Managing the Pediatric Dental Patient

~ Exam ~

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1. Drugs used in conscious sedation in dentistry are commonly…

  a. CNS depressants

  b. CVS depressants

  c. A and B

  d. Neither A nor B

2. The two most important dental procedures for reducing uncooperative behavior in children are…

  a. Slow speed handpiece and hand instrumentation where appropriate

  b. Profound anesthesia coupled with the use of rubber dam

  c. Tell-show-do and restraint

  d. None of above

3. NPO instructions prior to a sedation appointment should…

  a. Include no milk/solids after midnight the previous night

  b. Include no solids after midnight the previous night and no liquids the day of the procedure

  c. Be dependent upon the patient’s age

  d. A and C

4. Double dosing of sedation medications…

  a. Should never be undertaken under any circumstances

  b. Should be done if the patient vomits the medication

  c. Can only be done safely if medication administered nasally

  d. A and C

5. The goals of behavior management are…

  a. To establish effective communication

  b. To alleviate patient fear and anxiety

  c. To build a trusting relationship with the child that will ultimately permit the dentist to deliver quality dental care

  d. To promote the child's positive attitude towards oral/dental health.

  e. All of the above

6. Which ASA classification of patient can safely be treated by in-office conscious sedation?

  a. Some ASA I

  b. All ASA II

  c. All ASA I and some ASA II

  d. Some ASA I and some ASA II

7. Parents of dentally fearful children…

  a. Should always accompany the child into the dental operatory

  b. May accompany a fearful child at the dentist’s discretion

  c. Always improve a fearful child’s behavior

  d. Improve communication between dentist and patient

8. Body language is particularly important in the close communication that takes place during dental treatment.

  a. True

  b. False

9. Which of the following words/phrases commonly use in the dental setting is/are considered evocative language and should be avoided?

  a. “Whistle”

  b. “Make your tooth sleepy”

  c. “Clean the soft part of the tooth away”

  d. “Drill the soft part of the tooth away”

10. What is the desired end-point for moderate sedation?

  a. Unresponsive to verbal commands

  b. Responsive to verbal commands

  c. Responsive to verbal commands with painful stimulus

  d. None of the above

11. Tell-show-do is a behavioral technique that…

  a. Can only be used with young children

  b. May include visual demonstrations

  c. Involves diverting the patient's attention

  d. All of the above

12. Reward-oriented Management is a behavioral technique that…

  a. Uses positive reinforcement

  b. Involves the establishment of rules

  c. States that the reward is most effective if it comes directly from the dentist

  d. All of the above

13. What is the most commonly used anxiolytic agent in pediatric dentistry?

  a. Demerol

  b. Midazolam

  c. Nitrous oxide

  d. Halothane

14. Tell-show-do is rooted in learning theory.

  a. True

  b. False

15. Most emergencies involving children undergoing dental treatment under conscious sedation are first seen as…

  a. Cardiovascular collapse

  b. Heart attack

  c. Fainting

  d. Problems with ventilation

16. Which of the following means of restraint is not considered “passive?”

  a. Papoose board

  b. Pedi-Wrap

  c. Parent’s hands

  d. None of the above

17. Restraint is considered an appropriate form of behavior management to restrain patients…

  a. For long appointments

  b. For short appointments

  c. For patients who have previously experienced physical trauma from protective stabilization

  d. All of the above

18. Use of a mouthprop…

  a. Usually requires separate, specific written consent

  b. Is considered to be covered in general dental consent

  c. Is prohibited in developmentally challenged patients

  d. None of the above

19. Which of the following is not an absolute contraindication to the use of nitrous oxide?

  a. Tuberculosis

  b. Mild asthma

  c. Otitis media

  d. Cystic fibrosis

20. Voice control…

  a. Involves a controlled alteration in the volume, tone, or pace of voice

  b. Is aimed at influencing and directing the patient's behavior

  c. Is the same as shouting

  d. All of the above

  e. A and B only

21. What is the percent of children whose behavior in the dental office can be managed with routine behavioral techniques?

  a. 20

  b. 40

  c. 60

  d. 80

  e. 90

22. Which of the following are not considered desirable properties of nitrous oxide?

  a. Easily titratable

  b. Cost

  c. Decreased ventilation response to hypoxia

  d. Patient acceptability

23. What, according to the AAPD is defined as the “diminution or elimination of anxiety in a conscious patient?”

  a. Conscious sedation

  b. Deep sedation

  c. Anxiolysis

  d. General anesthesia

24. Most deaths during general anesthesia administered to permit the delivery of dental care are attributed to…

  a. Respiratory difficulties or sudden cardiovascular collapse

  b. Heart attack

  c. Laryngospasm

  d. Overdose of anesthetic gas

25. Monitoring requirements during sedation procedures…

  a. Depends upon the deepest level of consciousness that may be attained

  b. May include patient color, breathing and heart sounds

  c. May include use of a pulse oximeter

  d. All of the above