Download NBDHE case studies 17 – 29 with correct Answers highlighted 2025.pdf and more Exams Nursing in PDF only on Docsity!
NBDHE case studies 17 – 29 with correct
Answers highlighted
Case 17 Your patient is a 60-year old Caucasian male who is a sales representative for a national company and is on the road most of the time. He is married and has adult children who live in another state. If anesthesia were to be required to debride the teeth with furcations and deeper pockets, what would be the best choice of an anesthetic agent for this patient, taking into consideration, his medical history? A. Lidocaine HCL 2% with epinephrine 1:100, B. Articaine HCL 4% without epinephrine C. Prilocaine HCL 4% Plain D. Bupivicaine HCL 0.5% with epinephrine 1:200, A Taking into consideration, the patient’s clinical, radiographic and historical findings, how would you classify his periodontal condition based on the 2018 AAP Classification of Periodontal and Peri-Implant Diseases? A. Stage II, Grade B B. Stage III, Grade B C. Stage III, Grade C
D. Stage IV, Grade B B Given the patient’s blood pressure reading, how would you classify it based on the new AHA/ACC Guidelines? A. Normal B. Elevated C. Stage 1 D. Stage 2 D Of the medications that the patient is currently taking, which might be responsible for his current blood pressure reading? A. Prilosec should not be taken with Amlodipine B. Motrin should not be taken with Prilosec C. Amlodipine and Ramipril should not be taken with Ibuprofen D. Ramipril and Amlodipine should not be taken together C Given the amount of deposit, pocket depths, and bleeding index, what would be the best approach for a dental hygiene care plan? A. Quadrant scaling with local anesthesia, using both ultrasonics and hand instruments, polishing of the teeth B. Ultrasonic scaling throughout the mouth, followed by some hand scaling if necessary, selective polishing
C. Clenching habit D. Scrub brushing B The patient indicated that he has been getting recurrent painful ulcers in his mouth since he quit smoking, what do you suspect these ulcers might be? A. Herpetic lesions B. Traumatic ulcers C. Apthous ulcers D. Acid reflux C After discussing his brushing and flossing technique with him, what other home care recommendations would you make for him? A. Purchase a power toothbrush; use a toothpaste with stannous fluoride; use a proxabrush between the posterior teeth B. Use an air flosser; sodium fluoride toothpaste; and an alcohol-based mouthrinse C. Switch to a soft bristled toothbrush; a desensitizing toothpaste; and use a toothpick in the deeper pockets and furcations D. Use a stannous fluoride toothpaste; an essential oils mouthrinse; and a floss threader A Case 18
The patient is a 68 - year old Caucasian male who is semi-retired from farming. He has been a smoker for almost 40 years and has had a few health issues. He is reluctant to totally quit farming as he is helping his son take over the farm. He is 5'10" tall and weighs 185 lbs. Despite being on an antihypertensive medication, this patient's blood pressure is still in Stage II. What is the most likely explanation for this occurrence? A. The combination of Diltiazem and Aleve elevates blood pressure B. BMI falls within the "obese" category C. The combination of aspirin and Aleve elevates blood pressure D. He is overweight and smokes A The patient's daily use of NSAIDs and aspirin can increase his risk for: A. Xerostomia B. GI side effects C. Kidney problems D. Bleeding problems B What BEST identifies the cause for loss of tooth structure observed in the maxillary occlusal intraoral image? A. Abrasion B. Erosion C. Attrition
C. Professional in-office whitening; use of a more abrasive toothpaste; flossing; tongue cleaner D. Over-the-counter whitening agents; interdental brush; tongue cleaner; fluoridated toothpaste B What is the radiopaque U-shaped formation observed on the maxillary left molar periapical radiograph? A. Wall of the maxillary sinus B. Hyoid bone C. Zygomatic process of maxilla D. Air space C The patient's medical history findings indicate risk for all of the following EXCEPT: A. Cardiovascular disease B. Gastrointestinal issues C. Gout D. Cancer C Based on the patient's history and examination findings, what is the most urgent recommendation that you should make for the patient? A. Have the facial nevi checked out by a dermatologist B. Refer the patient to a periodontist
C. Stop taking Prilosec D. Quit smoking A The bilateral rounded bony projections located on the lingual mandibular areas adjacent to the premolar teeth are most likely: A. Osteomas B. Irritation fibromas C. Mandibular tori D. Sarcomas C Case # Patient Profile: The patient is a 67-year old Caucasian male who is recently retired and lives with his wife. He was the CEO of a large lumber company for the last 20 years of his career. He is 5’9” tall and weighs, 200 lbs. He has had extensive dental work done in the past, with multiple restorations and crowns. He has been a patient in your practice for over 25 years and has been attending regular periodontal therapy and maintenance appointments at recommended intervals. Today is his 6-week re-evaluation appointment after having had 2 previous appointments for scaling and root planing. Upon examination of the radiograph of the maxillary incisors, what percentage of bone loss is visible on tooth #8? A. 20% B. 33%
A. Pocket depths ≥6mm B. CAL 3-5mm C. Past history of smoking D. BOP >10% c The radiopaque areas observed in the mandibular anterior periapical radiographs are MOST likely: A. Compound odontomas B. Mandibular tori C. Non-odontogenic cyst D. Artifacts b The patient expresses concern about the continuing separation of his front teeth. Your BEST explanation for this is: A. Aging B. Gingival recession C. Continued bone loss D. Bleeding upon probing c Given the blood pressure readings that you recorded over this patient’s last three appointment, how would you classify these readings according to the new AHA/ACC guidelines? A. Normal
B. Elevated C. Stage 1 D. Stage 2 d Taking into consideration the patient’s height and weight you calculate his BMI to be 29.5 Kg/m2. How would you interpret this reading? A. Underweight B. Normal C. Overweight D. Obese c Based on your responses to questions # 7 & 8, what would you discuss with your patient? A. He may be at risk for cardiovascular disease B. He is in good health overall C. He should make an appointment with his physician to check out his blood pressure D. A and C d The patient has expressed interest in having his teeth whitened. You give him the following advice all of which is correct EXCEPT which one? A. Continue to use a stannous fluoride toothpaste but purchase one that has a whitening agent in it as well.
B. Case Type II, Grade B C. Case Type III, Grade C D. Case Type IV, Grade C c What was the determining factor for your Case Type choice in the above question? A. Direct Evidence of disease progression B. Smoking more than 10 cigarettes daily C. Indirect evidence of disease progression D. Presence of furcations d In reviewing the patient's profile and chief complaint, the dental hygiene care plan should include all of the following recommendations EXCEPT: A. Chew sugarless gum to stimulate saliva formation B. Stannous fluoride dentifrice with both pyrophosphate and hydrogen peroxide ingredients C. Smoking cessation program D. Switch to a non-alcoholic mouth rinse d What aspect of his daily home care regimen requires enhancement? A. Use of a floss wand to help him with his interproximal cleansing. B. Use of an interdental brush to cleanse the posterior regions of his mouth. C. Use of a fluoridated mouthrinse.
D. Use of a more abrasive toothpaste to tackle his stain. B The mandibular left second molar exhibits a furcation that can BEST be described as: A. Not detectable radiographically. B. Clinically open and exposed. C. A through-and-through involvement but is still covered by soft tissue. D. The involvement can be entered with a probe but cannot pass through to the opposite side. c What BEST describes the occlusal relationship between tooth #12 and #20? A. Open bite B. Overjet C. Crossbite D. End-to-end bite c Super-eruption is indicated on which tooth? A. Tooth # B. Tooth # C. Tooth # D. Tooth # c The bone loss visible on the radiographs is PRIMARILY:
B. Decreased vertical angulation C. Incorrect film placement D. Incorrect horizontal angulation C According to the new AHA/ACC blood pressure guidelines, how would you classify this patient's blood pressure reading? A. Normal B. Elevated C. Stage I D. Stage II d Upon calculating this patient’s Basal Metabolic Index (BMI) at 31.1, how would you classify her weight? A. Underweight B. Normal C. Overweight D. Obese d Given the patient’s medical history and additional findings, what health information would you discuss with this patient? A. She is in good health overall. B. She may be at risk for cardiovascular disease and should see her physician. C. She should quit smoking to lower any potential risk for overall health issues.
D. She is at high risk for cancer given her kidney hydronephrosis, polyps and facial nevus. b Based on the patient’s clinical, radiographic and historical findings, how would you classify her periodontal condition according to the 2018 AAP Classification of Periodontal and Peri-implant diseases? A. Periodontal Health B. Case Type 1, Grade B C. Case Type II, Grade B D. Case Type III, Grade B a You note that the incisal edges of her mandibular incisors are quite worn. What would you attribute the cause of this “wear” to be? A. Too heavy a bite B. It is a normal part of aging C. From drinking too many acidic types of drinks D. Grinding her teeth at night d Upon studying the radiographs, what might explain the “sensitivity” the patient has complained about between her maxillary molars? A. Deep periodontal pockets B. Overhanging amalgam restorations C. Carious lesions
D. Rinse her mouth daily with a non-alcoholic mouthrinse; use an interdental brush to clean under her bridges; use a floss threader in all other areas a What would you attribute the cause of the extrinsic stain to be that you note on most of her lingual surfaces? A. Drinking wine B. Cigarette smoking C. Drinking tea D. B and C d CASE 23 Your patient is a very personable 35-year old Caucasian male, whom you have not seen previously in your practice. He indicates he worked in Africa for the World Health Organization as a nurse for one year and returned home last year. He is now employed at one of the hospitals in the area. He did visit a dental hygienist when he returned from Africa and had some therapy done at that time but is now overdue for a maintenance appointment. He has several crowns on his teeth and is concerned about keeping his mouth healthy. Although he is under the care of a physician and is on multiple medications, he works out regularly and considers himself healthy. He claims he is very health conscious and eats well. This patient is on multiple medications but has not disclosed why they are being taken other than prophylactically and claims he is in good health. What is this combination of drugs typically used for?
A. HIV/AIDS cocktail B. Chronic inflammation C. Prevention of tropical diseases D. Sexually transmitted diseases a After examining his clinical and radiographic findings, how would you classify his periodontal condition according to the 2018 AAP classification of Periodontal and Peri-implant diseases? A. Gingivitis B. Stage I, Grade A C. Stage II, Grade B D. Stage III, Grade C c What were the determining factors for making the diagnostic decision in the question above? A. No CAL; no bone loss; bleeding index >10%; pocket depths ≤3mm; no tooth loss due to periodontal disease B. CAL 1-2mm; horizontal bone loss; bleeding index >10%; pocket depths ≤5mm; tooth loss due to periodontal disease C. Presence of risk factors; BOP >25%; pocket depths 3-4 mm; bone loss over 1/3rd of root; CAL 4-5mm D. CAL of 3-4 mm; bone loss in coronal third; Pocket depths ≤4mm; no tooth loss due to periodontal disease
