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REGISTERED DENTAL HYGIENE LOCAL
ANESTHESIA FINAL EXAM 2025-
QUESTIONS AND CORRECT ANSWERS
Which of the following symptoms can be caused by paresthesia?
a. Numbness
b. Pain
c. Swelling
D. All of the above
D. All of the above
Paresthesia commonly reported with anesthesia with high concentrations (prilocaine & articaine)
Which of the following drugs fall under pregnancy category B?
a. Carbocaine
b. Marcaine
C. Citanest
d. Septocaine
C. Citanest
Citanest (Prilocaine) and Xylocaine (Lidocaine) are pregnancy B
Carbocaine, Marcaine and Septocaine are pregnancy category C
Which of the following does not help alleviate the symptoms of trismus?
a. apply heat for 20 min
b. use warm saline rinses
c. use muscle relaxants
d. use oraverse
d. Use oraverse
oraverse increase amount of blood flow to target area which allows tissue to recover more rapidly. Used to decrease duration of anesthesia, not trismus
What is the most common cause of needle breakage?
a. bending of needle
b. sudden pt movement
c. forceful contact of bone
d. use of thin needles
b. sudden pt movement
Which of the following can be an early sign of local anesthetic overdose?
d. avoid local anesthetics within vasoconstrictors
What can cause paresthesia?
a. forceful contact of needle to the bone
b. hemorrhage around the nerve
c. change of needle direction
d. bending of the needle
b. hemorrhage around the nerve
Local anesthesia given in preparation for endo treatments can sometimes fail? What could be the reason?
a. excessive bleeding at the site
b. patient is anxious
c. patient is experiencing overdose
d. the pH of the tissue has been lowered
d. the pH of the tissue has been lowered
Which of the following emergency conditions occurs the most frequently with local anesthetic injections?
a. heart attack
b. breathing problems
c. syncope
d. anaphylaxis
c. syncope
Which of the following advice can help a patient prevent soft tissue injuries following local anesthesia?
a. do not consume hot drinks for 4 hours
b. do not eat for 4 hours
c. keep a cotton roll attached to a floss in the mucobuccal fold
d. all of the above
d. all of the above
Methemoglobinemia is a contraindication for which of the following local anesthetics?
a. prilocaine
b. mepivacaine
c. procaine
d. septocaine
a. prilocaine
when metabolized, prilocaine forms methemoglobin which causes methemoglobinemia.
a. PSA nerve block
b. MSA nerve block
c. ASA nerve block
d. Infiltration
PSA nerve block
Which of the following is true about the effect of local anesthetics on the CNS?
a. Local anesthetics do not cross the blood-brain barrier
b. Tonic-clonic convulsions always occur with overdose
c. toxicity is usually not observable within the first 10 min from injection
d. Overdose is expressed as CNS excitation followed by depression
d. Overdose is expressed as CNS excitation followed by depression
At the end of the dental appointment, you noticed that one side of the patient's face is "drooping". What could have caused this change?
a. Local anesthetic was deposited into the parotid
b. muscles spasms occurred from opening the jaw for too long
c. the needle nicked a blood vessel
d. the patient is experiencing syncope
a. Local anesthetic was deposited into the parotid
Which of the following method can best resolve symptoms associated with trismus?
a. cold compressions
b. heat compression with normal eating
c. use of a straw when drinking liquids
d. restriction of the movement of the jaw for a week
b. heat compression with normal eating
When providing local anesthesia for a child, which of the following is not true?
a. use topical anesthetics instead of injections if possible
b. needle penetration depth is generally less deep
c. use less anesthetics compared to adults
d. use infiltrations rather than nerve blocks
a. use topical anesthetics instead of injections if possible
topical anesthesia must be given with caution b/c they are at higher concentrations
b. had an MI episode 7 mos ago
c. have a pacemaker
d. all of the above
a. experience angina on a daily basis
While the patient was lying in supine position awaiting for dental treatment, she experiences a sudden pain in the chest that lasted about 3 minutes and resolved on its own. This is most likely to be:
a. angina
b. myocardial infarctioni
c. allergy
d. heart attack
a. angina
Which of the followings should the clinician provide for a patient who is experiencing hypoglycemia and angina?
a. glucose, nitroglycerin
b. sugar juice, epinephrine
c. sugar-free juice, bronchodilator
d. water, oxygen
a. glucose, nitroglycerin
Which of the following categories of patients is more prone to overdose?
a. young adults
b. heavier weight adults
c. pregnant women
d. children
e. c and d
e. c and d
The patient is experiencing tremor, numbness in the extremities. The patient also is very talkative, and then suddenly lost consciousness. Which of the following conditions did the patient most likely experience?
a. allergies
b. overdose
c. anxiety
d. none of the above
b. overdose
What can the patient do to stop a hematoma from spreading as soon as it appeared?
a. massage the area
b. apply ice on the area
c. apply heat on the area
Which of the following drugs can impair the biotransformation of lidocaine?
a. meperidine
b. phenytoin
c. quinidine
d. all of the above
d. all of the above
Meperidine
Phenytoin
Quinidine
Despiramine
H2-histamine blocker
The patient experienced a sharp pain when the needle was inserted. This is most likely related to the:
a. low pH of the anesthetic solution
b. rapid injection
c. needle contacting the nerve sheath
d. high temperature of the solution
c. needle contacting the nerve sheath
What is the reasoning behind taking blood pressure before administering local anesthesia?
a. to establish a baseline
b. to avoid malpractice
c. to diagnose hypertension
d. to monitor anxiety
a. to establish a baseline
Which of the following conditions may happen if a needle did not contact the bone when administering an inferior alveolar nerve block?
a. penetration of soft tissue
b. Hemorrhage
c. facial nerve paralysis
d. trismsus
c. facial nerve paralysis
for IAN: needle must contact bone above mandibular foramen around appropriate insertion depth.
if needle does not contact bone, do NOT attempt to insert needle to the hub. Retract it and reposition needle more anteriorly. Ensures that needle is not in parotid gland
We have an expert-written solution to this problem!
If the patient is affected by cirrhosis:
d. it will most likely cause a reaction
c. caution should be used
The patient you are treating starts to feel swelling in her throat. You also noticed that her blood pressure has dropped after local anesthesia injection. What can the clinician do to manage this situation?
a. provide oxygen
b. provide epinephrine
c. provide Benadryl
d. provide nitroglycerin
b. provide epinephrine
BP has already dropped. No longer a mild rxn (benadryl), this requires immediate injection of epinephrine.
If a patient develops anaphylaxis, the clinician should provide
a. epinephrine and oxygen
b. nitroglycerin
c. bronchodilator
d. benadryl
a. epinephrine and oxygen
Psychogenic pain describes:
a. headache
b. pain due to local anesthesia
c. pain due to allergic reactions
d. pain due to emotional stress
d. pain due to emotional stress
Which of the following is related to early signs of local anesthetic toxicity?
a. CNS excitation
b. CNS depression
c. Cardiac arrest
d. Respiratory arrest
a. CNS excitation
We have an expert-written solution to this problem!
After administering an IA nerve block, you notice that a bluish spot has appeared on the patient's buccal mucosa. This is most likely:
a. an allergic reaction
b. an infection
c. pus
d. a hematoma
d. a hematoma
What are the landmarks for the MSA nerve block?
a. mucobuccal fold, max 1st PM
b. mucobuccal fold, max 2nd PM
c. mucobuccal fold, max 2nd molar
d. incisive papilla
b. mucobuccal fold, max 2nd PM
Which of the following structures may not be anesthetized by the PSA nerve block?
a. MB root of max third molar
b. MB root of max second molar
c. MB root of max first molar
d. all of the above
c. MB root of max first molar
Which injection can best anesthetize the max molars of a 5 y/o child while avoiding side effects?
a. PSA Nerve block
b. ASA Nerve block
c. Infiltrations
d. all of the above
c. Infiltrations
Infiltration is sufficient enough for providing anesthesia to primary teeth
nerve blocks increase risk of soft tissue injuries
The injection depth for the PSA nerve block is:
a. 5 mm
b. 8 mm
c. 16 mm
d. 30 mm
c. 16 mm
Which of the following needles should be selected for an IA nerve block?
a. Long needle with smaller gauge
b. Short needle with larger gauge
c. Long needle with larger gauge
d. Short needle with smaller gauge
a. Long needle with smaller gauge
Needle needs to be inserted 20-25 mm deep. Deep insertion requires "thicker" needle/ larger diameter.
