HESI Dental Hygiene Exit Examination
Comprehensive 180-Question Exam
QUESTION 1
A 24-year-old patient presents for a routine dental prophylaxis. The patient's
medical history is significant for type 1 diabetes mellitus with poor glycemic
control (HbA1c 9.2%). Which finding is MOST likely to be present on intraoral
examination?
CORRECT ANSWER: Generalized gingival erythema and bleeding on gentle
probing
QUESTION 2
A dental hygienist is reviewing a patient's medication list and sees "alendronate 70
mg weekly." The patient has been taking this medication for 6 years. What is the
PRIMARY concern regarding dental treatment for this patient?
CORRECT ANSWER: Risk of medication-related osteonecrosis of the jaw
following extraction or invasive procedures
QUESTION 3
During an extraoral examination, a dental hygienist notes unilateral facial
asymmetry with swelling inferior to the angle of the mandible. The patient reports
the area is painful and has been increasing in size over the past 3 days. Which
structure is MOST likely involved?
CORRECT ANSWER: Submandibular gland
QUESTION 4
A patient presents with generalized attrited dentition. The patient reports waking
up several times per week with jaw muscle soreness and a headache localized to
,the temporal region. Which parafunctional habit is MOST likely causing these
symptoms?
CORRECT ANSWER: Sleep bruxism
QUESTION 5
A 55-year-old patient undergoes a comprehensive periodontal examination. The
hygienist records clinical attachment loss of 5-7 mm on multiple teeth, bleeding on
probing at 60% of sites, and class II furcation involvement on tooth #19.
Radiographs show moderate generalized bone loss. According to the 2017
AAP/EFP Classification, which periodontal diagnosis is MOST appropriate?
CORRECT ANSWER: Generalized stage III periodontitis, grade B
QUESTION 6
A dental hygienist is calculating the maximum safe dose of lidocaine with
1:100,000 epinephrine for a healthy 70 kg patient. What is the maximum number
of cartridges (1.8 mL each) that can be administered?
CORRECT ANSWER: 11 cartridges
QUESTION 7
A 16-year-old patient presents with a painless, dome-shaped, pink nodule on the
maxillary gingiva between teeth #8 and #9. The lesion has been present for 8
months and measures approximately 1.5 cm in diameter. Radiographs show no
bony involvement. Which is the MOST likely diagnosis?
CORRECT ANSWER: Peripheral ossifying fibroma
QUESTION 8
A dental hygienist is providing oral hygiene instruction to a patient with
xerostomia secondary to Sjögren's syndrome. Which recommendation would be
MOST beneficial for caries prevention?
,CORRECT ANSWER: Prescription fluoride gel applied nightly in custom trays
QUESTION 9
During an intraoral examination, the hygienist notes a white, adherent plaque on
the buccal mucosa bilaterally that cannot be scraped off. The patient is a 45-year-
old with a 30-pack-year smoking history. What is the MOST appropriate next step?
CORRECT ANSWER: Refer for biopsy to rule out dysplasia or malignancy
QUESTION 10
A pregnant patient in her first trimester requires a dental radiograph for evaluation
of tooth #30 pain. Which statement accurately describes the recommended
approach?
CORRECT ANSWER: Radiographs are acceptable with proper thyroid collar
and lead apron shielding
QUESTION 11
A dental hygienist is using a curette on a mandibular premolar. The blade is
positioned so that the lower shank is parallel to the distal surface of the tooth.
Which surface is being instrumented?
CORRECT ANSWER: Distal surface
QUESTION 12
A patient's blood pressure is measured at 162/94 mmHg at the beginning of the
appointment. The patient denies any history of hypertension and reports feeling
anxious. What is the MOST appropriate action?
CORRECT ANSWER: Delay definitive care, recheck blood pressure after 5
minutes of relaxation
QUESTION 13
, Which herpes virus is responsible for causing infectious mononucleosis?
CORRECT ANSWER: Epstein-Barr virus (HHV-4)
QUESTION 14
A 70-year-old patient wearing complete dentures reports chronic soreness on the
mandibular ridge. Intraoral examination reveals a single, erythematous, ulcerated
area with rolled borders on the posterior lingual alveolar ridge. The lesion has been
present for 3 months. What is the MOST appropriate action?
CORRECT ANSWER: Refer for immediate biopsy
QUESTION 15
A dental hygienist is evaluating the fit of a patient's athletic mouthguard. The
mouthguard should extend to cover which anatomical landmark on the maxillary
arch?
CORRECT ANSWER: Distal of the second molars
QUESTION 16
A patient with a history of rheumatic fever requires antibiotic prophylaxis prior to
dental procedures. According to the 2021 AHA guidelines, which cardiac
condition warrants prophylaxis?
CORRECT ANSWER: Prosthetic cardiac valve
QUESTION 17
During periodontal debridement, a dental hygienist notes a groove on the mesial
surface of tooth #28 that extends onto the root surface. This anatomical variation is
BEST described as:
CORRECT ANSWER: Developmental groove
Comprehensive 180-Question Exam
QUESTION 1
A 24-year-old patient presents for a routine dental prophylaxis. The patient's
medical history is significant for type 1 diabetes mellitus with poor glycemic
control (HbA1c 9.2%). Which finding is MOST likely to be present on intraoral
examination?
CORRECT ANSWER: Generalized gingival erythema and bleeding on gentle
probing
QUESTION 2
A dental hygienist is reviewing a patient's medication list and sees "alendronate 70
mg weekly." The patient has been taking this medication for 6 years. What is the
PRIMARY concern regarding dental treatment for this patient?
CORRECT ANSWER: Risk of medication-related osteonecrosis of the jaw
following extraction or invasive procedures
QUESTION 3
During an extraoral examination, a dental hygienist notes unilateral facial
asymmetry with swelling inferior to the angle of the mandible. The patient reports
the area is painful and has been increasing in size over the past 3 days. Which
structure is MOST likely involved?
CORRECT ANSWER: Submandibular gland
QUESTION 4
A patient presents with generalized attrited dentition. The patient reports waking
up several times per week with jaw muscle soreness and a headache localized to
,the temporal region. Which parafunctional habit is MOST likely causing these
symptoms?
CORRECT ANSWER: Sleep bruxism
QUESTION 5
A 55-year-old patient undergoes a comprehensive periodontal examination. The
hygienist records clinical attachment loss of 5-7 mm on multiple teeth, bleeding on
probing at 60% of sites, and class II furcation involvement on tooth #19.
Radiographs show moderate generalized bone loss. According to the 2017
AAP/EFP Classification, which periodontal diagnosis is MOST appropriate?
CORRECT ANSWER: Generalized stage III periodontitis, grade B
QUESTION 6
A dental hygienist is calculating the maximum safe dose of lidocaine with
1:100,000 epinephrine for a healthy 70 kg patient. What is the maximum number
of cartridges (1.8 mL each) that can be administered?
CORRECT ANSWER: 11 cartridges
QUESTION 7
A 16-year-old patient presents with a painless, dome-shaped, pink nodule on the
maxillary gingiva between teeth #8 and #9. The lesion has been present for 8
months and measures approximately 1.5 cm in diameter. Radiographs show no
bony involvement. Which is the MOST likely diagnosis?
CORRECT ANSWER: Peripheral ossifying fibroma
QUESTION 8
A dental hygienist is providing oral hygiene instruction to a patient with
xerostomia secondary to Sjögren's syndrome. Which recommendation would be
MOST beneficial for caries prevention?
,CORRECT ANSWER: Prescription fluoride gel applied nightly in custom trays
QUESTION 9
During an intraoral examination, the hygienist notes a white, adherent plaque on
the buccal mucosa bilaterally that cannot be scraped off. The patient is a 45-year-
old with a 30-pack-year smoking history. What is the MOST appropriate next step?
CORRECT ANSWER: Refer for biopsy to rule out dysplasia or malignancy
QUESTION 10
A pregnant patient in her first trimester requires a dental radiograph for evaluation
of tooth #30 pain. Which statement accurately describes the recommended
approach?
CORRECT ANSWER: Radiographs are acceptable with proper thyroid collar
and lead apron shielding
QUESTION 11
A dental hygienist is using a curette on a mandibular premolar. The blade is
positioned so that the lower shank is parallel to the distal surface of the tooth.
Which surface is being instrumented?
CORRECT ANSWER: Distal surface
QUESTION 12
A patient's blood pressure is measured at 162/94 mmHg at the beginning of the
appointment. The patient denies any history of hypertension and reports feeling
anxious. What is the MOST appropriate action?
CORRECT ANSWER: Delay definitive care, recheck blood pressure after 5
minutes of relaxation
QUESTION 13
, Which herpes virus is responsible for causing infectious mononucleosis?
CORRECT ANSWER: Epstein-Barr virus (HHV-4)
QUESTION 14
A 70-year-old patient wearing complete dentures reports chronic soreness on the
mandibular ridge. Intraoral examination reveals a single, erythematous, ulcerated
area with rolled borders on the posterior lingual alveolar ridge. The lesion has been
present for 3 months. What is the MOST appropriate action?
CORRECT ANSWER: Refer for immediate biopsy
QUESTION 15
A dental hygienist is evaluating the fit of a patient's athletic mouthguard. The
mouthguard should extend to cover which anatomical landmark on the maxillary
arch?
CORRECT ANSWER: Distal of the second molars
QUESTION 16
A patient with a history of rheumatic fever requires antibiotic prophylaxis prior to
dental procedures. According to the 2021 AHA guidelines, which cardiac
condition warrants prophylaxis?
CORRECT ANSWER: Prosthetic cardiac valve
QUESTION 17
During periodontal debridement, a dental hygienist notes a groove on the mesial
surface of tooth #28 that extends onto the root surface. This anatomical variation is
BEST described as:
CORRECT ANSWER: Developmental groove
