Dental Hygiene Theory and Practice 4th

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Chapter 10: Medical Emergencies
Test Bank

MULTIPLE CHOICE

1. Reasons for the increased likelihood of medical emergencies during dental hygiene care
include all of the following except one. Which one is the exception?
a. The aging population
b. Increased number of drugs used in dentistry
c. Less time available for dental hygiene appointments
d. Increased number of medically compromised clients
e. Wholesome facial image
ANS: C
Less time available for dental hygiene care is the exception because appointments are actually
longer than in the past. The aging population, increased number of drugs used in dentistry,
increased number of medically compromised clients, and a wholesome image are all reasons
for increased likelihood of medical emergencies in dental and dental hygiene practice.

REF: Competencies, page 120

2. Preparation of all dental personnel in the office for management of medical emergencies
should include training and current certification in Basic Life Support (BLS), practice in
medical emergency drills, and an annual refresher course in emergency medicine. All office
personnel should have emergency numbers memorized for use when needed.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true, and the second statement is false.
d. The first statement is false, and the second statement is true.
ANS: C
All personnel should have training in BLS, practice in managing medical emergencies, and
annual refresher courses. However, emergency numbers should be posted by all telephones
for reference when needed. The other choices are incorrect.

REF: Office Personnel and Environment Preparation, page 120

3. What is the term for a person who is not responding when spoken to and shaken gently?
a. Unconscious
b. Ventricular fibrillation
c. Dental fear and anxious
d. Immunosuppression
ANS: A
Unconscious is a term used for an unresponsive person. Ventricular fibrillation is a state of
totally disorganized electrical activity in the heart resulting in quivering of the ventricles.
Dental fear or anxiety is a state of fright or worry and nervousness about what will occur
during a dental appointment. Immunosuppression refers to the inhibition of the formation of
antibodies to antigens that may be present; used in transplantation procedures to prevent
rejection of the transplanted organ or tissue. It is an incorrect choice.
 REF: Recognition of Unresponsiveness, page 124

4. A medical consultation is performed by a dental professional after the client’s medical and
dental history is completed because legal liability is then the responsibility of the physician.
a. Both the statement and the reason are correct, and they are related.
b. Both the statement and the reason are correct, but they are not related.
c. The statement is correct, but the reason is not.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.
ANS: C
The dental professional completes medical consultations after completing the medical and
dental histories. Consultations are conducted because the additional information from the
physician is needed to reduce the risk of an emergency in a high-risk client. Transfer of legal
liability is not attained by a medical consultation. The other choices are incorrect.

REF: Client Assessment, page 120

5. Which medication is administered for a mild allergic reaction?

a. Diphenhydramine
b. Epinephrine
c. Amoxicillin
d. Nitrous oxide
e. Ammonia ampule
ANS: A
Diphenhydramine is administered for a mild allergic reaction. Epinephrine is administered for
severe allergic reactions. The other drugs are not administered in emergencies. Epinephrine,
amoxicillin, nitrous oxide, and ammonia ampule are incorrect choices.

REF: Table 10-3: Management of Specific Medical Emergencies, page 140

6. Which of the following is the term used to describe the level of care or intervention used for
victims of life-threatening illnesses or injuries until they can be given full medical care at a
healthcare facility offering such services?
a. Cardiopulmonary resuscitation
b. Rescue breathing
c. Conscious sedation
d. Basic Life Support (BLS)
ANS: D
BLS is the level of care or intervention used for victims of life-threatening illnesses or injuries
until they can be given full medical care at a healthcare facility offering such services.
Cardiopulmonary resuscitation, rescue breathing, and conscious sedation are incorrect
choices.

REF: Basic Life Support, page 122

7. The most important part of BLS is providing chest compressions and defibrillation. The first
cycle of compressions (30 per 18 seconds) is delivered without the delay.
a. Both statements are true.
 b. Both statements are false.
c. The first statement is true, and the second statement is false.
d. The first statement is false, and the second statement is true.
ANS: A
The most important part of BLS is providing chest compressions and defibrillation to keep the
blood circulating in the body. The first cycle of compressions (30 per 18 seconds) is delivered
without the delay because the compressions create a means for circulation. The other choices
are incorrect.

REF: Basic Life Support, page 122

8. The head tilt–chin lift technique is the most important step in maintaining an open airway for
rescue breaths because a blocked airway can be cleared with this technique.
a. Both the statement and the reason are correct, and they are related.
b. Both the statement and the reason are correct, but they are not related.
c. The statement is correct, but the reason is not.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.
ANS: C
The head tilt–chin lift is the most effective means of giving rescue breaths but it will not clear
a blocked airway. An abdominal thrust or chest thrust is used to clear a blocked airway. The
other choices are incorrect.

REF: Terminate Dental Hygiene Care, Summon Assisstance, and Position the Client, page 127

9. What is the recommended rate of rescue for a child who has a pulse but is unresponsive?
a. One breath every 5 to 6 seconds
b. Two breaths every 15 seconds
c. One breath every 30 seconds
d. Two breaths every 5 to 6 seconds
e. One breath every 3 seconds
ANS: E
One breath is given every 3 seconds for an infant or child, and every 5 to 6 seconds for an
adult. The other choices are incorrect.

REF: Mouth-to-Mouth Ventilation, page 128

10. Which of the following signs is the most common one associated with severe choking?
a. A person cannot talk or breathe
b. Coughing
c. Bent over position
d. Pallor
e. Perspiration
ANS: A
A person who is choking cannot cough, breathe, or speak. Coughing, bent over position,
pallor, and perspiration are not associated with facial signs of choking.

REF: Obstructed Airway, page 134

11. An electrical shock called defibrillation may restore a normal heart rhythm. Each minute
defibrillation is delayed reduces the victim’s chance of survival by 10%.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true, and the second statement is false.
d. The first statement is false, and the second statement is true.
ANS: A
Both statements are true. The other choices are incorrect.

REF: Effective Emergency Response, page 131

12. Any damage to the heart can disrupt the heart’s electrical system and result in a cardiac
arrhythmia. The two most common interruptions in the heart rhythm are ventricular
fibrillation and ventricular tachycardia.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true, and the second statement is false.
d. The first statement is false, and the second statement is true.
ANS: A
Both statements are true. The other choices are incorrect.

REF: The Heart's Electrical System, page 129

13. Rescue breathing must begin as soon as possible because clinical death is cessation of the
heart and brain death can begin within 4 minutes.
a. Both the statement and the reason are correct, and they are related.
b. Both the statement and the reason are correct, but they are not related.
c. The statement is correct, but the reason is not.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.
ANS: D
CPR, not rescue breathing, must begin as soon as possible to keep blood circulating to the
brain and prevent brain death from beginning within 4 minutes. The other choices are
incorrect.

REF: The Heart's Electrical System, page 129

14. What is the recommended depth of chest compressions for an adult?

a. 1 1/2 inches
b. 1 1/2 to 2 inches
c. At least 2 inches
d. 2 to 2 1/2 inches
e. At least 2 1/2 inches
ANS: C
The recommended depth of compressions is at least 2 inches for compressions to ensure
effectiveness; 1 1/2 inches, 1 1/2 to 2 inches, and 2 to 2 1/2 inches are incorrect choices.
 REF: Basic Life Support, page 123

15. The recommended rate for chest compressions in an adult is _____ per minute.
a. at least 20
b. 50
c. 60
d. 80
e. 100
ANS: E
The rate of compressions for an adult is 100 per minute. At least 20 per minute, 50 per minute,
60 per minute, and 80 per minute are incorrect choices.

REF: Basic Life Support, page 122

16. If a client encounters a medical emergency during dental hygiene care, the dental hygienist
has an option to provide emergency care or wait until emergency personnel are available. The
health professional providing emergency care must be trained to provide any care given to the
victim of an emergency.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true, and the second statement is false.
d. The first statement is false, and the second statement is true.
ANS: D
A healthcare professional has a responsibility to begin emergency care immediately if it is a
part of their job responsibilities and must be trained in any care provided. The other choices
are incorrect.

REF: Terminate Dental Hygiene Care, Summon Assisstance, and Position the Client, page 124

17. A good Samaritan is someone who renders aid in an emergency to an injured person on a
voluntary basis. There is no need for consent for the care provided to a conscious or an
unconscious person.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true, and the second statement is false.
d. The first statement is false, and the second statement is true.
ANS: C
The definition of a good Samaritan is correct; however, consent is needed before delivery of
emergency care if a victim is conscious. The other choices are incorrect.

REF: Legal, Ethical, and Safety Issues, page 142

18. A ventilation mask has benefits over mouth-to-mouth resuscitation because it provides a
barrier for prevention of disease transmission and creates a seal over the mouth and nose.
a. Both the statement and the reason are correct, and they are related.
b. Both the statement and the reason are correct, but they are not related.
c. The statement is correct, but the reason is not.
d. The statement is not correct, but the reason is correct.
 e. Neither the statement nor the reason is correct.
ANS: A
The statement and the reason are correct. The other choices are incorrect.

REF: Resuscitation Masks, page 127

19. A medical consultation should ask the client for very specific information regarding a client’s
diagnosis and health status. A facsimile machine is inadequate for legal documentation.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true, and the second statement is false.
d. The first statement is false, and the second statement is true.
ANS: C
The reason for a medical consultation is correct; however, the facsimile is adequate for legal
documentation, so the second statement is false. The other choices are incorrect.

REF: Box 10-2: Medical Consultation, page 121

20. An ASA II classification indicates which of the following?

a. Normal, healthy client
b. Mild systemic disease
c. Moderate systemic disease
d. Severe systemic disease that limits activity but is not incapacitating
e. Incapacitating systemic disease that is a constant threat to life
ANS: B
ASA II indicates mild systemic disease. Normal, healthy client; severe systemic disease that
limits activity but is not incapacitating; and incapacitating systemic disease that is a constant
threat to life are ASA I, III, and IV respectively, and mild systemic disease is not an ASA
classification.

REF: Box 10-1: The American Society of Aneshesiologists Physical Status Classification, page 121

21. Which of the following medical emergencies would be characterized by flushed skin, nausea,
rapid heart rate, and pallor?
a. Syncope
b. Myocardial infarction
c. Uncontrolled angina
d. Cerebrovascular incident
e. Seizure
ANS: A
Syncope is characterized by flushed skin, nausea, rapid heart rate, and pallor. Myocardial
infarction, uncontrolled angina, and cerebrovascular incident are incorrect choices because
these conditions are not characterized by these signs and symptoms.

REF: Table 10-3: Management of Specific Medical Emergencies, page 140

22. Which of the following conditions would require administration of oxygen, 162 mg aspirin,
and activation of emergency medical services (EMS)?
 a. Syncope
b. Myocardial infarction
c. Uncontrolled angina
d. Cerebrovascular incident
e. Seizure
ANS: B
Myocardial infarction requires administration of oxygen, 162 mg aspirin, and activation of
EMS. Syncope, myocardial infarction, uncontrolled angina, and seizures are incorrect choices
because these conditions are not characterized by these symptoms.

REF: Table 10-3: Management of Specific Medical Emergencies, page 140

23. Which of the following would be the correct emergency care to provide for a pregnant client
with a foreign body obstruction?
a. Abdominal thrusts
b. Heimlich maneuver
c. Chest thrusts
d. Finger sweep
e. Rescue breathing
ANS: C
Chest thrusts are performed to remove a foreign body obstruction for a medical emergency
involving a pregnant woman. Abdominal thrusts, Heimlich maneuver, finger sweep, and
rescue breathing are incorrect choices; abdominal thrusts (Heimlich maneuver) might harm
the fetus in a pregnant woman. A finger sweep might push the object farther down the airway,
and rescue breaths would be blocked.

REF: Figure 10-24, page 136

24. Which medical emergency would be characterized by slurred speech, confusion, and
headache?
a. Syncope
b. Myocardial infarction
c. Uncontrolled angina
d. Cerebrovascular incident
e. Seizure
ANS: D
A cerebrovascular accident or stroke would be characterized by slurred speech, confusion, and
headache. Syncope, myocardial infarction, uncontrolled angina, and seizures are incorrect
because these conditions are not characterized by these signs and symptoms.

REF: Table 10-3: Management of Specific Medical Emergencies, page 140

25. What sequence of emergency care should be provided for optimal emergency care of a
nonresponsive client without a pulse?
a. AED, chest compressions, check airway, rescue breathing
b. Chest compressions, AED, check airway, rescue breathing
c. AED, check airway, rescue breathing, chest compressions
d. Check airway, rescue breathing, AED, chest compressions
 e. Chest compressions, check airway, rescue breathing, AED
ANS: A
The correct sequence is AED first because defibrillation is critical to success in a cardiac
incident, chest compressions to maintain circulation and supply oxygen to the brain, followed
by checking the airway and providing rescue breaths. The other sequences are incorrect.

REF: Procedure 10-1: Overview of Basic Life Support for an Unresponsive Victim, page 125

26. Which is the correct rate of chest compressions and rescue breaths when providing single
rescuer CPR for a child?
a. 30 compressions to 2 rescue breaths
b. 15 compressions to 2 rescue breaths
c. 30 compressions to 1 rescue breath
d. 15 compressions to 1 rescue breath
e. 60 compressions to 2 rescue breaths
ANS: B
The ratio for a child is 15:2. The other choices are incorrect. The ratio for adults is 30:2.

REF: Procedure 10-3: Two-Recuer Cardiopulmonary Resuscitation (CPR) - Adult and Child, page
130

MULTIPLE RESPONSE

1. What are the four main risks related to dental hygiene care?
a. Hemostasis
b. Invasiveness of dental hygiene procedures
c. Drug reactions and interactions
d. Susceptibility to infection
e. Client’s ability to tolerate stress of procedures planned
f. Expanded scope of dental hygiene practice
g. The oral-systemic link
ANS: A, C, D, E
Hemostasis, drug reactions and interactions, susceptibility to infection, and the client’s ability
to tolerate stress of procedures planned are the four main risks associated with dental hygiene
care. Invasiveness of dental hygiene procedures, expanded scope of dental hygiene practice,
and the oral-systemic link are not the main risks associated with dental hygiene care.

REF: Competencies, page 120

2. Which of the following are signs of a client with moderate anxiety?

a. Cold sweaty palms
b. Pallor
c. Unnaturally stiff posture
d. White-knuckle syndrome
e. Xerostomia
f. Slow responses
g. History of emergency dental care only
 ANS: A, C, D, G
Cold sweaty palms, unnaturally stiff posture, white-knuckle syndrome, and history of
emergency dental care only are some of the signs of moderate anxiety. Pallor, xerostomia, and
slow responses are incorrect choices.

REF: Box 10-3: Clinical Signs of Moderate Anxiety, page 122

3. What are the three signs or symptoms of a mild (partial) airway obstruction?
a. Possible cyanosis
b. Good air exchange
c. Coughing forcefully
d. Wheezing
e. High-pitched noise while inhaling
f. Increasing respiratory difficulty
g. Victim makes universal sign of choking
ANS: B, C, D
Good air exchange, coughing forcefully, and wheezing are signs and symptoms of mild
(partial) airway obstruction. All of the others are signs and symptoms of severe (complete)
airway obstruction. Possible cyanosis, high-pitched noise while inhaling, increasing
respiratory difficulty, and victim makes universal sign of choking are incorrect choices
because they are signs and symptoms of severe (complete) airway obstruction.

REF: Obstructed Airway, page 134

4. Which of the following are emergencies that would require placing the client in an upright
position?
a. Syncope
b. Shock
c. Asthma attack
d. Congestive heart failure
e. Seizure
f. Adrenal crisis
g. Stroke
ANS: C, D
Asthma attacks and congestive heart failure are respiratory emergencies requiring an upright
position to facilitate breathing. Syncope, shock, seizures, adrenal crisis, and strokes are
conditions that would require supine, semisupine, or Trendelenburg positioning.

REF: Table 10-3: Management of Specific Medical Emergencies, page 140