Download Local Anesthetics Quizzes (Units 1-13) Questions with 100% correct answers. GRADED A+ and more Exams Nursing in PDF only on Docsity!
Local Anesthetics Quizzes (Units 1-13)
Questions with 100% correct answers.
GRADED A+
Early methods of pain control included which of the following? - CORRECT
ANSWER -(All of the above)
Use of opium Scaring off of demons Roots, berries, and seeds
Pain threshold is best described as which of the following? - CORRECT
ANSWER -The point at which a sensation starts to be painful and discomfort results.
The neurologic experience of pain is referred to as what? - CORRECT
ANSWER -Pain perception
An unpleasant sensory and emotional experience is called what? - CORRECT
ANSWER -Pain
The creation of the loss of sensation in a circumscribed area, without loss of
consciousness, best defines which of the following? - CORRECT ANSWER -
Local anesthesia The newest amide to arrive on the dental market in the United States is which one of
the following? - CORRECT ANSWER -Articaine
Lidocaine is said to have revolutionized pain control in dentistry. Why? - CORRECT
ANSWER -Patients experience fewer allergic reaction with lidocaine.
The benefit of local anesthesia is not limited to pain control but could also include which
of the following? - CORRECT ANSWER -(All of the above)
Hemostasis Time Management Patient centered stress reduction An aware practitioner looks for signs of patient anxiousness. These signs may include
which of the following? - CORRECT ANSWER -(All of the above)
Overwillingness to cooperate with clinician History of emergency dental care only Elevated blood pressure and heart rate
The best method to manage an anxious patient is by - CORRECT ANSWER -
Prevention
Polarization (Resting State) - CORRECT ANSWER -- The electrical potential of
the neuron is approximately −70 mV.
- During this stage, the electrical charge on the outside of the membrane is positive, while the electrical charge on the inside of the membrane is negative.
- The outside of the cell contains excess sodium ions at a ratio of 14:1; the inside of the cell contains excess potassium ions
Slow Depolarization - CORRECT ANSWER -- The nerve is stimulated by the
minimal threshold level.
- The resting potential of the cell changes to become more negative, but not enough to trigger the firing threshold.
Rapid Depolarization - CORRECT ANSWER -- The impulse moves between the
uninsulated nodes of Ranvier that exist between each Schwann cell.
- The gated Na+ channels on the resting neuron's membrane release and open suddenly in order to allow the Na+ in the extracellular fluid to influx into the cell
Repolarization - CORRECT ANSWER -- Occurs once the peak of the action
potential is reached and the membrane potential begins to move back toward the resting potential
Relative Refractory Period - CORRECT ANSWER -- During this stage, the
second action potential is inhibited but not impossible should a larger stimulus be applied.
Absolute Refractory Period - CORRECT ANSWER -- The interval during which a
second action potential cannot be initiated, no matter how large a stimulus is applied. What are the nerves that conduct signals from sensory neurons to the spinal cord or
brain called? - CORRECT ANSWER -Afferent nerves
What are the nerves that conduct signals away from the brain or spinal cord called? -
CORRECT ANSWER -Efferent nerves
Why is protein binding an important characteristic of local anesthetic drugs? -
CORRECT ANSWER -Increased protein binding allows more cations (RNH+) to
bind to the receptor sites within the sodium channels, prolonging the presence of anesthetic at the site of action What does the membrane expansion theory of the action of local anesthetics suggest? -
CORRECT ANSWER -Anesthetics that are highly lipid soluble cause the
lipoprotein matrix of the nerve membrane to expand, narrowing the sodium channels, thus preventing depolarization What does the specific protein receptor theory of the action of local anesthetics
suggest? - CORRECT ANSWER -Displaced Ca++ and local anesthetic drugs
compete to bind to receptor sites within the ion channels of cell membranes
Tachyphylaxis is a term used to describe what phenomenon? - CORRECT
ANSWER -(All of the above)
- An increased tolerance to a drug that is administered repeatedly
- If the dental procedure lasts longer than the duration of the anesthetic and the mantel and core fibers have fully recovered, the reinjection of local anesthetic will be ineffective.
- Once the mantel fibers return to function, the patient experiences pain yet administration of anesthetic does not alleviate the pain. What factor/factors influence the duration of the effects of local anesthetics? -
CORRECT ANSWER -(All of the above)
- Degree of protein binding
- Vascularity of injection site
- Addition or absence of a vasoconstrictor Which organs of the body will have higher concentrations of anesthetics? -
CORRECT ANSWER -Some combination of the above
Vasodilation of the blood vessels at the site of the administration of a local anesthetic
will cause what? - CORRECT ANSWER -(All of the above)
- An increased rate of anesthetic absorption
- A decrease in the duration of the anesthetic
- Increased risk of toxicity True or False: Vasoconstrictors important additives to the local anesthetic solution, as they provide hemostasis at the injection site, they reduce the possibility of systemic toxicity and they prolong the duration of the anesthetic's effect. Vasoconstrictors can
also induce excessive bleeding. - CORRECT ANSWER -The first statement is
true; the second statement is false
Which receptors have inhibitory actions from adrenergic drugs on smooth muscle? -
CORRECT ANSWER -Beta receptors
Neleen indicates on her health history that she is allergic to novocaine and sulfa drugs.
What patient education might you provide to Neleen? - CORRECT ANSWER -
Explain that novocaine is in the ester family of drugs and you will be using a local anesthetic from the amide family. You have administered 2% lidocaine, 1:50,000 mg/ml epinephrine to a healthy patient. The patient experiences restlessness, nausea, and begins to hyperventilate. What
should you suspect? - CORRECT ANSWER -Overdose of epinephrine
Once epinephrine is absorbed, what happens to the action of the epinephrine? -
CORRECT ANSWER -It is deactivated in order to provide hemostasis.
Under what conditions might the risks of using a local anesthetic with a vasoconstrictor
outweigh the benefits? - CORRECT ANSWER -(1, 2, 5)
- A medically compromised patient
- A patient with unstable angina or uncontrolled hypertension
- A patient with uncontrolled diabetes
How long do adverse effects of vasoconstrictors last in the body? - CORRECT
ANSWER -5 to 10 minutes
True or False: More concentrated formulations of epinephrine are safer for patients who are cardiovascularly compromised. More diluted formulations of epinephrine provide the
greatest bleeding control. - CORRECT ANSWER -Both statements are false.
Which of the following may cause an endogenous release of epinephrine? -
CORRECT ANSWER -(All of the above)
- An injection of epinephrine
- Anxiety related to a divorce
- Apprehension about a dental appointment What is the term that describes a situation in which a drug should not be administered
to an individual under any circumstances? - CORRECT ANSWER -Absolute
contraindication What does the collection of pre anesthetic data, guide the dental hygienist in
determining? - CORRECT ANSWER -(All of the above)
- Need for medical consultation
- Appropriateness of administering a local anesthetic or vasoconstrictor
What is produced when the thumb ring of a syringe is pulled back by the clinician,
causing retraction of the rubber stopper? - CORRECT ANSWER -Negative
pressure Why might the harpoon of the syringe become disengaged during aspiration? -
CORRECT ANSWER -(b and c)
- Dullness
- Improper syringe set-up True or False: The importance of aspirating prior to anesthetic deposition and the potential hazards associated with intravascular injections are widely known and accepted. The self-aspirating syringe achieves the positive pressure for an aspiration
without a harpoon. - CORRECT ANSWER -The first statement is true; the
second statement is false. True or False: Patient comfort can be increased by the sharpness of the bevel. The
bevel of the needle should be turned toward the bone. - CORRECT ANSWER -
Both statements are true.
The buccal gingival tissue of the maxillary molars innervates - CORRECT
ANSWER -Posterior superior alveolar nerve
Which area of the maxilla articulates with the other to form the anterior or major part of
the hard palate? - CORRECT ANSWER -Palatine process
What is the name of the foramen located posterior to the maxillary central incisors? -
CORRECT ANSWER -Incisive foramen
What is the name of the opening that is located between the apices of the mandibular
first and second premolars? - CORRECT ANSWER -Mental foramen
The coronoid notch is a landmark for the administration of which injection? -
CORRECT ANSWER -Inferior alveolar nerve block
Successful delivery of local anesthetic agents depends on which of the following? -
CORRECT ANSWER -(All of the above)
- Effective client management
- Safe administration of the drug
- Client assessment
What is the main advantage of the nerve block over other types of anesthesia? -
CORRECT ANSWER -Provides profound pulpal and soft tissue anesthesia over
a larger area What can the clinician safely do if a client is experiencing excessive bleeding while
undergoing root planing? - CORRECT ANSWER -Infiltrate epinephrine 1:50,
in small amounts directly into the area of bleeding True or False: Local anesthesia is best administered by quadrants or sextants. It is an
effective client management strategy. - CORRECT ANSWER -Both statements
are true Why is the pterygoid venous plexus an area of concern when administering the PSA? -
CORRECT ANSWER -It is a highly vascular area
What is the name of the type of injection that anesthetizes a small area of one or two teeth and the associated structures, when the local anesthetic agent is deposited near
the terminal nerve endings? - CORRECT ANSWER -Supraperiosteal
In which order would you administer the maxillary injections? - CORRECT
ANSWER -PSA, MSA, ASA
Which of the following are best practices for the maxillary injection technique? -
CORRECT ANSWER -The needle should be inserted parallel with the long axis
of the tooth Where should the site for the MSA injection be if the client is missing one of his
premolars due to orthodontic treatment? - CORRECT ANSWER -Halfway in the
dental arch
What is an important post infraorbital injection procedure? - CORRECT
ANSWER -Maintain pressure and massage the solution into the infraorbital foramen
for approximately 2 minutes to enhance anesthetic diffusion True or False: There is more variation in the anatomy of the mandibular anesthetic landmarks than in similar maxillary structures. Lack of consistent success with the IA
block injection is due in part to anatomic variations. - CORRECT ANSWER -Both
statements are true
What usually causes the discomfort associated with the IA injection? - CORRECT
ANSWER -(a and b)
If a patient's MRD is 240 mg and 108 mg of 3% mepivacaine has already been
administered, how much more mepivacaine can the patient receive? - CORRECT
ANSWER -132 mg of 3% mepivacaine (240-108=132)
Which anesthetic/vasoconstrictor combination is most likely to limit the anesthetic drug?
- CORRECT ANSWER -Lidocaine 2% 1:50,000 epinephrine
What is the MRD for epinephrine for a compromised patient? - CORRECT
ANSWER -0.04 mg per appointment
What is the solution that is added to the cartridge of local anesthetic to prevent oxidation
of the vasoconstrictor called? - CORRECT ANSWER -Vasoconstrictor
preservative What is the solution that was added to the cartridge of local anesthetic to prevent
bacterial growth? - CORRECT ANSWER -Methylparaben
Which of the following questions should the dental hygienist consider prior to
administering local anesthetic to a patient? - CORRECT ANSWER -(All of the
above)
- What is the dental or dental hygiene care plan?
- What is the need for post-treatment pain control after the procedure?
- What is the patient's level of anxiety?
Prilocaine is the generic name for which of the following? - CORRECT
ANSWER -Citanest
What is the lipid solubility and the protein-binding ability of the local anesthetic related
to? - CORRECT ANSWER -Anesthetic duration of action
Which of the following statements are true regarding local anesthetics and allergic
reactions? - CORRECT ANSWER -(A and C)
- Sulfite sensitivities have been well documented and may rule out anesthetic formulations that contain vasoconstrictors.
- A documented drug allergy would indicate the need for an alternative drug selection and may represent an absolute contraindication to the offending drug Which local anesthetic agent/agents would be considered safer for cardiovascular
patients? - CORRECT ANSWER -(A and b)
- Prilocaine 1:200,000 epinephrine
- Articaine 1:200,000 epinephrine
Which amide anesthetic agent is metabolized in both the plasma and the liver? -
CORRECT ANSWER -Articaine
What is the term used to describe the persistent anesthesia or the altered sensation of
tingling or itching beyond the expected duration of local anesthetic? - CORRECT
ANSWER -Paresthesia
True or False: Inflamed tissue experiences an increase in vascularity, slowing the onset of anesthetic action and decreasing the duration of anesthetic action; however, in healthy tissues the onset of action and the duration of action are more predictable. -
CORRECT ANSWER -True
What is the name of a common ester topical anesthetic? - CORRECT
ANSWER -Benzocaine
Which of the following are considered advantages for the use of topical anesthetic
agents? - CORRECT ANSWER -(1,3,4)
- Pain control
- Can be purchased over the counter
- Ease of use Which of the following characteristics could contribute to the properties of an ideal
intraoral topical anesthetic? - CORRECT ANSWER -Allow pain-free application
True or False: To obtain the most benefit from the use of topical anesthetics, a fairly substantial amount of topical should be placed on the cotton tip applicator. This amount mixes with the saliva and may numb the tongue, soft palate, or pharynx. -
CORRECT ANSWER -The first statement is false; the second statement is true.
Which of the following properties are advantages to topical anesthetics being in a liquid
form? - CORRECT ANSWER -(All of the above)
-Provides anesthesia to a widespread area
- Useful to decrease a patient's gag reflex
- Can be applied to site-specific areas with an applicator Which topical anesthetic has warnings about the risk of methemoglobinemia? -
CORRECT ANSWER -Benzocaine sprays
Which of the following is/are true regarding topical anesthetics? - CORRECT
ANSWER -Allergic reactions can occur up to 2 days after the anesthetic is given.
What should the clinician do if she notices that the client is developing a hematoma? -
CORRECT ANSWER -Apply direct pressure immediately
Best practices to prevent needle breakage include which of the following? -
CORRECT ANSWER -Use a good technique
Which of the following could be cause for pain during injection? - CORRECT
ANSWER -(All of the above)
- Dull needle
- Barbed needle
- Lack of communication True or False: A dental hygienist does not necessarily need to purchase his/her own liability insurance because he/she is typically covered under the umbrella of the
supervising dentist's professional liability insurance. - CORRECT ANSWER -
False True or False: Any refusal of treatment by the patient and a brief statement documenting the discussion of risks associated with refusal of treatment should be
documented in the patient record. - CORRECT ANSWER -True
Which of the following factors may serve to decrease the risk of possible litigation? -
CORRECT ANSWER -(All of the above)
-Minimizing misunderstandings
- Resolving problems as they arise
- Developing a one-on-one relationship with the patient to build trust and confidence Which of the following is true regarding the best practice in obtaining informed consent?
- CORRECT ANSWER -Ultimately, it is the patient's decision whether to accept a procedure or not.
Dental hygienist-employer communication best practices include: - CORRECT
ANSWER -(All of the above)
- Open discussion regarding the potential liabilities for dental personnel
- Brainstorming liability prevention strategies
- Writing or reviewing the office protocol What should the dental hygienist do to prevent the possibility of litigation? -
CORRECT ANSWER -(A and b)
-Practice life-long learning
- Document accurately and thoroughly
True or False: Always be sure to administer the appropriate volume of anesthetic for the area that can reasonably be completed during one appointment. On completion of one quadrant of nonsurgical periodontal treatment, the clinician can administer more
anesthetic, even if the MRD has been reached. - CORRECT ANSWER -The first
statement is true; the second statement is false. What must the qualified health care professional consider when assessing the need for
follow-up of occupational exposures? - CORRECT ANSWER -(All of the above)
- Susceptibility of exposed person
- Infectious status of source
- Amount of fluid/tissue involved in the exposure
Which of the following meet dental hygiene standards of practice? - CORRECT
ANSWER -(All of the above)
-Confidentiality
- Meeting the standards set by other practitioners
- Informed consent
