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Local Anesthetic Quiz Questions Key
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When using an aspirating syringe, negative pressure applied on the thumb ring allows for aspiration to occur. Positive pressure applied on the thumb ring forces the local anesthetic solution into the needle lumen and the patient's tissues. Both statements are true. Both statments are false. The first statement is true, the second statement is false.
The first statement is false, the second statement is true. - CORRECT
ANSWER -Both statements are true.
Which of the following gauge numbers indicates the needle with the largest lumen? 25 27
30 - CORRECT ANSWER -
When calculating the drug dosage delivered in one cartridge of local anesthetic, the standard volume of ______ ml is used. 0.18 ml 1.8 ml 1.0 ml
0.10 ml - CORRECT ANSWER -1.8ml
Small air bubbles seen in local anesthetic cartridges are indicative of: a cracked or broken cartridge. normal nitrogen added to the carpule. the local anesthetic solution being oxidized.
the cartridge needing to be discarded. - CORRECT ANSWER -normal nitrogen
added to the carpule. Which of the following components of the anesthetic cartridge increases the safety and the duration of the local anesthetic drug? vasopressor sodium chloride sodium bisulfite
methylparaben - CORRECT ANSWER -vasopressor
True or False. The location where needle breakage is most likely to occur is at the tip of the needle. True
False - CORRECT ANSWER -false
Sodium chloride is added to local anesthetic solutions as a preservative for the vasoconstrictor drug. True
False - CORRECT ANSWER -false
Which statement describes the correct method to ensure that the harpoon is seated in the stopper? Press on the finger ring to ensure solution passes through the needle. Pull back on the thumb, then the rubber stopper will retract. Use firm hand pressure against the syringe ring.
Apply pressure on the needle cap - CORRECT ANSWER -Use firm hand
pressure against the syringe ring. When anesthetizing the upper left maxillary second molar, anesthesia is delivered to the: Pterygoid Plexus Posterior Superior Alveolar Nerve Middle Superior Alveolar Nerve
Zygomatic Nerve - CORRECT ANSWER -Posterior Superior Alveolar Nerve
The area indicated by this picture is innervated by: (picture pointing to mandibular premolars, canine, lateral and central incisor) Mylohyoid Nerve Incisive Nerve branch of the Inferior Alveolar Nerve Inferior Alveolar Nerve
Mental Nerve branch of V3 - CORRECT ANSWER -Mental Nerve branch of V
When a nerve is at rest, which of the following statements is true? Na+ concentration is highest inside the cell. The cell membrane is more negative on the outside. The cell membrane can be excited if a stimulus is intense enough to initiate an impulse. Regardless of the stimulus intensity, the nerve cannot respond to a stimulus when in
this particular state. - CORRECT ANSWER -The cell membrane can be excited if
a stimulus is intense enough to initiate an impulse. The administration of local anesthesia to control pain is an example of: Lowering the pain reaction threshold. Cortical depression. Interrupting pain perception. Removing the cause of the pain.
Psychosomatic pain control. - CORRECT ANSWER -Interrupting pain
perception.
Local anesthetic drugs are effective only at the nodes of Ranvier and in order to be effective, multiple nodes must be exposed to the drug to block impulses. True
False - CORRECT ANSWER -True
Which of the following statements regarding nerve fiber types is INCORRECT? Dental pulp has more A than C nerve fiber types. C fibers are more numerous in the peripheral nervous system. A delta fibers are lightly myelinated and are responsible for the sensation of sharp pain. C fibers are nonmyelinated and are responsible for the sensation of dull and aching
pain. - CORRECT ANSWER -Dental pulp has more A than C nerve fiber types.
Which of the following local anesthetics has the longest duration of action? 4% Articaine HCL with epinephrine 1:100, 0.5% Bupivacaine HCL with epinephrine 1:200, 3% Mepivacaine plain (without vasoconstrictor)
4% Prilocaine HCL with 1:200,000 epinephrine - CORRECT ANSWER -0.5%
Bupivacaine HCL with epinephrine 1:200, Match the generic local anesthetic drug name to the proprietary or brand name associated with it. lidocaine mepivacaine articaine prilocaine
bupivacaine - CORRECT ANSWER -Xylocaine
Carbocaine Septocaine Citanest Marcaine Which local anesthetic drug is contraindicated for use with a patient taking tricyclic antidepressant drugs. 2% mepivacaine with 1:20,000 levonordefrin 3% mepivacaine plain 4% prilocaine
0.5 % bupivacaine - CORRECT ANSWER -2% mepivacaine with 1:20,
levonordefrin Assuming that an equal dose of each of the following drugs is administered, which local anesthetic drug below would have the greatest potential for complications for a patient ASA II or III cardiovascular disease? 2% lidocaine 1:100,000 epi 4% prilocaine plain
2% mepivacaine with 1:20,000 levonordefrin - CORRECT ANSWER -2%
lidocaine 1:100,000 epi Which of the following is the best fit for a definition of Maximum Recommended Dose (MRD) of a drug? A safe dose to administer in all situations A dose that a 150 pound individual can have a dose that cannot be exceeded under any circumstance
a safe guideline when administering local anesthetic drugs - CORRECT
ANSWER -a safe guideline when administering local anesthetic drugs
Which of the following best describes the metabolism of Articaine? Articaine is metabolized approximately 25% in the liver Articaine is metabolized primarily via plasma cholinesterase Much of articaine is excreted unchanged
Articaine's metaolism is similar to procaine's - CORRECT ANSWER -Articaine is
metabolized primarily via plasma cholinesterase Arrange the injectable local anesthetic drugs in descending order of overall CNS and CVS toxicity. Bupivicaine, mepivacaine, lidocaine, prilocaine, articaine Bupivacaine, mepivacaine, lidocaine, articaine, prilocaine Bupivacaine, lidocaine, mepivacaine, articaine, prilocaine
bupivacaine, mepivacaine, articaine, lidocaine, prilocaine - CORRECT
ANSWER -Bupivacaine, lidocaine, mepivacaine, articaine, prilocaine
What is the maximum dose of epinephrine per appointment for a healthy adult? 1.8 mg 0.2 mg 0.4 mg
4.0 mg - CORRECT ANSWER -0.2 mg
Epinephrine may be contraindicated for patients with a previous history of stroke, radiation therapy, or brittle diabetes. True
False - CORRECT ANSWER -true
A 1:100,000 concentration of epinephrine in a local anesthetic solution is the most common concentration used. A 1:200,000 concentration contains twice as much vasoconstrictor than the 1:100,000 concentration. Both statements are true. Both statements are false. The first statement is true and the second statement is false.
During your initial assessment of a patient, you take the blood pressure and notice that the systolic pressure is 190mmHg. What should be your recommended course of action? Continuously monitor the blood pressure during treatment Proceed with giving anesthetic Proceed with treatment but without the use of anesthetic
Defer all elective treatment - CORRECT ANSWER -Defer all elective treatment
A patient presents for their initial assessment and tells you that they are currently taking Propranolol, a non-specific beta-blocker. Which of the following issues could arise if an anesthetic is delivered which contains a vasoconstrictor? Vasoconstrictors and beta blockers interact to increase blood pressure Vasoconstrictors and beta blockers interact to cause blood pressure to fall Vasoconstrictors and beta blockers interact to cause kidney disease Vasoconstrictors and beta blockers interact to cause blood sugar levels to fall -
CORRECT ANSWER -Vasoconstrictors and beta blockers interact to increase
blood pressure Which of the following muscles is pierced when administering the Inferior Alveolar Nerve Block? Temporalis Masseter Buccinator
Pterygoid - CORRECT ANSWER -Buccinator
A patient can develop a transient facial nerve paralysis (i.e. facial anesthesia) if the anesthetic solution is deposited into which of the following structures during administration of the Inferior Alveolar Nerve Block. Masseter muscle Parotid gland Mylohyoid muscle
Mental foramen - CORRECT ANSWER -Parotid gland
Which of the following injections will provide pulpal anesthesia to the mandibular premolars, canines and anterior incisors? Mental nerve block Incisive nerve block Long buccal nerve block
Lingual nerve block - CORRECT ANSWER -Incisive nerve block
You will be completing periodontal debridement on the mandibular left quadrant. Which of the following injections will you most commonly administer in order to provide complete anesthesia in this area? Click all that apply. Inferior Alveolar Nerve Block Mental nerve block
Long Buccal Nerve Block
Incisive nerve block - CORRECT ANSWER -Inferior Alveolar Nerve Block
Long Buccal Nerve Block The lingual nerve is usually anesthetized along with the Inferior alveolar nerve when an IANB is administered. True
False - CORRECT ANSWER -true
Which one of the following statements best describes the technique error(s) that results in premature contact with bone immediately after penetration for an IA nerve block? Penetration was too high and too lateral to pterygomandibular raphe Penetration was too low and too lateral to pterygomandibular raphe Penetration was too medial to the internal oblique ridge in relationship to the pterygomandibular raphe
Angle of the syringe was anterior to the premolars - CORRECT ANSWER -
Penetration was too low and too lateral to pterygomandibular raphe Of all the common maxillary local anesthesia injections, the placement of only this injection may benefit from use of the long (30 mm ) needle: Greater palatine Nasopalatine Middle superior alveolar
Posterior superior alveolar - CORRECT ANSWER -Posterior superior alveolar
Which of the following types of injections anesthetizes the smallest area: Field block Nerve block Infiltration
Ice block - CORRECT ANSWER -Infiltration
The target area (deposition site) for the Posterior Superior Alveolar nerve block is: The foramina posterior, superior, and medial to the maxillary second (or third) molar. The maxillary bone superior to the apex of the maxillary second premolar. The infraorbital foramen.
The height of the mucobuccal fold of the second molar - CORRECT ANSWER -
The foramina posterior, superior, and medial to the maxillary second (or third) molar. Which maxillary injections are needed to provide complete pulpal and soft tissue anesthesia to teeth 6-8? Click all that apply MSA nerve block Greater palatine nerve block ASA nerve block Nasopalatine nerve block
but despite your skill, the patient's anxiety is increasing by the minute. What do you think you could have done differently? Address their chief complaint earlier Rushed through the appointment to get them out sooner
Not talking through the procedure - CORRECT ANSWER -Address their chief
complaint earlier Lowering your chair and sitting your patient up when speaking to them is a way to show your patient: That the relationship is of equals, and we are partners in their care That you need to look them in the eye when telling them what they need
That they need to trust you as you know what is best for them - CORRECT
ANSWER -That the relationship is of equals, and we are partners in their care
Patients need to feel a sense of control over their care in order to decrease anxiety. Which of the following is NOT a method of providing control to your patient? Informational Cognitive Behavioral Retrospective
Autonomous - CORRECT ANSWER -Autonomous
Before working on your patient, you provide a simple description of the procedure, with emphasis on the sensations that the patient will experience. This is an example of: Informational control Cognitive control Behavioral control
Retrospective control - CORRECT ANSWER -Informational control
Guided imagery provides patients with active roles replacing negative thoughts with mental images of pleasant scenes or scenarios. This is an example of: Informational control Cognitive control Behavioral control
Retrospective control - CORRECT ANSWER -Cognitive control
A patient reports in his medical history that he is allergic to "Novocaine". Based on this response, it is very likely that he could have an allergic response to the local anesthetics which are currently used in dentistry. True
False - CORRECT ANSWER -False
Which of the following conditions, as reported in the medical history, pose a relative contraindication to use of local anesthetics? Click all that apply
true allergy to local anesthetics malignant hyperthermia atypical plasma cholinesterase
idiopathic or congenital methemoglobinemia - CORRECT ANSWER -malignant
hyperthermia atypical plasma cholinesterase idiopathic or congenital methemoglobinemia Local anesthetics are absolutely contraindicated for a pregnant patient during any trimester. True
False - CORRECT ANSWER -False
Which of the following conditions is commonly a occurring reaction to the administration of local anesthetics? vasodepressor syncope hypotension angina pectoris
convulsions - CORRECT ANSWER -vasodepressor syncope
Which of the following forms of anemia may represent a relative contraindication to the use of local anesthetics with or without epinephrine? sickle cell anemia iron deficiency anemia methemoglobinemia
all of the above - CORRECT ANSWER -methemoglobinemia
Upon reviewing a patient's medical history, you notice that he reports that he bruises easily. What is the best explanation of why this finding may be significant when deciding to administer local anesthetic? It may indicate that the patient will find the injection painful It may indicate a bleeding disorder necessitating further questioning It is an indication off iron deficiency anemia which may contraindicate use of any local anesthetic It is an indication that he may have liver disease resulting in an unusual response to the dose of local anesthetic given It is a sign of congestive heart failure which may be a contraindication to use of local
anesthetic with epinephrine - CORRECT ANSWER -It may indicate a bleeding
disorder necessitating further questioning You are preparing to give your patient for administration of a local anesthetic. You apply a topical anesthetic gel and notice redness and slight swelling of the area, and the patient is complaining of itching. What should be your immediate next action. Remove all traces of the topical agent Refer the patient for allergy testing
