NBDE Part II – (Fall) Exam A with Complete Solutions

Alcohol abuse occurs when someone A. drinks more than the legal limit of alcohol. B. experiences withdrawal symptoms when not drinking. C. gets seriously intoxicated on a regular basis. D. drinks enough that it puts their relationships, job, or health in jeopardy. - ANSWER-D. drinks enough that it puts their relationships, job, or health in jeopardy. Which of the following represents the purpose of an open-ended question? A. Eliciting specific information B. Testing patient's truthfulness C. Gathering medical/legal information D. Producing maximal freedom of response E. Probing details of a specific topic - ANSWER-D. Producing maximal freedom of response Which of the following exhibits the most personal behavior by the dentist? A. Leaning toward patient B. Facing directly toward patient C. Sitting 2 feet from patient D. Touching patient gently on arm - ANSWER-D. Touching patient gently on arm Which of the following most accurately explains how biofeedback works? A. Reduces cognitive dissonance B. Stimulates sympathetic nervous system C. Relaxes and, to some extent, hypnotizes patient D. Distracts and engages patient in active coping task E. Enables patient to gain control of certain physiological functions - ANSWER-E. Enables patient to gain control of certain physiological functions The characteristics of effective punishment include each of the following EXCEPT one. Which one is this EXCEPTION? A. Immediacy B. Consistency C. Authority D. Maximum Intensity - ANSWER-D. Maximum Intensity Stress and illness are often related. The best description of their relationship is which of the following? A. Stress is a primary cause of illness. B. Illness is an adaptation to stress. C. Stress is a psychological reaction. D. They often occur together but are causally unrelated. E. Stress is contributory to illness and illness is usually stressful. - ANSWER-E. Stress is contributory to illness and illness is usually stressful. Which of the following is seen most frequently among chronic temporomandibular-joint disorder patients? A. Depression B. Psychosis C. Sociopathy D. Schizotypical behavior E. Passive-aggressive behavior - ANSWER-A. Depression For a patient with multiple sclerosis A. epinephrine is contraindicated in local anesthetic. B. the amount of anesthetic needed for a given procedure is less than for a normal patient. C. the amount of anesthetic needed for a given procedure is more than for a normal patient. D. a single cartridge of anesthetic will most likely not last as long as it would for a normal patient. - ANSWER-A. epinephrine is contraindicated in local anesthetic. Each of the following is a common reason for early retirement of dentists EXCEPT one. Which one is this EXCEPTION? A. Carpal tunnel syndrome B. Chronic back pain C. Hypertension D. Mercury toxicity syndrome E. Latex powder sensitivity - ANSWER-D. Mercury toxicity syndrome Which of the following represents the median of the data set below? 1, 1, 1, 1, 2, 2, 3, 3, 7, 9 (n=10; sum=30) A. 1 B. 2 C. 3 D. 7 E. 9 - ANSWER-B. 2 The ability of a patient to make choices among treatment options represents the concept of A. autonomy. B. competence. C. beneficence. D. paternalism. - ANSWER-A. autonomy. According to the American Dental Association (ADA) publication entitled Principles of Ethics and Code of Professional Conduct, a dentist can announce specialization in which of the following? A. Implantology B. Hospital dentistry C. Esthetic dentistry D. Dental public health E. Geriatric dentistry - ANSWER-D. Dental public health For a population, the researcher divides the number of disease cases by the number of people. By so doing, this investigator will have calculated which of the following rates? A. Incidence B. Odds ratio C. Prevalence D. Specificity - ANSWER-C. Prevalence Which of the following computer databases contains references to dental literature electronically? A. LEXUS B. OVID-MEDLINE C. Dental Abstracts D. Index to Dental Literature - ANSWER-B. OVID-MEDLINE In which of the following teeth does the pulpal anatomy dictate a triangular-access cavity preparation? A. Maxillary central incisor B. Maxillary first premolar C. Mandibular second premolar D. Mandibular canine - ANSWER-A. Maxillary central incisor An 8-year-old child has an exposed vital but inflamed coronal pulp in Tooth #14. The treatment of choice is A. pulpectomy B. a direct pulp cap C. an indirect pulp cap D. pulpotomy - ANSWER-D. pulpotomy Which of the following is the least reliable finding from a clinical examination of teeth subjected to traumatic injury? A. Mobility of teeth B. Vitality of teeth C. Displacement of teeth D. Loss of tooth structure - ANSWER-B. Vitality of teeth Which of the following teeth most often refer pain to the ear? A. Maxillary molars B. Mandibular molars C. Maxillary premolars D. Maxillary anteriors E. Mandibular anteriors - ANSWER-B. Mandibular molars Five hours ago, a 12-year-old boy fell and fractured his maxillary right central incisor at the level of the gingival tissue. The exposed pulp is vital. For this tooth, which of the following represents the treatment of choice? A. Pulp cap B. Pulpotomy C. An apexogenesis procedure D. Complete root canal treatment E. Pulpectomy and placement of calcium hydroxide - ANSWER-D. Complete root canal treatment For access preparation, the root canal anatomy of a maxillary second molar with 4 canals requires which outline form? A. Ovoid B. Round C. Triangular D. Trapezoidal E. Square - ANSWER-C. Triangular Which of the following is the best aid in the diagnosis of an irreversible pulpitis? A. Electric pulp test B. Thermal test C. Percussion D. Test cavity - ANSWER-B. Thermal test Which of the following characterizes replacement resorption? A. Chronic pain B. Apical pathosis C. Rapid progression D. Acute inflammation E. Ankylosis - ANSWER-E. Ankylosis Which of the following has the best prognosis for treatment? A. A tooth with external apical root resorption B. A tooth with external lateral root resorption C. A tooth with a vertical fracture that extends through the floor of the pulp chamber D. An avulsed tooth that was replanted within one hour E. A tooth with a small area of internal resorption - ANSWER-E. A tooth with a small area of internal resorption Which of the following represents the sequence in the replantation of mature, avulsed teeth? A. Repositioning, splinting, and performing root canal therapy B. Performing root-canal therapy, repositioning, and splinting C. Performing canal debridement, performing calcium hydroxide therapy, repositioning, splinting, and filling with gutta- percha D. Repositioning, splinting, performing canal debridement, performing calcium hydroxide therapy, and filling with gutta- percha E. Repositioning and splinting only - ANSWER-D. Repositioning, splinting, performing canal debridement, performing calcium hydroxide therapy, and filling with gutta- percha The pulpal floor is perforated during access preparation. Which of the following is the best course of action? A. Repair the perforation immediately; continue the root canal treatment B. Continue the root canal treatment; repair the perforation at a subsequent appointment only if associated pathosis develops C. Continue the root canal treatment; repair the perforation at a subsequent appointment D. Perform no further treatment at this time; repair the perforation and continue the root canal treatment at a subsequent appointment - ANSWER-A. Repair the perforation immediately; continue the root canal treatment Early stage periapical cemental dysplasia is best differentiated from chronic apical periodontitis by A. percussion. B. subjective symptoms. C. periodontal examination. D. results of pulp testing. E. radiographic appearance. - ANSWER-D. results of pulp testing. Establishing drainage is an important aspect of emergency treatment for an acute periradicular abscess. An equally important aspect is A. adjusting the occlusion. B. prescribing appropriate analgesics. C. debriding the canal system of necrotic tissue. D. introducing antimicrobial medicaments into the pulp space. - ANSWER-C. debriding the canal system of necrotic tissue. A maxillary central incisor of an adult patient is traumatized in an accident. The tooth is slightly tender to percussion, is in good alignment, and responds normally to pulp vitality tests. Radiographic examination shows a horizontal fracture of the apical third of the root. The best treatment is which of the following? A. Root canal treatment B. Splint and re-evaluate the tooth for pulpal vitality at a later time C. Apexification D. Apicoectomy to remove the fractured apical section of the root followed by root canal treatment - ANSWER-B. Splint and re-evaluate the tooth for pulpal vitality at a later time A tooth with an incomplete crown fracture A. should be treated immediately with a direct pulp cap. B. requires placement of a stainless steel crown to provide good pulpal protection. C. does not need to be evaluated with thermal and electric pulp tests. D. requires recontouring of chipped enamel. E. requires vitality tests to determine the extent of pulpal damage. - ANSWER-E. requires vitality tests to determine the extent of pulpal damage. The complete separation of a tooth from its alveolus is A. avulsion. B. ankylosis. C. subluxation. D. extrusive luxation. - ANSWER-A. avulsion. After obturation of a traumatized central incisor, a horizontal line of material in the midroot area extending both mesially and distally from the canal to the periodontal ligament space is noted. This indicates the presence of A. accessory canals. B. a midroot fracture. C. internal resorption. D. external resorption. - ANSWER-B. a midroot fracture. If periapical radiolucency is present at the apex of a tooth with a middle third root fracture and the apical canal space is non-negotiable, the required treatment would be A. extraction because of the poor prognosis. B. calcium hydroxide treatment of the coronal segment only. C. apical surgery with a Super EBA reverse filling. D. apical surgery with removal of the apical segment root canal treatment on the coronal segment. E. extraction with removal of the apical segment and replantation of the coronal segment. - ANSWER-E. extraction with removal of the apical segment and replantation of the coronal segment. A patient experienced a blow to the mouth. Radiographs show a horizontal mid-root fracture of a maxillary central incisor. The tooth is NOT mobile and NOT symptomatic; however, it does not respond to pulp testing. No radiographic lesion is present. The best treatment is to A. institute root canal treatment to include both segments of the tooth. B. extract the coronal segment and surgically remove the apical segment. C. surgically remove the apical segment and reverse fill the coronal segment. D. reform root canal treatment and place an endodontic endosseous implant pin to hold the two segments together. E. render no treatment at this time and periodically recheck clinically and radiographically. - ANSWER-E. render no treatment at this time and periodically recheck clinically and radiographically. The apical foramen most often exits the root A. at the anatomic apex B. less than 0.5 mm from the anatomic apex C. 0.5-1.0 mm from the anatomic apex D. more than 1 mm from the anatomic apex - ANSWER-C. 0.5-1.0 mm from the anatomic apex A 7-year-old patient fractured the right central incisor three hours ago. A clinical examination reveals a 2-mm exposure of a "bleeding pulp." The treatment-of-choice is A. pulpectomy and apexification. B. pulpotomy with calcium hydroxide. C. direct pulp cap with calcium hydroxide. D. one-appointment root canal treatment. - ANSWER-B. pulpotomy with calcium hydroxide. Which of the following outlines best describes the access cavity preparation on a mandibular molar with four canals? A. Oval B. Trapezoidal C. Triangular D. Rectangular - ANSWER-B. Trapezoidal Which of the following injuries to the teeth most often results in pulpal necrosis? A. Avulsion B. Concussion C. Intrusive luxation D. Extrusive luxation E. Mid-root horizontal root fracture - ANSWER-A. Avulsion Loss of the apical seat caused by overinstrumentation is best managed by A. prescribing analgesics and antibiotics. B. filling with a warm gutta-percha technique. C. increasing the file size and decreasing the file length. D. using a chelating agent and packing with calcium hydroxide. E. filling with a gutta-percha cone that is larger than the apical perforation. - ANSWER-C. increasing the file size and decreasing the file length. Which of the following sequences will a dentist most likely use in replantating mature avulsed teeth? A. Root canal therapy, repositioning, and splinting B. Repositioning, splinting, and root canal therapy C. Repositioning, splinting, canal debridement, calcium hydroxide therapy, and gutta-percha fill D. Canal debridement, calcium hydroxide therapy, repositioning, splinting, and gutta-percha fill - ANSWER-C. Repositioning, splinting, canal debridement, calcium hydroxide therapy, and gutta-percha fill A 34-year-old black woman presents for a routine oral examination. She is asymptomatic and there is no evidence of decay or tooth destruction, although slight periodontal disease is present. Radiographically, there are periapical radiolucencies present on two mandibular central incisors. Electric pulp testing indicates all teeth are responsive in a similar fashion. Which of the following is the treatment of choice? A. Initiate root canal treatment on the two teeth. B. Test cavities on mandibular central incisors. C. Identify the dark, potentially necrotic pulp chambers by transillumination. D. Refer for evaluation to rule out possible malignancy. E. No treatment is necessary at this time. - ANSWER-E. No treatment is necessary at this time. A patient of record calls late Saturday night because of severe, throbbing pain, aggravated by "heat, biting, and touching" in a mandibular premolar. What procedure is recommended? A. Instruct the patient to apply ice intermittently, take aspirin, and call Monday for an appointment. B. See the patient at the office and initiate endodontic treatment. C. See the patient at the office, remove the carious dentin and place sedative zinc oxide-eugenol cement. D. Prescribe an analgesic and refer the patient to an endodontist. E. Refer the patient to the hospital oral surgery department for extraction. - ANSWER-B. See the patient at the office and initiate endodontic treatment. Incomplete removal of bacteria, pulp debris, and dentinal shavings is commonly caused by failure to irrigate thoroughly. Another reason is failure to A. use broaches. B. use a chelating agent. C. obtain a straight line access. D. use Gates-Glidden burs. - ANSWER-C. obtain a straight line access. The prognosis for internal bleaching is favorable when the discoloration is caused by A. necrotic pulp tissue. B. amalgam restorations. C. precipitation of metallic salts. D. silver-containing root canal sealers. - ANSWER-A. necrotic pulp tissue. Which of the following is the most effective way to reduce injury to the pulp during a restorative procedure? A. Prepare dentin with slow-speed burs. B. Use anesthetics without vasoconstrictors. C. Minimize dehydration of the dentinal surface. D. Keep the dentinal surface clean by frequent irrigation. E. Use light, short duration contact with the bur. - ANSWER-C. Minimize dehydration of the dentinal surface. To enhance the patient's comfort in the dental setting, the dentist should do which of the following? A. Tell the patient what to expect during the appointment B. Limit eye contact to avoid being unduly intimate C. Provide an immediate evaluation of the patient's oral health D. Demonstrate control through a directive interviewing style - ANSWER-A. Tell the patient what to expect during the appointment Which of the following teeth have the most consistent canal morphology? A. Mandibular incisors B. Maxillary canines C. Mandibular premolars D. Maxillary premolars E. Mandibular molars - ANSWER-C. Mandibular premolars Rigid splinting of an avulsed permanent incisor will most likely lead to A. normal healing response. B. calcific metamorphosis. C. replacement resorption. D. internal resorption. E. root fracture. - ANSWER-C. replacement resorption. Which of the following diagnoses represents an injury that causes the tooth to loosen but is not displaced? A. Concussion B. Luxation C. Subluxation D. Extrusion E. Intrusion - ANSWER-A. Concussion Waiting to allow intruded permanent central incisors to reerupt in an 8-year-old child will likely lead to A. a healing response and reeruption. B. calcific metamorphosis. C. internal resorption. D. tooth discoloration. E. ankylosis. - ANSWER-A. a healing response and reeruption. A traumatic injury can cause the pulp space to calcify, because the accident can trigger odontoclasts into accelerated activity. A. Both the statement and the reason are correct and related. B. Both the statement and the reason are correct but NOT related.