NURS 502 – Midterm Exam, Advanced Pathophysiology Nursing Course, Comprehensive
Review and Study Guide
Which of the following dental procedures does NOT requires antibiotic prophylaxis for
individuals at high risk of bacterial endocarditis?
Routine fillings
Post-operative suture removal
Dental cleaning
Fluoride treatments
Orthodontic appliance adjustment - ✔✔Fluoride treatments
Which clinical finding distinguishes periodontitis from gingivitis?
Inflammation of the gums
White discoloration of the permanent teeth
Enlarged pockets at the gum base
Gingival hypertrophy - ✔✔Enlarged pockets at the gum base
Which of the following is the least common site for the development of oral cancer?
The tongue
Floor of mouth
Hard palate
Lower lip - ✔✔Hard palate
Which of the following factors reduces the risk for caries in adults?
,Low socioeconomic status
Existing tooth restoration
A vegetarian diet
Decreased salivary flow
Low sugar diet - ✔✔Low sugar diet
Which of the following patients require bacterial endocarditis antibiotic prophylaxis?
A 26-year-old woman with mitral valve prolapse undergoing routine teeth cleaning with no
anticipated bleeding.
A 64-year-old man with a prosthetic mitral valve who is undergoing a tooth extraction.
A 16-year-old boy with a ventricular septal defect completely repaired in infancy who requires
extraction of an impacted wisdom tooth.
A 32-year-old man who had bacterial endocarditis 5 years ago who is undergoing orthodontic
appliance adjustment. - ✔✔A 64-year-old man with a prosthetic mitral valve who is
undergoing a tooth extraction.
Which of the following is an abnormal tooth change not explained by aging alone?
Gingival recession
Root caries
Yellowing of teeth
Wearing away of teeth with exposed dentin - ✔✔Root caries
Which of the following statements concerning xerostomia, or dry mouth, is NOT true?
,Xerostomia is caused by a decrease in the production of saliva.
Xerostomia can cause a burning sensation, change in taste, and difficulty swallowing.
Medications can contribute to the development of xerostomia.
Xerostomia increases risk for the development of caries.
Xerostomia is rarely a problem for patients wearing complete dentures. - ✔✔Xerostomia is
rarely a problem for patients wearing complete dentures.
Which of the following has been implicated in the development of recurrent aphthous ulcers?
Trauma
Vitamin C deficiency
Sickle Cell Anemia
Herpes simplex virus infection - ✔✔Trauma
Mrs. Pederson is a 74 year old who presents for a routine blood pressure follow up visit. Her
blood pressure is well controlled, but on review of systems she reports dry mouth of several
years duration that has acutely worsened over the past 2 months. She quit smoking after she
developed thyroid cancer that required surgery and neck radiation for cure. She has been
drinking more water than usual, but it only improves her symptoms for a few minutes. She
drinks wine with dinner and sometimes before bed for insomnia.
All of the following are likely contributing to Mrs. Pederson's xerostomia (the sensation of dry
mouth) except:
The aging process
Antihypertensive medications
Alcohol use
Head and neck radiation
Sedative medications - ✔✔The aging process
, Mrs. Pederson's active medical problems include Hypertension, Type 2 Diabetes Mellitus, and
Glaucoma. Her past history is remarkable for treated thyroid cancer, seasonal allergies, and
intermittent insomnia. She smoked when she was younger, but quit 30 years ago. She is
widowed and a retired administrative assistant. She enjoys a glass of wine about five times a
week with dinner and walks daily for exercise.
Her medications include:
- lisinopril/HCTZ 10/25 mg orally once daily
- metformin 1000 mg orally twice daily
- aspirin 81 mg orally once daily
- zolpidem 10 mg orally at bedtime approximately twice per week
- diphenhydramine 25 mg orally as needed for allergy symptoms in the spring and fall
- latanoprost ophthalmic drops daily (topical prostaglandin analog for closed angle glaucoma
treatment)
Based on the information provided above, which of the following scenarios would most likely
contribute to Mrs. Pederson's - ✔✔2. She has been taking zolpidem nightly for worsening
insomnia following the recent death of her favorite cousin.
Mrs. Pederson reduces her alcohol intake and stops taking diphenhydramine and zolpidem. She
understands the need for her antihypertensive and diabetic medications and will continue to
take those as directed. After these changes her dry mouth improves to some degree, but is still
symptomatic. She inquires what else she can do to improve her symptoms.
Which of the following interventions would be contraindicated for Mrs. Pederson?
Use of an over-the-counter saliva substitute
Sucking sugarless candy during the day to promote saliva production
Starting cevimeline in an effort to increase saliva production
Switching to an electric toothbrush from a traditional one
Avoiding sugary and caffeinated drinks - ✔✔Starting cevimeline in an effort to increase saliva
production
Review and Study Guide
Which of the following dental procedures does NOT requires antibiotic prophylaxis for
individuals at high risk of bacterial endocarditis?
Routine fillings
Post-operative suture removal
Dental cleaning
Fluoride treatments
Orthodontic appliance adjustment - ✔✔Fluoride treatments
Which clinical finding distinguishes periodontitis from gingivitis?
Inflammation of the gums
White discoloration of the permanent teeth
Enlarged pockets at the gum base
Gingival hypertrophy - ✔✔Enlarged pockets at the gum base
Which of the following is the least common site for the development of oral cancer?
The tongue
Floor of mouth
Hard palate
Lower lip - ✔✔Hard palate
Which of the following factors reduces the risk for caries in adults?
,Low socioeconomic status
Existing tooth restoration
A vegetarian diet
Decreased salivary flow
Low sugar diet - ✔✔Low sugar diet
Which of the following patients require bacterial endocarditis antibiotic prophylaxis?
A 26-year-old woman with mitral valve prolapse undergoing routine teeth cleaning with no
anticipated bleeding.
A 64-year-old man with a prosthetic mitral valve who is undergoing a tooth extraction.
A 16-year-old boy with a ventricular septal defect completely repaired in infancy who requires
extraction of an impacted wisdom tooth.
A 32-year-old man who had bacterial endocarditis 5 years ago who is undergoing orthodontic
appliance adjustment. - ✔✔A 64-year-old man with a prosthetic mitral valve who is
undergoing a tooth extraction.
Which of the following is an abnormal tooth change not explained by aging alone?
Gingival recession
Root caries
Yellowing of teeth
Wearing away of teeth with exposed dentin - ✔✔Root caries
Which of the following statements concerning xerostomia, or dry mouth, is NOT true?
,Xerostomia is caused by a decrease in the production of saliva.
Xerostomia can cause a burning sensation, change in taste, and difficulty swallowing.
Medications can contribute to the development of xerostomia.
Xerostomia increases risk for the development of caries.
Xerostomia is rarely a problem for patients wearing complete dentures. - ✔✔Xerostomia is
rarely a problem for patients wearing complete dentures.
Which of the following has been implicated in the development of recurrent aphthous ulcers?
Trauma
Vitamin C deficiency
Sickle Cell Anemia
Herpes simplex virus infection - ✔✔Trauma
Mrs. Pederson is a 74 year old who presents for a routine blood pressure follow up visit. Her
blood pressure is well controlled, but on review of systems she reports dry mouth of several
years duration that has acutely worsened over the past 2 months. She quit smoking after she
developed thyroid cancer that required surgery and neck radiation for cure. She has been
drinking more water than usual, but it only improves her symptoms for a few minutes. She
drinks wine with dinner and sometimes before bed for insomnia.
All of the following are likely contributing to Mrs. Pederson's xerostomia (the sensation of dry
mouth) except:
The aging process
Antihypertensive medications
Alcohol use
Head and neck radiation
Sedative medications - ✔✔The aging process
, Mrs. Pederson's active medical problems include Hypertension, Type 2 Diabetes Mellitus, and
Glaucoma. Her past history is remarkable for treated thyroid cancer, seasonal allergies, and
intermittent insomnia. She smoked when she was younger, but quit 30 years ago. She is
widowed and a retired administrative assistant. She enjoys a glass of wine about five times a
week with dinner and walks daily for exercise.
Her medications include:
- lisinopril/HCTZ 10/25 mg orally once daily
- metformin 1000 mg orally twice daily
- aspirin 81 mg orally once daily
- zolpidem 10 mg orally at bedtime approximately twice per week
- diphenhydramine 25 mg orally as needed for allergy symptoms in the spring and fall
- latanoprost ophthalmic drops daily (topical prostaglandin analog for closed angle glaucoma
treatment)
Based on the information provided above, which of the following scenarios would most likely
contribute to Mrs. Pederson's - ✔✔2. She has been taking zolpidem nightly for worsening
insomnia following the recent death of her favorite cousin.
Mrs. Pederson reduces her alcohol intake and stops taking diphenhydramine and zolpidem. She
understands the need for her antihypertensive and diabetic medications and will continue to
take those as directed. After these changes her dry mouth improves to some degree, but is still
symptomatic. She inquires what else she can do to improve her symptoms.
Which of the following interventions would be contraindicated for Mrs. Pederson?
Use of an over-the-counter saliva substitute
Sucking sugarless candy during the day to promote saliva production
Starting cevimeline in an effort to increase saliva production
Switching to an electric toothbrush from a traditional one
Avoiding sugary and caffeinated drinks - ✔✔Starting cevimeline in an effort to increase saliva
production
