DAANCE Anesthesia Techniques 5

Question 1

A 68-year-old patient on warfarin requires local anesthetic infiltration for a dental extraction. The primary concern regarding epinephrine use is:

Accepted Answer

Risk of hematoma formation at the injection site

Answer

Anticoagulated patients have increased risk of hematoma formation, particularly with regional nerve blocks; infiltration is preferred and pressure should be applied post-injection.

Question 2

The buccal nerve block is MOST commonly used as a supplemental injection to which primary mandibular block?

Accepted Answer

Inferior alveolar nerve block

Answer

The buccal (long buccal) nerve is not anesthetized by the IAN block, so it is routinely added when buccal soft tissue anesthesia is needed for mandibular molar procedures.

Question 3

During monitored anesthesia care (MAC), the anesthesia assistant notes the patient's respiratory rate has fallen to 6 breaths per minute. The MOST appropriate immediate action is:

Accepted Answer

Perform jaw thrust and apply positive pressure ventilation if needed

Answer

Airway positioning and assisted ventilation take priority before pharmacologic reversal; naloxone is used if opioid-induced respiratory depression is confirmed and ventilation is inadequate.

Question 4

Which pH-related factor makes local anesthetics LESS effective in infected or inflamed tissue?

Accepted Answer

Low pH of infected tissue increases ionization of the anesthetic, reducing membrane penetration

Answer

Infected tissue has a lower pH, causing more local anesthetic molecules to exist in the ionized (cationic) form, which cannot cross the nerve membrane to block sodium channels.

Question 5

The recommended maximum epinephrine dose for a healthy adult dental patient in a single appointment is:

Accepted Answer

0.2 mg

Answer

The standard recommendation allows up to 0.2 mg of epinephrine per appointment for healthy adults, approximately equivalent to 11 cartridges of 1:100,000 epinephrine.

DAANCE - Dental Anesthesia Assistant National Certification Examination Practice Test

DAANCE - Dental Anesthesia Assistant National Certification Examination Practice Test

DAANCE Anesthesia Techniques 5