NBDHE Management of Special Needs Patients 3

Question 1

A patient with chronic kidney disease (CKD) on hemodialysis should receive dental hygiene treatment on which day relative to dialysis?

Accepted Answer

The day after dialysis (not on dialysis day)

Answer

Immediately before dialysis

Answer

During dialysis

Answer

Any day, as dialysis has no effect on dental care timing

Question 2

Patients taking phenytoin (Dilantin) for seizure control may develop which notable oral side effect?

Accepted Answer

Drug-influenced gingival enlargement (gingival overgrowth)

Answer

Angular cheilitis

Answer

Geographic tongue

Answer

Hairy leukoplakia

Question 3

An elderly patient with Alzheimer's disease presents with increased plaque accumulation and root caries. The MOST effective oral hygiene strategy involves:

Accepted Answer

Training and involving the caregiver in daily oral hygiene, using fluoride varnish applications, and simplified hygiene tools

Answer

Teaching the patient complex multi-step oral hygiene techniques

Answer

Relying on chlorhexidine rinse alone

Answer

Recommending dental extractions to simplify care

Question 4

A patient with a history of head and neck radiation therapy (≥60 Gy) presents for a hygiene appointment 2 years post-treatment. Which complication requires the most careful monitoring?

Accepted Answer

Osteoradionecrosis risk, severe xerostomia, radiation caries, and trismus

Answer

Delayed tooth eruption only

Answer

Increased fluorosis risk

Answer

Enhanced wound healing

Question 5

Which of the following best describes the American Heart Association's current recommendation regarding antibiotic prophylaxis before dental procedures for patients with prosthetic heart valves?

Accepted Answer

Prophylaxis is recommended before all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth, or perforation of the oral mucosa

Answer

Prophylaxis is no longer recommended for any cardiac condition

Answer

Prophylaxis is required for all patients with any type of heart murmur

Answer

Prophylaxis is only required for pediatric patients with congenital heart disease

Question 6

A patient with multiple sclerosis (MS) reports increased fatigue and heat sensitivity. Which appointment modification is MOST appropriate?

Accepted Answer

Schedule short morning appointments in a cool room, with frequent rest breaks

Answer

Schedule long afternoon appointments to complete all treatment in one visit

Answer

Keep the operatory warm for patient comfort

Answer

Perform all procedures simultaneously to minimize chair time