Chapter 51 Wilkins: The Patient with a Disability

Which of the following is not true of a disability?

a) It can be permanent or temporary.

b) It involves any loss or abnormality of psychologic, physiologic, or anatomic structure or function.

c) It affects musculoskeletal, sensory, or neurologic function.

d) It is a reduction in a person's activity resulting from a health condition.

b

An estimated __________ of persons between 17 and 64 years of age are affected by a disability.

a) 3%

b) 5.5%

c) 10.5%

d) 16%

c

A patient who does not comprehend the importance of dental health and does not brush displays what type of barrier to dental care?

a) Financial

b) Physical

c) Attitude

d) Professional

c

If a patient with a disability has a legal guardian, the legal guardian must:

a) give consent for treatment, including signing consent forms.

b) translate what the patient is saying.

c) be the caregiver for the patient.

d) be present in the treatment room.

a

How wide should walkways be in order to accommodate a wheelchair?

a) 32 inches

b) 3 feet

c) 5 feet

d) 8 feet

b

In preparing for a wheelchair transfer, what should you do first?

a) Move chair padding to dental chair.

b) Place the wheelchair parallel to the dental chair.

c) Find someone else in the office to help with the transfer.

d) Clear the area of any items that may be in the way.

d

When is it appropriate to use the stand-and-pivot mobile patient transfer technique?

a) When the patient can support his or her own weight

b) When the patient cannot support his or her own weight

c) When there are two people to complete the transfer

d) When the patient uses a walker

a

When doing a sliding board transfer, the seat of the dental chair should be positioned:

a) 90 degrees to the wheelchair seat.

b) at equal height to the wheelchair seat.

c) higher than the wheelchair seat.

d) slightly lower than the wheelchair seat.

d

A patient with quadriplegia who shifts his or her weight every 20 minutes does so in order to:

a) prevent cramping.

b) feel more comfortable in the dental chair.

c) maintain good circulation.

d) prevent spasms.

c

When using restraints for body stabilization, you:

a) need more than one dental personnel.

b) need written consent from a guardian or the patient.

c) have to use a mouth prop.

d) only use it on the arms.

b

Patients with developmental disabilities have an increased incidence of congenital malformations, which include all of the following, except:

a) cleft lip.

b) dentinogenesis imperfecta.

c) enamel hyperplasia.

d) periodontal disease.

e) malocclusion.

d

A patient who is unable to complete brushing and flossing on his or her own and depends on someone else to attend to his or her oral care would be classified as:

a) high functioning.

b) moderate functioning.

c) low functioning.

d) self-care able.

e) partial care able.

c

Dentifrice should not be used by patients who:

a) require a caregiver to brush.

b) have developmental disabilities.

c) have epilepsy.

d) cannot control saliva, rinse, or expectorate.

d

A self-care aid must be have all of the following characteristics, except:

a) be able to be disinfected.

b) be durable.

c) be replaceable.

d) be inexpensive.

e) be absorbent.

d

When presenting an in-service education program to caregivers, you should address all of the following, except:

a) the participants' own biofilm control.

b) complex issues in oral care.

c) facts about causes and prevention of oral disease.

d) instructions on completing an oral examination.

e) biofilm control techniques.

b

Alternative methods for pain control for the disabled patient includes all of the following, except:

a) pharmacological-induced sedation.

b) administration of valerian root 1 hour before the appointment.

c) general anesthesia.

d) All of these are alternative methods of pain control.

b

A) An early morning appointment may be difficult for a patient who requires a long time for morning preparation, such as a patient with a spinal cord injury or colostomy. B) The cooperation of the patient may be decreased if basic routines are disturbed.

a. Statement A is true and statement B is false.

b. Statement A is false and statement B is true.

c. Both statements are true.

d. Both statements are false.

c

The rubber mouth prop can fall out. What is the best solution to prevent this from occurring?

a) Use a rubber dam to prevent swallowing.

b) Use floss to tie it down.

c) Have an assistant hold it in place.

d) All of these are correct.

b

A patient with impaired respiratory function, swallowing, or gag reflex is at risk for which of the following?

a) Coughing

b) Vomiting

c) Uncontrolled kicking

d) Aspirating

d

Introduce each procedure and sound to prevent startling a patient: Follow the basic instruction rule:

a) tell, show, do.

b) show, tell, do.

c) tell, show, repeat.

d) show, tell, repeat.

b

Jim, a 14-year-old patient, presents to the dental office with his mother, complaining of bleeding gums and sensitivity. His mother reports on his medical history that he has muscular dystrophy and has had epilepsy since he was 3. A few years ago, he had to start using a wheelchair. He has difficulty bending his arm at the elbow and has limitations in raising his arms. The dental hygienist notes that Jim has moderate gingival overgrowth and generalized heavy biofilm accumulation. Jim's mother states that she tries to help him brush his teeth, but he still wants to be as independent as possible and does not like to have help. She knows he probably cannot reach his back teeth by himself. She is also concerned that he may have several cavities because he eats a lot of candy when he is with his caregiver before and after school, but he does drink a lot of bottled water each day.

The gingival overgrowth indicated may be caused by which of the following medications?

a) Depakote

b) Phenytoin

c) Aspirin

d) Benadryl

b

Jim, a 14-year-old patient, presents to the dental office with his mother, complaining of bleeding gums and sensitivity. His mother reports on his medical history that he has muscular dystrophy and has had epilepsy since he was 3. A few years ago, he had to start using a wheelchair. He has difficulty bending his arm at the elbow and has limitations in raising his arms. The dental hygienist notes that Jim has moderate gingival overgrowth and generalized heavy biofilm accumulation. Jim's mother states that she tries to help him brush his teeth, but he still wants to be as independent as possible and does not like to have help. She knows he probably cannot reach his back teeth by himself. She is also concerned that he may have several cavities because he eats a lot of candy when he is with his caregiver before and after school, but he does drink a lot of bottled water each day.

What could be done to Jim's toothbrush to enable him to brush more effectively?

a) Make a handle Jim could slide his hand into.

b) Make the diameter of the handle larger.

c) Lengthen the handle of the brush.

d) Make the handle softer.

c

Jim, a 14-year-old patient, presents to the dental office with his mother, complaining of bleeding gums and sensitivity. His mother reports on his medical history that he has muscular dystrophy and has had epilepsy since he was 3. A few years ago, he had to start using a wheelchair. He has difficulty bending his arm at the elbow and has limitations in raising his arms. The dental hygienist notes that Jim has moderate gingival overgrowth and generalized heavy biofilm accumulation. Jim's mother states that she tries to help him brush his teeth, but he still wants to be as independent as possible and does not like to have help. She knows he probably cannot reach his back teeth by himself. She is also concerned that he may have several cavities because he eats a lot of candy when he is with his caregiver before and after school, but he does drink a lot of bottled water each day.

Why is it important for Jim to have adequate daily biofilm removal?

a) To prevent halitosis

b) To prevent trauma to his teeth and soft tissue

c) To prevent xerostomia

d) To have effective daily biofilm removal, which is associated with less gingival enlargement

d

Jim, a 14-year-old patient, presents to the dental office with his mother, complaining of bleeding gums and sensitivity. His mother reports on his medical history that he has muscular dystrophy and has had epilepsy since he was 3. A few years ago, he had to start using a wheelchair. He has difficulty bending his arm at the elbow and has limitations in raising his arms. The dental hygienist notes that Jim has moderate gingival overgrowth and generalized heavy biofilm accumulation. Jim's mother states that she tries to help him brush his teeth, but he still wants to be as independent as possible and does not like to have help. She knows he probably cannot reach his back teeth by himself. She is also concerned that he may have several cavities because he eats a lot of candy when he is with his caregiver before and after school, but he does drink a lot of bottled water each day.

The hygienist is concerned that Jim drinks bottled water and makes some recommendations to his mother. What recommendation may she make?

a) Jim should stop drinking so much water.

b) Jim's mother should be sure that the bottled water contains fluoride.

c) Jim should drink more water.

d) Jim should drink water with the candy and sweets.

b

Jim, a 14-year-old patient, presents to the dental office with his mother, complaining of bleeding gums and sensitivity. His mother reports on his medical history that he has muscular dystrophy and has had epilepsy since he was 3. A few years ago, he had to start using a wheelchair. He has difficulty bending his arm at the elbow and has limitations in raising his arms. The dental hygienist notes that Jim has moderate gingival overgrowth and generalized heavy biofilm accumulation. Jim's mother states that she tries to help him brush his teeth, but he still wants to be as independent as possible and does not like to have help. She knows he probably cannot reach his back teeth by himself. She is also concerned that he may have several cavities because he eats a lot of candy when he is with his caregiver before and after school, but he does drink a lot of bottled water each day. How could Jim's mom lengthen his toothbrush?

a) Add a Styrofoam ball.

b) Attach a Velcro strap to the handle.

c) Put the toothbrush into a bicycle handle.

d) Tape tongue depressors to the brush handle.

d