HESI Case Study Sixteen & 17

Which statement will help with the pts uncooperative behavior?

A. "I am going to tell your mom how badly you are behaving"

B. "If you don't start being good, I will not give you a treat"

C. "Let me show you how the slurpy straw works"

D. "Stop crying"

C. "Let me show you how the slurpy straw works"

Which malocclusion is evident?

A. Overjet

B. Edge-to-edge

C. Overbite

D. Crossbite

C. Overbite

The pt lives in an area where there is 0.6ppm of fluoride in the drinking water. Which fluoride supplement dosage, in mm, should be prescribed to the pt?

A. 1.0

B. None

C. 0.25mm

D. 0.50mm

B. None

The most common type of asthma is extrinsic. Triggers associated with extrinsic asthma include emotional stress and GERD.

A. The first statement is true, second is false

B. Both are false

C. The first statement is false, second is true

D. Both are true

A. The first statement is true, second is false

Which is the ASA classification for extrinsic asthma?

A. II

B. I

C. IV

D. III

A. II

Children with asthma may exhibit acute episodes of bronchospasm when faced with dental treatment. Children with respiratory diseases experience hyperventilation.

A. Both are false

B. The first statement is false, second is true

C. Both are true

D. The first statement is true, second is false

D. The first statement is true, second is false

Tooth #D is positioned facially due to

A. Thumbsucking

B. Eruption of #7

C. Genetics

D. Tongue thrust

B. Eruption of #7

Each is a sign or symptom of an asthma attack EXCEPT one. Which is the EXCEPTION?

A. Coughing

B. Copious sputum

C. Wheezing

D. Dyspnea

B. Copious sputum

At age 7, which tooth is the fourth from the midline?

A. 2nd permanent molar

B. 1st permanent molar

C. 2nd deciduous molar

D. 1st deciduous molar

D. 1st deciduous molar

Where are mamelons located?

A. Facial cervical third of posterior

B. Incisal edges of anteriors

C. Lingual fossa of anteriors

D. Marginal ridges of posterior teeth

B. Incisal edges of anteriors

Where is the arrow pointing to on the photograph?

A. Wear facet

B. Fracture

C. Composite restoration

D. Erosion

B. Fracture

Which is the first permanent tooth to erupt?

A. Max central incisior

B. Max 1st molar

C. Mand central incisor

D. Mand 1st molar

D. Mand 1st molar

Which teeth are NOT succedaneous?

A. Permanent premolars

B. Deciduous molars

C. Deciduous anteriors

D. Permanent molars

D. Permanent molars

At which stage does the dental lamina form?

A. Bud

B. Bell

C. Cap

D. Apposition

A. Bud

When asthmatic pts do not responded well to bronchodilator in an acute attack, which should be administered orally?

A. Ventolin

B. Prednisone

C. Albuterol

D. Aspirin

B. Prednisone

The patient's dental erosion is most likely due to excessive soft drink consumption. Patients using methamphetamines generally consume excessive amounts of soft drinks.
A. Both statements are false.
B. The first statement is true and the second is false.
C. Both statements are true. — Correct
D. The first statement is false and the second is true.

Both statements are true. Soft drink consumption (Mountain Dew) and methamphetamine use can both lead to enamel erosion.

Which G. V. Black classification for decay do patients who abuse methamphetamines most likely exhibit?
A. I.
B. III.
C. II.
D. V. — Correct
E. IV.

Those who abuse methamphetamines and consume soft drinks most likely show evidence of erosion or cervical decay, which is a Class V G.V. Black classification. Although the other choices can and do occur, Class V decay typically will be evident.

Zantac is prescribed to reduce stomach acid. Zantac can cause tachycardia.
A. The first statement is true and the second is false.
B. The first statement is true and the second is false.
C. Both statements are false.
D. Both statements are true.

D. Both statements are true.

Both statements are true. Zantac is prescribed to reduce stomach acid and does cause tachycardia.

Methamphetamine use is increasing in the United States because its duration is much longer than cocaine.
A. Neither the statement nor reason is correct.
B. The statement is correct but the reason is not.
C. Both statement and reason are correct, but not related.
D. Both statement and reason are correct and related.
E. The statement is not correct, but the reason is an accurate statement.

D. Both statement and reason are correct and related.

Both statement and reason are correct and related. The other choices do not correctly define the statement.

Which rigid Gracey curets could remove the calculus on tooth #19?
A. 11/12 and 13/14 — Correct
B. 11/12 and 15/16.
C. 17/18 and 1/2.
D. 13/14 and 17/18.
E. 1/2 and 5/6.

The rigid gracey curets 11/12 and 13/14 would remove the calculus on tooth #19. The 11/12 would debride the mesials and cervical thirds and the 13/14 would debride the distal surface. The 13/14 and 17/18 graceys are both used for distal surfaces. The 11/12 and 15/16 are used on mesial surfaces. The 1/2 and 5/6 are used on anterior and premolars, respectively. The 17/18 and 1/2 are used on distal surfaces and anteriors, respectively.

Excessive bleeding can be expected when scaling and root planing because aspirin blocks thromboxane A2 and irreversibly inhibits COX-3.
A. Neither statement nor reason is correct.
B. The statement is not correct, but the reason is an accurate statement.
C. The statement is correct, but the reason is not. — Correct
D. Both statement and reason are correct and related.
E. Both statement and reason are correct, but not related.

The statement is correct, but the reason is not. Aspirin interferes with the clotting mechanism by reducing the platelet adhesives.

Each of the following can be recommended for patient home care EXCEPT one. Which one is the EXCEPTION?
A. Desensitizing toothpaste.
B. Antimicrobial mouthrinse. — Correct
C. Power-assisted toothbrush.
D. Floss holder.

Recommending an antimicrobial mouthrinse would not be advised. However, due to the amount of decay, a fluoride mouthrinse would be recommended. A power-assisted toothbrush, floss holder, and desensitizing toothpaste would help with this patient's home care.

Each of the following is a clinical symptom of methamphetamine use EXCEPT one. Which one is the EXCEPTION?
A. Insomnia.
B. Insensitive to noise. — Correct
C. Tremors.
D. Increased cravings to sweets.

Clinical symptoms of methamphetamine use do not include insensitivity to noise. However, they do include insomnia, increased cravings to sweets, and tremors.

The patient's blood pressure is
A. stage 1 hypertension.
B. stage 2 hypertension.
C. normal.
D. prehypertension.

A. stage 1 hypertension.

The patient's blood pressure is 130/86, which is stage 1. For stage 1, the systolic readings are between 130 and 139 and the diastolic readings are between 80 and 89.

Smoking is the most damaging form of methamphetamine (meth) to the tooth structure. The "high" associated with meth use does not last as long as cocaine.
A. Both statements are false.
B. The first statement is false and the second is true.
C. Both statements are true.
D. The first statement is true and the second is false.

D. The first statement is true and the second is false.

The first statement is true and the second is false. Smoking methamphetamine is the most damaging form to tooth structure, but the "high" from methamphetamine lasts longer than cocaine use.

The patient's chronic periodontal condition is
A. localized severe.
B. localized slight.
C. localized moderate.
D. generalized moderate.

A. localized severe.

The patient's periodontal condition is localized severe—there are less than 30% of the areas involved with 5 mm or greater clinical attachment loss (severe).

Zantac is an H2-receptor antagonist. Adverse reactions of Zantac include both tachycardia and bradycardia.
A. Both statements are true. — Correct
B. The first statement is false and the second is true.
C. Both statements are false.
D. The first statement is true and the second is false.

Both statements are true—Zantac is an H2-receptor antagonist and adverse reactions of Zantac include tachycardia and bradycardia.

Which is evident on the mesial of the mandibular left second molar?
A. Caries. — Correct
B. Composite.
C. Calculus.
D. Amalgam.

A class II carious lesion is evident on the mesial of the mandibular left second molar.

During debridement, the patient could have an increase in bleeding due to
A. Zantac.
B. methamphetamine use.
C. high blood pressure.
D. aspirin.

D. aspirin.

Aspirin is an anticoagulant and can therefore cause bleeding. An increase in bleeding is not caused by methamphetamine use, Zantac, or high blood pressure.

Which home care recommendation is most beneficial for the patient?
A. Sodium bicarbonate rinses.
B. Toothbrushing.
C. Flossing.
D. Fluoride.

D. Fluoride.

Due to the patient's rampant decay, the patient would benefit most from fluoride. The other choices would be beneficial for the patient's home care as well, but the patient still needs fluoride for remineralization.

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Megaloblastic anemia is characterized by abnormally small red blood cells. A type of megaloblastic anemia is pernicious.
A. The first statement is true and the second is false.
B. The first statement is false and the second is true. — Correct
C. Both statements are true.
D. Both statements are false.
The first statement is false and the second is true—megaloblastic anemia is characterized by abnormally large, not small, red blood cells. Pernicious anemia is a type of megaloblastic anemia.

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