?
o Answer: Chest pain, shortness of breath, and fatigue.
34. Question: What adjunctive treatment can manage anxiety for a patient undergoing dental
procedures?
o Answer: Short-acting benzodiazepines.
35. Question: Which dietary changes are recommended to help manage hypertension?
o Answer: Reducing salt intake and increasing fruit and vegetable consumption.
36. Question: When taking blood pressure, what is the importance of patient positioning?
o Answer: Proper positioning helps ensure an accurate reading.
37. Question: In dental treatment, what is a recommended approach for patients with a history of
myocardial infarction?
o Answer: Consult their physician before treatment.
38. Question: What should be done for patients undergoing dental procedures with a history of
heart valve replacement?
o Answer: Provide antibiotic prophylaxis as per AHA guidelines.
39. Question: Which condition requires you to review a patient’s medical history in detail before
providing dental care?
o Answer: Infective endocarditis
40. Question: How has the prevalence of hypertension in the U.S. population changed over recent
decades?
o Answer: It has been steadily increasing.
Additional Scenarios and Considerations
41. Question: Which medications can affect the metabolism of local anesthetics?
o Answer: Anticoagulants and certain antihypertensives.
, LITTLE AND FALACE'S DENTAL MANAGEMENT OF THE MEDICALLY COMPROMISED PATIENT
9TH EDITION TEST BANK ISBN-978-0323443555
42. Question: For patients with controlled hypertension, what dental procedures are typically
authorized?
o Answer: Both surgical and nonsurgical treatments may proceed.
43. Question: How can a history of severe allergic reactions affect dental treatment plans?
o Answer: It may require the use of alternative medications or procedures.
44. Question: How should dental professionals prepare for patients with a history of major
cardiovascular conditions?
o Answer: Develop a care plan in collaboration with their healthcare provider.
45. Question: In the context of dental emergency procedures, what protocols should be in place
for patients with uncontrolled hypertension?
o Answer: Immediate referral to a physician and stabilization prior to any treatment.
46. Question: What information should be documented in a patient's chart regarding their cardiac
health?
o Answer: History of conditions, any medications they are taking, and past procedures.
47. Question: What dietary recommendations can be provided to patients struggling with
hypertension?
o Answer: Encourage a Mediterranean diet rich in fruits, vegetables, whole grains, and healthy
fats.
48. Question: How should a dental professional handle a patient exhibiting signs of anxiety during
treatment?
o Answer: Offer reassurance, allow breaks, and adjust treatment speed accordingly.
49. Question: What should patients with known bleeding disorders do before dental procedures?
o Answer: Inform their dentist and possibly consult a hematologist.
50. Question: What lifestyle modifications can significantly contribute to hypertension
management?
o Answer: Regular exercise, decreased alcohol consumption, and smoking cessation.
Medical History and Patient Assessment
51. Question: What is the purpose of obtaining thorough medical histories from dental patients?
o Answer: To identify contraindications for dental procedures and medications.
52. Question: If a patient presents with symptoms of possible endocarditis, what immediate
actions should the dental professional take?
o Answer: Referral to a physician for evaluation and possibly necessary testing.
53. Question: Why is it important to monitor blood pressure in patients receiving dental care?
o Answer: To prevent complications associated with uncontrolled hypertension.
54. Question: In the presence of anaphylactic reactions, what emergency medications should be
available in the dental office?
o Answer: Epinephrine, antihistamines, and corticosteroids.
55. Question: In terms of dental procedure scheduling, what factors can minimize patient stress?
o Answer: Flexibility in appointment times and clear communication prior to procedures.
