Patient Management, Preparation for NBDE Part II

  • Category: Patient Management
  • Aim: Revising for NBDE Part II
  • Questions: 25
  • Hint: No
  • Mutiple Opportunites: No
  • Time Limit: No
  • Answer Explaining: Yes

Patient Management

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Question 1

Dental intervention studies suggest that educating patients regarding dental care (patient education) is more effective than behavioral modification (behavioral intervention) in increasing compliance.

A
True.
B
False.
C
Sometimes.
D
Both are equally effective.
E
Cannot be determined.
Question 1 Explanation: 
B. Research has demonstrated that behavioral inter¬ vention is typically more effective than patient education alone. A combination of the two is considered the most effective approach to increasing patient compliance.
Question 2
You need to inject a local anesthetic for a 10-year-old patient You note that this patient appears to be very anxious and frequently asks what you are doing or are about to do. To which technique is the patient least likely to respond well?
A
Distraction.
B
Taking a few deep breaths.
C
Bringing his mother in the room for reassurance.
D
Provide him with age-appropriate information about the injection.
E
Give the patient an amount of time (how long it will take) and ask him to count.
Question 2 Explanation: 
A. Distraction is not typically a very effective technique for very anxious patients.
Question 3
The following component of a scientiñc article provides the reader with detailed information regarding the study design.
A
Introduction
B
Background
C
Literature review
D
Methods
E
Abstract
Question 3 Explanation: 
D. The Methods section organizes the research paper and allows the reader to assess the validity of the study and the reliability of the measures. This section should provide the reader with specific and detailed information regarding how the study was conducted. Based on this information, the reader should be able to replicate the study.
Question 4
The variance for data set A is 25 and for data set B is 9. Therefore, we can conclude ____.
A
There are more items in data set A than data set B
B
The mean of data set B is smaller than the mean for data set A
C
The items in data set A are more widely spread ' about the mean value than in data set B
D
The standard deviation for data set B is larger than for data set A
E
None of the above
Question 4 Explanation: 
C. The variance determines the way individual values are located around the mean. The larger the variance, the more widely the data items are spread about the mean value. Variance is measured in squared units (s2). The standard deviation is the square root of the variance. The mean is expressed in the same units as the data items, but the variance is expressed in squared units. Thus, the standard deviation measures the average deviation from the mean in the same units as the mean.
Question 5
During a previous dental visit, you assisted a patient by generating his statement, “Even if there is some pain, it will be brief I have ways to cope and I’ve done well using them.99 The patient will remind himself of this during future dental procedures. This patient's statement exemplifies which of the following strategies?
A
Rational response
B
Self-efficacy induction
C
Relaxation statement
D
Imagery
E
Systematic desensitization
Question 5 Explanation: 
A. A rational response is a cognitive therapy technique in which the patient develops (with or without assistance) a more adaptive thought or statement as a means of coping.
Question 6

What is the most likely consequence of the avoidance of a feared stimulus?

A
Reinforcement of the associated anxiety.
B
Habituation to the stimulus.
C
Decreased anxiety in response to the stimulus.
D
Learned helplessness.
E
Increased coping resources.
Question 6 Explanation: 
A. Avoidance of a feared stimulus inadvertently reinforces the anxiety reaction, thereby maintaining the associated anxiety.
Question 7
Some dental plans allow the dentist to charge the patient any difference between what the plan agrees to pay and the dentist's UCR (usual, customary, reasonable) fees. This arrangement is called ____.
A
Payment differential
B
Balance billing
C
Prospective reimbursement
D
Managed care
E
None of the above
Question 7 Explanation: 
B. Balance billing. Prospective reimbursement is a mechanism in which the dentist is compensated before treatment is provided (i.e., in capitation systems). Managed Care is an arrangement in which a third party mediates between providers and patients negotiating reimbursement for certain services and overseeing the treatments delivered.
Question 8
Which statement is false regarding child pain management?
A
It is recommended that a dentist provide specific direction and praise for cooperation.
B
Children do not have a fully developed sense of time; therefore, it is recommended that one use more concrete measures of time such as counting or a visible timer (e.g., egg timer).
C
The Tell-Show-Do technique is no longer recommended since it has been demonstrated to increase anxiety and reports of pain during treatments.
D
In order to enhance the sense of control, it is recommended that one establish a hand signal signifying distress and a desire for the dentist to stop or take a break.
E
Once a child begins to complain about poor pain control, the chances of having a successful visit drop dramatically.
Question 8 Explanation: 
C. The Tell-Show-Do method, in which the clinician explains, demonstrates, and allows a child (or an adult patient) to learn and understand what will be happening before proceeding, contributes to decreased self-reports of anxiety and pain.
Question 9

The following definition refers specifically to the process in which am antimicrobial agent destroys (germicide) or inhibits the growth (micro bios tatic) of pathogenic microorganisms on inanimate surfaces.

A
Antisepsis
B
Microbacterial control
C
Sterilization
D
Disinfection
E
Asepsis
Question 9 Explanation: 
D. Disinfection refers only to the inhibition or destruction of pathogens. Spores are not killed during disinfection procedures. By custom, the term disinfection is reserved for chemicals applied to inanimate surfaces, and the term anti¬septic is used for antimicrobial agents that are applied to living tissues.
Question 10
What route of transmission is a needlestick injury of infectious disease?
A
Direct contact
B
Indirect contact
C
Accidental contact
D
Parenteral contact
E
Droplets
Question 10 Explanation: 
D. Parenteral contact is defined as the transmission of pathogenic microorganisms by piercing the skin or mucous membrane (e.g., intravenous, subcutaneous, intramuscular) by an accidental or intentional stick with a needle or other sharp instrument that is contaminated with blood or other body fluid.
Question 11

Empathic understanding reflects which of the following characteristics?

A
It accurately reflects others’ feelings.
B
It connects the feelings to concrete circumstances that are likely to be causing the feelings.
C
It accepts the feelings as real and important.
D
It is nonjudgmental: it does not compromise the listener’s objectivity.
E
All of the above.
Question 11 Explanation: 
E. The use of empathy serves a number of purposes, including all of the choices given.
Question 12

Which of the following statements is false regarding behavior change?

A
Goals are long-term targets, whereas objectives are reachable steps/goals along the way.
B
Shaping is a behavior change strategy in which the patient learns though the dental professional’s demonstration of the desired behavior.
C
The basic behavioral model consists of antecedents, behaviors, and consequences.
D
Some consequences will strengthen a behavior whereas others will weaken it.
E
Generally, the consequences of today’s behavior will affect the way in which we behave tomorrow.
Question 12 Explanation: 
B. This is an example of modeling. Shaping is the process of achieving successive approximations toward a desired behavior.
Question 13

Which of the following statements about material safety data sheets (MSDSs) is/are correct?

A
Employees have the right to know about on- the-job hazards.
B
The MSDSs help to protect employees.
C
An MSDS contains information on hazardous materials, substance, and wastes.
D
The MSDS describes chemical hazards and how to work with the chemical safely.
E
All of the above.
Question 13 Explanation: 
E. The Material Safety Data Sheet (MSDS) is an easy reference for information on hazardous sub¬stances. The MSDS must be “readily accessible” to workers exposed to hazardous substances. The MSDS provides information on hazardous materials, substances, and wastes. Chemical manufacturers develop and provide an MSDS for each hazardous product. The distributor is responsible for getting MSDSs to employers. At least one copy of the MSDS should be maintained with the chemical.
Question 14
A 20-year-old woman has significant plaque build-up. Upon inquiry? she tells you that she brushes twice daily and flosses daily. You determine that the patient should be educated about optimal brushing procedures. Which strategy might you first use in a series of steps for improving her brushing skills?
A
Demonstrate your recommended brushing practices.
B
Explain to her good brushing technique.
C
Tell her you don’t believe she brushes twice daily.
D
Ask her to demonstrate her teeth brushing.
E
Clean her teeth.
Question 14 Explanation: 
D. In order to initiate behavior change, one must first fully assess the behavior. In this case, in order to address the patient’s inadequate brush¬ing technique one should observe the patient engaging in the behavior in order to identify the strengths and weaknesses of the process.
Question 15
The most effective method to prevent caries on the occlusal surfaces among school-age children is ____.
A
Sealants
B
Community water fluoridation
C
School dietary fluoride
D
School fluoride mouth rinse
E
School fluoridation
Question 15 Explanation: 
A. Sealants. Community water fluoridation is the most cost-effective and economical method to prevent dental caries. However, fluoride is believed to be the least effective on the occlusal surface. Most decay among school children occurs on the chewing surfaces’ pits and surfaces.
Question 16
Which of the following is/are recommendations for the use of masks?
A
Use whenever aerosols or spatter may be generated.
B
A new mask should be worn for each patient.
C
Masks should be changed at least once every hour.
D
Masks should be changed more frequently in the presence of heavy aerosol contamination.
E
All of the above.
Question 16 Explanation: 
E. Masks that cover the mouth and nose reduce inhalation of potentially infectious aerosol particles. They also protect the mucous membranes of the mouth and nose from direct contamination. Masks should be worn whenever aerosols or spatter may be generated. If a mask is worn longer than 20 minutes in an aerosol environment, the outside surface of the mask becomes a nidus of pathogenic bacteria rather than a barrier. It is recommended that a new mask be worn for each patient and that masks be changed routinely at least once every hour and more often in the presence of heavy aerosol contamination.
Question 17

In clinical practice, you frequently see young patients who are nervous about seeing the dentist. Knowing which factors are important influences on young patients9 comfort, you consider which of the following to help your patients to feel more comfortable?

A
Inviting a parent into the operatory for support.
B
Placing toys and children’s books in the waiting room.
C
Hanging child-friendly decor in the operatory.
D
Talking to the child about his or her interests before beginning your work.
E
All of the above.
Question 17 Explanation: 
E Creating a child-oriented environment (e.g., having toys and books in the waiting room, hanging pictures on the wall and/or ceiling that a child would find interesting), conveying interest in the child by asking about their interests, and having the parent present are all variables that may put child patients more at ease.
Question 18

Which technique is typically not useful in treating the anxious patient?

A
Using less structure in establishing rapport.
B
Reassuring the patient by telling the patient not to worry.
C
Providing reasons before asking for sensitive information.
D
Using empathy.
E
Making expectations clear.
Question 18 Explanation: 
B. Clinicians should use caution in providing premature reassurance because, if the outcomes are inconsistent with what the clinician asserted, trust and rapport may be compromised.
Question 19
The most common site for oral cancers in the oral cavity is ____.
A
Lip
B
Soft palate
C
Hard palate
D
Tongue
E
Tonsils
Question 19 Explanation: 
D. The tongue is the most common place for inci¬dent cancers in the oral cavity.
Question 20

A 14-year-old male patient has significant plaque build-up and one cavity. Upon inquiry? the patient tells you that he brushes his teeth about once a day and does not floss because it is difficult and too time-consuming. Which of the following would likely be the least effective way to address his oral hygiene practices and get him to improve his oral self-care?

A
Educate him regarding the ways in which he can improve his oral hygiene and avoid dental problems in the future.
B
Use a collaborative relationship to arrange for modification of consequences.
C
Use the Premack principle.
D
Set up a behavioral contract.
E
Set up a system of positive reinforcers.
Question 20 Explanation: 
A. Although education is an essential component of patient care overall, research indicates that, in an effort to influence behavior change, education alone is not nearly as effective as behavioral intervention.
Question 21

Which of the following are guidelines for disinfectants used in dental practice?

A
Have an EPA registration number.
B
Kill the Mycobacterium tuberculosis.
C
Have an ADA seal of approval.
D
Must be used according to guidelines.
E
All of the above.
Question 21 Explanation: 
E. A disinfectant should be able to kill the Mycobacterium tuberculosis. This is the benchmark organism for disinfectants. It is much harder to kill than most bacteria, viruses, fungi, and protozoa. This resistance is partially due to the waxy cell wall of Mycobacterium.
Question 22
In this type of study design, neither the subject nor the investigator knows to which group a subject belongs.
A
Matching studies
B
Randomized
C
Double-blind
D
Single-blind
E
None of the above
Question 22 Explanation: 
C. Double-blind designs help prevent the potential for a biased interpretation of a treatment effect that might occur if either the investigator or sub¬jects know to which group the latter belong.
Question 23

The following biological test is used to check the effectiveness of the sterilization process.

A
Spore test
B
Total bacterial count test
C
Aseptic test
D
EPA test
E
Disinfection test
Question 23 Explanation: 
A. The spore test is a biological monitor. The process consists of placing into the autoclave bacterial spores on strips or in envelopes along with a normal instrument load. If the autoclave is working properly, the autoclave reaches the tem¬perature and pressure to kill the spores. Spore testing must be conducted weekly.
Question 24
The first time you perform a complicated dental procedure, you feel uncomfortable and nervous« At one point, you even think for a moment that you will not be able to complete the procedure. However, you stay with it, and near the end of the procedure you feel much better. Which concept does this best exemplify?
A
Covert conditioning
B
Systematic desensitization
C
Habituation
D
Cognitive restructuring
E
Psychoeducation
Question 24 Explanation: 
C. Habituation is the decrease in response that occurs as a result of repeated or prolonged exposure to a conditioned stimulus.
Question 25
What behavior can you typically expect from an anxious patient in the waiting room?
A
He or she is more likely to sit still, hands clasped together.
B
He or she is more likely to sit casually, legs crossed, reading a magazine.
C
He or she is more likely to keep to himself or herself and not speak unless spoken to.
D
He or she is more likely to fidget in the chair, moving his or her hands and feet.
E
Both A and C.
Question 25 Explanation: 
D. Anxious patients are typically more likely to fidget in their chairs, unable to focus on a task such as reading or relaxing in the waiting room.
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