Pain Management: Quiz: Ch. 1, 7, 9

Which is the most popular anesthetic used in the U.S. today?

Lidocaine

Which is the definition of pain threshold? 

The point at which a sensation starts to be painful and discomfort results.

Which three are stress reduction protocols for an anxious patient?

• Look for physical signs of anxiousness

• Schedule the appointment in the morning

• Schedule shorter appointments

Which three pharmacologic options may be needed to manage an anxious dental patient?

• Administer profound local anesthesia.

• Prescribe pre-appointment sedation.

• Offer sedation during the appointment

Which is NOT an example of a clinical sign of anxiety in the dental office?

Natural posture

A tool used to rate the intensity of certain sensations and feelings such as pain is the: 

Visual Analog Scale

Which group of local anesthetics were introduced in the 1940's and are still used today?

Amides

Which medication, when combined with a local anesthetic containing epinephrine, can cause a significant increase in blood pressure?

non-selective beta blockers

Which drug is the best choice to administer to a patient with a history of cirrhosis?

articaine

Which three factors cause an increase in the pulse rate?

• acute pain and anxiety

• diseases such as asthma and COPD

• positive chronotropic drugs (e.g. epinephrine)

Which class of drugs is most likely to exhibit an interaction with a vasoconstrictor?

Tricyclic antidepressants (TCAs)

Which is NOT an example of an ASA II classification?

A patient with poorly controlled hypertension

Which is the likelihood that a patient will experience a true allergic reaction to an amide local anesthetic?

Extremely unlikely

Which is the cardiac dose of epinephrine?

0.04 mg

Which four are absolute contraindications for the use of a vasoconstrictor?

• Recent use of cocaine or methamphetamine use

• Sulfite allergy

• Uncontrolled angina

• Uncontrolled hyperthyroidism

Which is the purpose of applying negative pressure to the harpoon?

To evaluate whether the needle is within a blood vessel.

Before using a cartridge, the clinician should…

A. autoclave and/or sterilize it

B. soak it in alcohol

C. wipe it with a disinfectant

D. NONE of the above

NONE of the above

Which intraoral needle gauges used in dentistry are listed from smallest to the largest?

30, 27, 25

All are acceptable ways to recap a needle EXCEPT one. Which one is the EXCEPTION?
A. Single-handed scoop method

B. The use of recapping devices.

C. Using cotton pliers to recap the needle

D. Using fingers to recap the needle

Using fingers to recap the needle

Which local anesthetic cartridge is identified by a red color band?

lidocaine

Which is the approximate length of a long dental needle?

32 mm

The sharp tip attached to the internal end of the piston that embeds into the cartridge’s rubber stopper is the:

harpoon

Which four will increase the risk of needle breakage?

• bending the needle

• forcing the needle against resistance

• inserting the needle to the hub 

• using a 30 gauge needle

A cartridge that has an extruded stopper and a large bubble has been:

frozen

If the harpoon disengages during an aspiration, the clinician should:

remove the syringe from the patient’s mouth and reengage the harpoon into the rubber stopper