HESI STUDY FINAL EXAM
STUDY GUIDE REVISION
QUESTIONS
Which of the following local anesthetics may be useful in patients with herpetic
dysfunction?
A. lidocaine
B. mepivacaine
C. articaine
D. bupivacaine - ANSarticaine
What are the two groups of local anesthetics? Which has the highest potential
for allergic reactions? Which are allergic reactions rare? - ANSesters and
amides; esters; amides
Where are esters metabolized? Where are amides metabolized? - ANSplasma
and blood; liver
T/F: If you are allergic to one ester, you will not be allergic to all the other esters.
- ANSFalse (if allergic to one ester allergic to all esters)
What is the most commonly used topical anesthetic? What product do we use in
clinic that contains this anesthetic? Is it an ester or an amide? -
ANSbenzocaine; lollicaine; bEnzocaine is an Ester
Which ester local anesthetic is no longer used in dentistry?
A. propoxycaine (Ravocaine)
B. tetracaine (Pontocaine)
C. procaine (Novocaine) - ANSprocaine (NOvocain) like no
All are amide local anesthetics except:
A. lidocaine
B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSbenzocaine (ester)
What is the most commonly used anesthetic in dentistry?
A. lidocaine
,B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSlidocaine
What local anesthetics are safe in pregnancy and during lactation? Which is the
drug of choice for pregnant women? What class drug are these two?
A. lidocaine
B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSlidocaine and prilocaine; lidocaine; class B
Which local anesthetic is a category B?
A. lidocaine
B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSlidocaine
Which local anesthetic is an amide anesthetic with ester linkage/hybrid/partially
metabolized in the liver and partially metabolized in the blood?
A. lidocaine
B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSarticaine
Which local anesthetic has the greatest duration of action?
A. lidocaine
B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSbupivacaine
Which local anesthetic has a longer duration and lower epi content than
lidocaine?
A. lidocaine
B. mepivacaine
,C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSprilocaine
Which local anesthetic is associated with methemoglobinemia?
A. lidocaine
B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSprilocaine
All are contraindications of using prilocaine except:
A. patients with anemias
B. patients taking aspirin
C. Patients taking acetaminophen
D. patients with methemoglobinemia - ANSpatients taking aspirin
What condition is characterized by iron in hemoglobin not carrying oxygen
effectively? What does acetaminophen do in patients with this condition?
A. pernicious anemia
B. methemoglobinemia
C. sickle anemia
D. thalassemia - ANSmethemoglobinemia; raises methemoglobin levels
Which local anesthetic has the shortest duration of action?
A. lidocaine
B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSmepivacaine
When choosing a local anesthetic, a lower pKa does what?
A. make it more potent
B. make it longer duration
C. make it more potent and longer duration
D. better absorbed - ANSbetter absorbed, related to onset of action
Put the local anesthetics in order from shortest to longest duration of action?
A. lidocaine
B. mepivacaine
C. prilocaine
, D. bupivacaine
E. articaine - ANSmepivacaine, lidocaine, prilocaine, articaine, bupivacaine
When choosing a local anesthetic, stronger binding to a protein does what?
A. make it more potent
B. make it longer duration
C. make it more potent and longer duration
D. better absorbed - ANSlonger duration; related to duration of action
When choosing a local anesthetic, the more lipid soluble it is, what happenst?
A. make it more potent
B. make it longer duration
C. make it more potent and longer duration
D. better absorbed - ANSmore potent; related to potency
When choosing a local anesthetic, less vasodilation (vasoconstrictor added)
does what?
A. make it more potent
B. make it longer duration
C. make it more potent and longer duration
D. better absorbed - ANSmore potent and longer duration; related to potency
and duration of action
All are reasons vasoconstrictors are added to local anesthetics except:
A. decreased absorption
B. Increased bleeding
C. Decreased bleeding
D. Increased duration of action - ANSincreased bleeding
T/F: Vasoconstrictors in local anesthetic prevent toxicity by decreasing
absorption. What is the only true contraindication to vasoconstrictors? -
ANStrue; sulfite allergy
What is a preservative in local anesthetics that is used with vasoconstrictors and
can cause allergy? What are the two vasoconstrictors used in the US? -
ANSsulfite; epi and levonordefrin
What is the highest concentration of epi? What is the lowest concentration?
A. 1:200,000
B. 1:100,000
C. 1:50,000 - ANS1:50,000; 1:200,000 (lowest number is highest
concentration)
What is levonordefrin only used in combination with?
STUDY GUIDE REVISION
QUESTIONS
Which of the following local anesthetics may be useful in patients with herpetic
dysfunction?
A. lidocaine
B. mepivacaine
C. articaine
D. bupivacaine - ANSarticaine
What are the two groups of local anesthetics? Which has the highest potential
for allergic reactions? Which are allergic reactions rare? - ANSesters and
amides; esters; amides
Where are esters metabolized? Where are amides metabolized? - ANSplasma
and blood; liver
T/F: If you are allergic to one ester, you will not be allergic to all the other esters.
- ANSFalse (if allergic to one ester allergic to all esters)
What is the most commonly used topical anesthetic? What product do we use in
clinic that contains this anesthetic? Is it an ester or an amide? -
ANSbenzocaine; lollicaine; bEnzocaine is an Ester
Which ester local anesthetic is no longer used in dentistry?
A. propoxycaine (Ravocaine)
B. tetracaine (Pontocaine)
C. procaine (Novocaine) - ANSprocaine (NOvocain) like no
All are amide local anesthetics except:
A. lidocaine
B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSbenzocaine (ester)
What is the most commonly used anesthetic in dentistry?
A. lidocaine
,B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSlidocaine
What local anesthetics are safe in pregnancy and during lactation? Which is the
drug of choice for pregnant women? What class drug are these two?
A. lidocaine
B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSlidocaine and prilocaine; lidocaine; class B
Which local anesthetic is a category B?
A. lidocaine
B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSlidocaine
Which local anesthetic is an amide anesthetic with ester linkage/hybrid/partially
metabolized in the liver and partially metabolized in the blood?
A. lidocaine
B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSarticaine
Which local anesthetic has the greatest duration of action?
A. lidocaine
B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSbupivacaine
Which local anesthetic has a longer duration and lower epi content than
lidocaine?
A. lidocaine
B. mepivacaine
,C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSprilocaine
Which local anesthetic is associated with methemoglobinemia?
A. lidocaine
B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSprilocaine
All are contraindications of using prilocaine except:
A. patients with anemias
B. patients taking aspirin
C. Patients taking acetaminophen
D. patients with methemoglobinemia - ANSpatients taking aspirin
What condition is characterized by iron in hemoglobin not carrying oxygen
effectively? What does acetaminophen do in patients with this condition?
A. pernicious anemia
B. methemoglobinemia
C. sickle anemia
D. thalassemia - ANSmethemoglobinemia; raises methemoglobin levels
Which local anesthetic has the shortest duration of action?
A. lidocaine
B. mepivacaine
C. prilocaine
D. bupivacaine
E. benzocaine
F. articaine - ANSmepivacaine
When choosing a local anesthetic, a lower pKa does what?
A. make it more potent
B. make it longer duration
C. make it more potent and longer duration
D. better absorbed - ANSbetter absorbed, related to onset of action
Put the local anesthetics in order from shortest to longest duration of action?
A. lidocaine
B. mepivacaine
C. prilocaine
, D. bupivacaine
E. articaine - ANSmepivacaine, lidocaine, prilocaine, articaine, bupivacaine
When choosing a local anesthetic, stronger binding to a protein does what?
A. make it more potent
B. make it longer duration
C. make it more potent and longer duration
D. better absorbed - ANSlonger duration; related to duration of action
When choosing a local anesthetic, the more lipid soluble it is, what happenst?
A. make it more potent
B. make it longer duration
C. make it more potent and longer duration
D. better absorbed - ANSmore potent; related to potency
When choosing a local anesthetic, less vasodilation (vasoconstrictor added)
does what?
A. make it more potent
B. make it longer duration
C. make it more potent and longer duration
D. better absorbed - ANSmore potent and longer duration; related to potency
and duration of action
All are reasons vasoconstrictors are added to local anesthetics except:
A. decreased absorption
B. Increased bleeding
C. Decreased bleeding
D. Increased duration of action - ANSincreased bleeding
T/F: Vasoconstrictors in local anesthetic prevent toxicity by decreasing
absorption. What is the only true contraindication to vasoconstrictors? -
ANStrue; sulfite allergy
What is a preservative in local anesthetics that is used with vasoconstrictors and
can cause allergy? What are the two vasoconstrictors used in the US? -
ANSsulfite; epi and levonordefrin
What is the highest concentration of epi? What is the lowest concentration?
A. 1:200,000
B. 1:100,000
C. 1:50,000 - ANS1:50,000; 1:200,000 (lowest number is highest
concentration)
What is levonordefrin only used in combination with?
