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Little: Dental Management of the Medically Compromised Patient, 9th Edition
Chapter 01: Patient Evaluation and Risk Assessment Test Bank
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
CORRECT ANSWER: C
Elective dental care should be deferred for patients with severe, uncontrolled hypertension,
which is blood pressure of greater than or equal to 180/110 mm Hg, until the condition
can be brought under control.
PTS: 1 REF: p. 4
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
CORRECT 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; current guidelines
omit this recommendation on the basis of accumulated scientific evidence. If a murmur is
due to specific cardiac conditions (e.g., previous endocarditis, prosthetic heart valve,
complex congenital cyanotic heart disease), the AHA continues to recommend antibiotic
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prophylaxis for most dental procedures. Patients with pacemakers do not require antibiotic
prophylaxis.
PTS: 1 REF: pp. 4-5
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
CORRECT ANSWER: C
Patients with chronic hepatitis (B or C) or cirrhosis have an associated impairment of liver
function. This deficit may result in prolonged bleeding and less efficient metabolism of
certain drugs, including local anesthetics and analgesics.
PTS: 1 REF: p. 6
4. Which of the following symptoms and signs is most consistent with allergy?
A. heart palpitations
B. itching
C. vomiting
D. fainting
CORRECT 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.
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PTS: 1 REF: p. 6
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.
CORRECT 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.
PTS: 1 REF: p. 6-7
6. Vasoconstrictors should be avoided in patients who are using cocaine or
methamphetamine because these agents may precipitate .
A. severe hypotension
B. severe hypertension
C. respiratory depression
D. cessation of intestinal peristalsis
CORRECT ANSWER: B
Vasoconstrictors may precipitate cardiac arrhythmias or severe hypertension in patients
who are using cocaine or methamphetamine. Respiratory depression is associated with
the use of opioids.
PTS: 1 REF: p. 8
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Little: Dental Management of the Medically Compromised Patient, 9th Edition
Chapter 01: Patient Evaluation and Risk Assessment Test Bank
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
CORRECT ANSWER: C
Elective dental care should be deferred for patients with severe, uncontrolled hypertension,
which is blood pressure of greater than or equal to 180/110 mm Hg, until the condition
can be brought under control.
PTS: 1 REF: p. 4
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
CORRECT 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; current guidelines
omit this recommendation on the basis of accumulated scientific evidence. If a murmur is
due to specific cardiac conditions (e.g., previous endocarditis, prosthetic heart valve,
complex congenital cyanotic heart disease), the AHA continues to recommend antibiotic
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prophylaxis for most dental procedures. Patients with pacemakers do not require antibiotic
prophylaxis.
PTS: 1 REF: pp. 4-5
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
CORRECT ANSWER: C
Patients with chronic hepatitis (B or C) or cirrhosis have an associated impairment of liver
function. This deficit may result in prolonged bleeding and less efficient metabolism of
certain drugs, including local anesthetics and analgesics.
PTS: 1 REF: p. 6
4. Which of the following symptoms and signs is most consistent with allergy?
A. heart palpitations
B. itching
C. vomiting
D. fainting
CORRECT 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.
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PTS: 1 REF: p. 6
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.
CORRECT 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.
PTS: 1 REF: p. 6-7
6. Vasoconstrictors should be avoided in patients who are using cocaine or
methamphetamine because these agents may precipitate .
A. severe hypotension
B. severe hypertension
C. respiratory depression
D. cessation of intestinal peristalsis
CORRECT ANSWER: B
Vasoconstrictors may precipitate cardiac arrhythmias or severe hypertension in patients
who are using cocaine or methamphetamine. Respiratory depression is associated with
the use of opioids.
PTS: 1 REF: p. 8
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