NURS502 Midterm
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 - (correct Answer) - 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 - (correct Answer) - 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 - (correct Answer) - 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 - (correct Answer) - 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. - (correct Answer) - 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 - (correct Answer) - 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. - (correct Answer) - 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 - (correct Answer) - 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 - (correct Answer) - 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 - (correct Answer) - 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 - (correct Answer) - Starting cevimeline in an effort to increase
saliva production
Tanya is a 20 year old female who presents to your office with a painful mouth sore that has been
present for three days. The sore developed spontaneously and has not changed since its appearance. Six
months ago, she noticed similar sores that resolved spontaneously after two weeks. She denies fever or
systemic symptoms.
What is the most likely cause of Tanya's oral lesion?
Primary oral herpes
Gingival trauma
Coxsackie virus
Aphthous ulcer - (correct Answer) - Aphthous ulcer
Which of the following is true regarding Recurrent Aphthous Ulcers (RAU)?
These lesions commonly present as a single painful ulcer that resolves after two months.
RAUs have been associated with vitamin deficiencies.
Most lesions require immediate treatment with topical steroids.
These lesions typically occur on keratinized mucosal surfaces such as the gingival and hard palates. -
(correct Answer) - RAUs have been associated with vitamin deficiencies.
Two months later Tanya returns with similar complaints. She has developed recurrent painful month
sores that resemble her previous lesions. The lesions have been present for almost 2 weeks. In the past,
her pain was minimal, but she now reports that it has become painful to eat, drink and speak. She has
tried over the counter mouth rinses without much improvement.
Which of the following is the most appropriate next step in management?
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 - (correct Answer) - 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 - (correct Answer) - 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 - (correct Answer) - 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 - (correct Answer) - 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. - (correct Answer) - 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 - (correct Answer) - 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. - (correct Answer) - 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 - (correct Answer) - 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 - (correct Answer) - 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 - (correct Answer) - 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 - (correct Answer) - Starting cevimeline in an effort to increase
saliva production
Tanya is a 20 year old female who presents to your office with a painful mouth sore that has been
present for three days. The sore developed spontaneously and has not changed since its appearance. Six
months ago, she noticed similar sores that resolved spontaneously after two weeks. She denies fever or
systemic symptoms.
What is the most likely cause of Tanya's oral lesion?
Primary oral herpes
Gingival trauma
Coxsackie virus
Aphthous ulcer - (correct Answer) - Aphthous ulcer
Which of the following is true regarding Recurrent Aphthous Ulcers (RAU)?
These lesions commonly present as a single painful ulcer that resolves after two months.
RAUs have been associated with vitamin deficiencies.
Most lesions require immediate treatment with topical steroids.
These lesions typically occur on keratinized mucosal surfaces such as the gingival and hard palates. -
(correct Answer) - RAUs have been associated with vitamin deficiencies.
Two months later Tanya returns with similar complaints. She has developed recurrent painful month
sores that resemble her previous lesions. The lesions have been present for almost 2 weeks. In the past,
her pain was minimal, but she now reports that it has become painful to eat, drink and speak. She has
tried over the counter mouth rinses without much improvement.
Which of the following is the most appropriate next step in management?
