NBDHE Test Professional Ethics and Law 1 — Questions and Answers
Question 1: A dental hygienist discovers that a colleague is consistently falsifying patient records to cover up incomplete procedures. The hygienist's primary ethical obligation is to:
- Ignore the situation to maintain workplace harmony
- Report the behavior through appropriate channels to protect patient welfare (Correct answer)
- Confront the colleague privately and take no further action if they deny it
- Document personal observations but wait until a patient complaint is filed
Correct answer: Report the behavior through appropriate channels to protect patient welfare
The ethical principle of nonmaleficence (do no harm) and professional accountability require dental hygienists to report misconduct that places patients at risk, even when it involves a colleague. Patient welfare takes precedence over collegial loyalty.
Question 2: A patient refuses a recommended bitewing series, citing concerns about radiation exposure. The dental hygienist should:
- Proceed with the radiographs because they are clinically necessary
- Document the refusal, respect the patient's decision, and note it in the chart (Correct answer)
- Contact the patient's family to obtain consent on their behalf
- Reschedule the appointment until the patient agrees to the radiographs
Correct answer: Document the refusal, respect the patient's decision, and note it in the chart
Patient autonomy is a core ethical principle that gives competent adults the right to refuse treatment. The hygienist must respect this decision, document it thoroughly, and continue to provide care within the patient's stated limits.
Question 3: Under the doctrine of respondeat superior, which of the following statements is TRUE?
- A dental hygienist is personally immune from liability when acting under a dentist's direct supervision
- An employer may be held legally responsible for negligent acts committed by employees within the scope of their employment (Correct answer)
- The supervising dentist alone bears all liability for any patient injury regardless of who performed the act
- A written employment contract eliminates the employer's vicarious liability
Correct answer: An employer may be held legally responsible for negligent acts committed by employees within the scope of their employment
Respondeat superior ('let the master answer') holds employers vicariously liable for employees' negligent acts performed within the scope of employment. However, the employee (dental hygienist) may also retain personal liability.
Question 4: A dental hygienist receives a subpoena for a patient's dental records in connection with a personal injury lawsuit. The hygienist should:
- Refuse to release records because HIPAA prohibits any disclosure without patient consent
- Provide the records as required by law after notifying the patient if permitted (Correct answer)
- Destroy the records to protect the patient's privacy
- Release only a summary of the records rather than the originals
Correct answer: Provide the records as required by law after notifying the patient if permitted
A valid subpoena is a court order that constitutes a legal basis for disclosure under HIPAA. The hygienist should comply with the subpoena, notify the patient when feasible, and provide complete, unaltered records as requested.
Question 5: The ethical concept of justice in dental hygiene practice is BEST demonstrated by:
- Explaining all treatment risks and benefits to patients before obtaining consent
- Providing the same quality of care to all patients regardless of their ability to pay or background (Correct answer)
- Maintaining patient confidentiality in all professional communications
- Referring patients to specialists when a procedure exceeds the hygienist's competence
Correct answer: Providing the same quality of care to all patients regardless of their ability to pay or background
Justice requires fair and equitable treatment of all patients without discrimination based on socioeconomic status, race, gender, or other characteristics. It means distributing care and professional resources fairly across all patient populations.
Question 6: A dental hygienist who exceeds the scope of practice defined by their state's Dental Practice Act may face which of the following consequences?
- A civil lawsuit only, because scope of practice violations are not criminal matters
- License suspension or revocation, civil liability, and potentially criminal charges (Correct answer)
- Only a written warning for a first offense with no impact on licensure
- Consequences borne solely by the supervising dentist, not the hygienist
Correct answer: License suspension or revocation, civil liability, and potentially criminal charges
Practicing outside the legally defined scope of practice can result in disciplinary action by the state dental board (including license suspension or revocation), civil liability for patient harm, and in some cases criminal prosecution for unauthorized practice of dentistry.
NBDHE Test Professional Ethics and Law 1
A dental hygienist discovers that a colleague is consistently falsifying patient records to cover up incomplete procedures.
The hygienist's primary ethical obligation is to: