LOCAL ANESTHESIA UPDATED 2026 EXAMINERS
QUESTIONS AND ANSWERS SURE A+
✔✔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
✔✔The patient is currently taking Elavil (tricyclic antidepressants). What should be
avoided when administering local anesthesia?
a. avoid topical anesthetics
b. avoid levonordefrin
c. avoid local anesthesia
d. avoid amides - ✔✔b. avoid levonordefrin
levonordefrin is a vaso added to mepivacaine to counteract vasodilating actions.
Vasopressor potencies (ex. elavil) can heighten the cardiac stimulation and interact with
the vasoconstrictor.
✔✔What can the patient do to relieve trismus?
a. apply pressure
b. apply ice
c. apply heat
d. restrict jaw movements for days - ✔✔c. apply heat
✔✔Epinephrine should not be used on patients who:
a. experience angina on a daily basis
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
d. restrict jaw movement - ✔✔b. apply ice on the area
✔✔The patient may experience burning pain upon a local anesthesia injection because:
a. injection is given too slowly
b. needle touches a nerve.
c. pH of the solution is low
d. the drug has a high concentration of local anesthetic - ✔✔c. pH of the solution is low
burning sensation related to acidity. Acidity is result of two factors:
1. addition of hydrochloride salt
, 2. addition of sodium bisulfite as a perservative
✔✔What type of adverse reaction is related to elevated levels of drugs in the blood?
a. allergic reaction
b. overdose reaction
c. idiosyncratic reaction - ✔✔b. overdose reaction
✔✔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
QUESTIONS AND ANSWERS SURE A+
✔✔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
✔✔The patient is currently taking Elavil (tricyclic antidepressants). What should be
avoided when administering local anesthesia?
a. avoid topical anesthetics
b. avoid levonordefrin
c. avoid local anesthesia
d. avoid amides - ✔✔b. avoid levonordefrin
levonordefrin is a vaso added to mepivacaine to counteract vasodilating actions.
Vasopressor potencies (ex. elavil) can heighten the cardiac stimulation and interact with
the vasoconstrictor.
✔✔What can the patient do to relieve trismus?
a. apply pressure
b. apply ice
c. apply heat
d. restrict jaw movements for days - ✔✔c. apply heat
✔✔Epinephrine should not be used on patients who:
a. experience angina on a daily basis
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
d. restrict jaw movement - ✔✔b. apply ice on the area
✔✔The patient may experience burning pain upon a local anesthesia injection because:
a. injection is given too slowly
b. needle touches a nerve.
c. pH of the solution is low
d. the drug has a high concentration of local anesthetic - ✔✔c. pH of the solution is low
burning sensation related to acidity. Acidity is result of two factors:
1. addition of hydrochloride salt
, 2. addition of sodium bisulfite as a perservative
✔✔What type of adverse reaction is related to elevated levels of drugs in the blood?
a. allergic reaction
b. overdose reaction
c. idiosyncratic reaction - ✔✔b. overdose reaction
✔✔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
