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American Student Dental Association
National Board Dental Examinations TEST PACKET ll-M
Compiled, released items from approximately 2000-2008
American Student Dental Association 211 East Chicago Avenue • Suite 700 • Chicago, Illinois 60611 • 312-440-2795
These released examination materials are distributed by the American Student Dental Association with permission from the American Dental Association Joint Commission on National Dental Examinations. You may not copy for any purpose this publication, or any part of it, in print, electronic or other format without prior express written permission from the American Dental Association.
Important Notice and Disclaimer Concerning These Materials
These materials are distributed by the American Student Dental Association (ASDA) with permission from the American Dental Association Joint Commission on National Dental Examinations. All of these released items are the copyrighted property of the American Dental Association. You may not copy for any purpose this publication, or any part of it, in print, electronic or other format without prior express written permission from the American Dental Association.
This collection of examination materials includes questions compiled from examinations administered by the Joint Commission on National Dental Examinations from approximately 2000 to 2008. The Joint Commission periodically releases items no longer in use to familiarize candidates, educators and others with the general format and content of its examinations. A content outline of the current examination may be found in the Guide. The same information is available online at www.ada.org or on request from the Joint Commission office.
The American Student Dental Association and the Joint Commission on National Dental Examinations do not guarantee that the information in released National Board examinations is accurate, current or relevant. Released materials may no longer be consistent with the current content specifications, content emphasis or examination structure. Because ofthe dynamic nature of dental practice and the biomedical sciences, these materials may be outdated.
The Joint Commission communicates and emphasizes the following cautions to examination candidates and others. All released items are the copyrighted property of the American Dental Association. These materials are intended for the personal, non-commercial use of the purchaser and may not be reproduced in any format, whether paper or electronic, without the express written permission of the ADA Joint Commission on National Dental Examinations.
WARNING: All test material, items or questions currently in use in the National Board examination programs are considered "unreleased" items. Examination regulations prohibit the sharing or use of unreleased items under any circumstances, including efforts to remember and reconstitute exam items. Individuals who breach the confidentiality of an examination may face serious consequences, including voiding of National Board scores and notification to state boards of dentistry.
JOINT COMMISSION ON NATIONAL DENTAL EXAMINATIONS AMERICAN DENTAL ASSOCIATION
Part II Released Items 5 Case A Questions 23 Case B Questions 24 Case A.. 26 Case B 31 Answer Key 36
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A patient has pain over the left pre-auricular area; this patient can open approximately 45 mm and has a "pop-and-click" in the joint area. The most likely diagnosis is
A. myofascial pain dysfunction syndrome. B. internal derangement with reduction. C. auriculotemporal syndrome. D. coronoid hyperplasia.
Erythromycin is responsible for numerous drug interactions, some of which are fatal. This is because erythromycin
A. increases the absorption of many drugs. B. decreases the absorption of many drugs. C. decreases cytochrome P-450 metabolism of
other drugs. D. increases renal reabsorption of many drugs. E. decreases distribution of many drugs.
The penetrating quality of x-ray beams is influenced by which of the following?
A. Kilovoltage B. Milliamperage C. Exposure time D. Focal-film distance E. Filament temperature
6. A 2-day-old developing plaque consists primarily of
-r : „ A. B. C. D. E.
Treponema species Bacteroides species. filamentous organisms. gram-positive cocci and rods. a structureless, non-mineralized pellicle.
Each of the following is an electromagnetic radiation EXCEPT one. Which one is the EXCEPTION?
A. B. C. D. E.
Radar X rays Alpha rays Gamma rays Visible light
Which of the following is NOT a complication of radiation therapy?
A. Mucositis B. Xerostomia C. Osteoradionecrosis D. Granuloma
Each of the following is known to contribute to orofacial clefting EXCEPT one. Which one is the EXCEPTION?
Contraction ofthe lateral pterygoid muscle moves the articular disk in which of the following directions?
A. Anteriorly and medially B. Posteriorly and medially C. Anteriorly and laterally D. Posteriorly and laterally E. Anteriorly, laterally, and interiorly
A decrease in which of the following causes an increase in radiographic density?
A. Milliamperage (mA) B. Kilovoltage peak (kVp) C. Object-film distance D. Source-film distance E. Exposure time
A. B. C. D.
Valium® Poor diet Acetaminophen Vitamin deficiency or excess
10. Which of the following physical signs indicates severe CNS oxygen deprivation?
A. Dilated pupils with increased light reflex B. Pinpoint pupils with increased light reflex C. Dilated pupils with an absence of light reflex D. Pinpoint pupils with an absence of light
reflex
11. Subconjunctival hemorrhage is most commonly found in which of the following fractures?
A. Nasal B. LeFort I C. Frontal sinus D. Zygomatic arch E. Zygomaticomaxillary complex
A. Catecholamines B. Belladonna alkaloids C. Anticholinesterases D. Organophosphates
17. An analgesic compound #3 contains how many mg
of codeine?
A, B. C. D.
7.5 15 30 60
18. Acute pyogenic bacterial infections produce
13. Which of the following best describes a vestibu-loplasty?
A.
B.
C.
D. E.
Bone is added to the mandible to augment its height. Osseointegrated dental implants are placed to support prosthesis. Soft tissue is repositioned in order to increase the area on which the denture may be supported. The chin is augmented to enhance esthetics. Periodontal tissue is removed from around a tooth to establish a biologic width.
19.
14. On a new patient's initial appointment, the dentist
should do which of the following first?
A. Establish rapport B. Inform C. Gather information D. Evaluate
15. An elderly patient has worn a maxillary complete denture against 6 mandibular anterior teeth for an extended period of time. In examining the edentulous mouth of this patient, the dentist would probably see which of the following?
A. Intrusion of the mandibular anterior teeth B. Flabby ridge tissue in the posterior maxillary
arch C. Loss of osseous structure in the anterior
maxillary arch D. Cystic degeneration of the foramina of the
anterior palatine nerve
16. The use of study casts in orthognathic surgery does each of the following EXCEPT one. Which one is the EXCEPTION?
A. Constructs splints B. Performs model surgery C. Determines the postoperative occlusion D. Identifies the type of skeletal deformity E. Aids in explaining the surgical procedure to
22. Gingival overgrowth, hirsutism, coarsening of facial
features, lymph gland hypertrophy, cognitive
deficits, and fetal abnormalities are side effects
associated with which of the following antiepileptic
drugs?
A.
B.
C.
D.
E.
GX Phenobarbital
Carbamazepine (Tegretol1^)
Valproate (Depakene®)
Phenytoin (Dilantin®)
Ethosuximide (Zarontin®)
27 . What space management treatment should be
planned for a child age 4. missing both primary
mandibular first molars with no primate space
present?
A. Lingual arch B. Distal shoe(s) C. Nance holding arch D. Band-and-loop space maintainer(s) E. Observation; no space maintainer
necessary.
23. Which of the following should be performed first for
a collapsed or unconscious victim of illness or
accident?
A. Open the airway B. Establish unresponsiveness C. Establish pulselessness D. Examine the victim for bleeding and
fractures
24. A patient presents with facial lacerations that have
irregular or devitalized wound edges. In excising
the wound elliptically, a practitioner takes into
account each of the following EXCEPT one. Which
is the EXCEPTION?
A. Excision is perpendicular to the natural skin tension lines.
B. Length to width ratio of the excision is at least 3 to 1.
C. Excision is done as conservatively as possible.
D. The wound is undermined prior to closure.
25 . Which of the following represents the major route
of excretion of penicillin V?
A. Secretion in the bile and into the feces B. Excretion in the urine as inactive metabolites C. Total metabolism by the liver and excretion
in the feces D. Secretion not metabolized in the urine
26. Which of the following systemic conditions lowers resistance, impairs healing, and indicates early use of antibiotics for infections?
A. Vitamin C deficiency B. Diabetes mellitus C. Polycythemia vera D. Systemic lupus erythematosus
28 . Each of the following characterizes an impending
insulin shock EXCEPT one. Which one is the
EXCEPTION?
A. Weakness B. Convulsions C. Mental confusion D. Cold perspiration
29 . An unconscious patient is suspected of having an
obstructed airway. How should this patient be
managed?
A. Protrude the tongue, clear the pharynx, extend the neck, and protrude the mandible
B. Extend the neck, clear the pharynx, protrude the tongue, and protrude the mandible
C. Extend the neck, protrude the mandible, protrude the tongue, and clear the pharynx
D. Clear the pharynx, extend the neck, protrude the mandible, and protrude the tongue
30. A tender swelling in the soft tissue of the
submandibular triangle is most likely caused by
A. lipoma. B. lymphadenopathy. C. an obstruction of Stensen's duct. D. an infected thyroglossal duct cyst.
3 1 . Which of the following is the least helpful in
determining the anatomical integrity of the
temporomandibular joint?
A. Arthrography B. Arthroscopy C. Panoramic films D. Computerized tomography E. Magnetic resonance imaging
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32 . A freshly condensed Class II amalgam restoration
has a deficient margin at the proximogingival
cavosurface angle. This might have been caused
by which of the following?
A. Overtightening the matrix band B. Neglecting to wedge the matrix band C. Neglecting to contour the matrix band D. Using too large an initial increment of
amalgam
36. Which of the following is a local contraindication for
the surgical removal of an impacted tooth?
A. A nonvital tooth B. Fever of unknown origin C. A history of bleeding disorder D. An undiagnosed ulcer in the oral cavity E. Pale gingiva with a confirmed history of
anemia
37 .
33.
34 .
35.
Each of the following measures can minimize
fractures of the maxillary alveolar process
EXCEPT one. Which one is the EXCEPTION?
A. Use of controlled force when using forceps and elevators
B. Removal of buccal bone and/or sectioning of teeth
C. A thorough presurgical analysis and planning alterations in the surgical approach
D. Use of the maxillary pinch grasp to detect expansion of the alveolar bone
E. Use of forceps with beaks that grasp the roots more firmly
Ethyl alcohol is a good antidote for methanol poisoning because
A. it inhibits methanol metabolism. B. it competes successfully with methanol for
alcohol dehydrogenase. C. it prevents formation of formaldehyde. D. it prevents damage to the optic nerve. E. All of the above.
Each of the following nonsedating antihistamines would be contraindicated in an individual taking cimetidine for heartburn EXCEPT one. Which one is the EXCEPTION?
38.
39.
40.
A.
B.
C.
D.
E.
Astemizole (Hismanal®)
Diphenhydramine (Benadryl®)
Fexofenadine (Allegra®)
Hydroxyzine (Vistaril®)
Terfenadine (Seldane®)
41.
Which of the following properties increases when
the intermediate chain of a local anesthetic drug is
lengthened?
A. Potency B. Allergenicity C. Solubility in water D. Rate of biotransformation
Which of the following is NOT an advantage of
chemical vapor sterilization?
A. Cycle time is short. B. It will not char fabrics. C. It will not cause corrosion. D. There is no need for special ventilation. E. Instruments are dry at the end of the cycle.
The most common cause of fracture at the isthmus
of a Class II restoration is
A. delayed amalgam expansion. B. a sharp axio-pulpal line angle. C. isthmus width too narrow. D. moisture contamination of the amalgam
during placement. E. lack of interproximal contact.
Alveoplasty following closed extraction is usually
performed with
A. B. C. D.
a bur. fingers. a rongeur. a bone file
The periosteal elevator is used to do each of the
following EXCEPT one. Which one is the
EXCEPTION?
A. Luxate the teeth B. Retract the soft tissue flap C. Elevate the interdental papillae D. Provide protection to the soft tissue flap
8
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42. The fenestration technique for mandibular vestibu-loplasty is based on the premise that the mucosal attachment will
A. not cross the skin graft. B. not cross the mucosal graft. C. not cross a fibrous scar band. D. be maintained in its lowered position by the
new denture.
48. How does the growth of the cranial base generally relate in time to the growth of the jaws?
A. Follows B. Precedes C. Unrelated D. Accompanies E. Initially follows, then accompanies
43. Which of the following represents a constitutional symptom?
A. B. C. D.
Tinnitus Chills Xerostomia Dysphagia
49. Aplastic anemia is a serious toxic effect associated most frequently with which of the following antibiotics?
A. Streptomycin B. Tetracycline C. Chloramphenicol D. Chlortetracycline
44. Which of the following is the most commonly used surgical procedure to correct maxillary retrognathia?
A. C-osteotomy B. Le Fort I osteotomy C. Inverted L-osteotomy D. Anterior maxillary osteotomy
50. The therapeutic index of a given drug indicates the relative
A. B. C. D. E.
safety. potency. efficacy. duration. solubility.
45. In the preauricular approach to the TMJ, which of the following anatomic structures, if damaged, presents the potential for greatest morbidity?
A. Facial nerve B. Parotid gland C. Auriculotemporal nerve D. Superficial temporal vein E. Facial artery
51. Which of the following flap designs allows the best surgical access to the apical aspect of a tooth root with the least reflection of soft tissue?
46. Which of the following is most clearly associated with the appearance of "moon fades"?
A. Hyperthyroidism B. Regular corticosteroid use C. Diabetes mellitus D. Pancreatic insufficiency
47. Osteomyelitis of the mandible is most likely to develop because of
A. failure of pus to localize. B. a resistant strain of bacteria. C. low resistance of the patient. D. lack of drainage from the infected area.
52. Each of the following is a disadvantage of oral sedation EXCEPT one. Which one is the EXCEPTION?
A. The administrator has little control over the ultimate clinical actions ofthe drug(s).
B. There can be significant differences in the bioavailability of oral drugs.
C. With most oral drugs, there is a relatively slow onset of clinical activity and a prolonged duration of action.
D. Oral anxiolytic drugs are effective in relieving anxiety in the hours immediately preceding the dental appointment.
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53. Principles for managing a localized alveolar osteitis after extraction of a mandibular first molar include each of the following EXCEPT one. Which one is the EXCEPTION?
A. Flushing out debris with normal saline solution
B. Curetting the boney wall to promote bleeding C. Placing a sedative dressing in the socket to
protect exposed bone D. Administering mild analgesic drugs as an
adjunct to local treatment
54. When is the most appropriate time to permanently modify/alter the occlusion of an acute TMD patient?
A. During the first visit, while the patient has the acute symptoms
B. Prior to initiating splint therapy, one week after the first visit
C. Only after the patient is sympton-free and has shown improvement during splint therapy
D. Never, until definitive orthodontic treatment has been started
55. Which of the following best defines the term "Temporomandibular Disorders"?
A. A clinical condition related to dysfunction of the temporomandibular joint and disk
B. A collective term for a heterogenous group of musculoskeletal disorders of varying etiologies, that present with similar signs and symptoms
C. A clinical condition caused by disharmony between the occlusal proprioceptors and masticatory muscles
D. A group of clinical conditions that arise from excessive loads being placed on the TM joints by muscle spasms, resulting in disk displacement on one or both sides
56. You are doing some preprosthetic surgery on a patient in preparation for a new denture. Which of the following statements about removal of her moderate-sized mandibular lingual tori is correct?
A. The tori should be removed using a large pear-shaped acrylic bur.
B. The tori should be removed by grooving the superior surface then shearing the torus off with a mono-beveled chisel. The area is then smoothed with a bone file.
C. The tori should be removed by grooving the superior surface of the torus with a bur, then shear the torus off with a bibeveled chisel.
D. The tori should be removed by inserting a rongeurs vertically under a lingual flap and "snipping off' the tori.
57. Which of the following statements about the flap for the removal of a palatal torus is correct?
A. The most optimal flap uses a midline incision which courses from the papilla between teeth #8 and 9 posteriorly to the junction of the hard and soft palates.
B. The most optimal flap is a reflection of the entire hard palate mucoperiosteum back to a line between the 2 first molar teeth.
C. The most optimal flap uses a midpalatal incision that courses from the palatal aspect of tooth #3 across to the palatal aspect of tooth #14.
D. The most optimal flap is shaped like a "double-Y", with a midline incision and anterior and posterior side arms extending bilaterally from the ends of the midline incision.
58. Which of the following statements about maxillofacial bone grafts is INCORRECT?
A. Xenografts are frequently used in mandibular reconstruction.
B. The most common source of autologous bone is the iliac crest.
C. Allogeneic banked bone is often used as a carrier, supplemented with an autogenous graft.
D. An example of isogeneic bone grafting is transplanting bone marrow in the treatment of such diseases as leukemia.
maxillofacial surgeon for an implant, and you were
advised that she was going to need a sinus lift
procedure with placement of an autogenous bone
graft. What is the definition of that graft?
A. The graft will use an artificial, bone-like material.
B. The graft uses bone from another human being.
C. The graft uses the patient's own bone, taken from another site.
D. The graft uses bovine bone, or bone from another animal species.
60. A complete denture patient returns for a 24-hour
post-op appointment after insertion of new
dentures. The patient points to a sore area on top
of the mandibular ridge crest on the posterior right
side but no sore spot is visually evident. Which of
the following is the first procedure the dentist
should perform?
A. Reduce the centric contacts on all posterior teeth on the right side of the mandibular denture.
B. Using a large acrylic bur, grossly reduce the internal surface of the denture.
C. Reduce all eccentric contacts on the right side of the maxillary and mandibular dentures.
D. Apply pressure indicator paste to the internal surface of the mandibular denture and check for pressure spots.
E. Tell the patient this is normal for the first day of wearing new dentures and to return in one week for another post-op check.
62. Each of the following statements concerning the
administration technique of inhalation sedation is
correct, EXCEPT one. Which one is the
EXCEPTION?
A. If the patient is wearing contact lenses, they should be removed prior to administration of the sedation.
B. The patient should be seated in an upright (85-90 degree) position in the dental chair.
C. The initial flow rate of oxygen should be at least 6 L/min via the nasal hood.
D. As the flow of nitrous oxide through a mixing dial style unit is increased, the flow rate of oxygen is reduced, so the correct percentage of each is delivered at a constant flow rate.
63. Each of the following is a common cause of
postsurgical atelectasis (decreased expansion of the alveoli) EXCEPT one. Which one is the EXCEPTION?
A. Shallow inspirations B. Pain-limiting movement C. Inactivity after surgery D. Preoperative respiratory infection E. Narcotic analgesic that depress the
respiratory drive
64. Cavity liners should have a minimal thickness of
A. B. C. D.
1 mm. 1.5 mm. 15 mm. 125 mm
6 1 . When a patient bites on a hard object on the left
mandibular molar, the interarticular pressure of the
right temporomandibular joint is
A. increased. B. decreased. C. remains unchanged. D varied but it is unpredictable.
65. Each of the following statements is correct
regarding phenytoin EXCEPT one. Which one is
the EXCEPTION?
A. Causes gingival hyperplasia B. Corrects certain cardiac dysrhythmias C. Is ineffective when administered orally D. Causes toxic effects related to the
cerebellum and vestibular system E. Exerts antiseizure activity at doses which do
66. A properly executed posterior superior alveolar 7 1 . nerve block will anesthetize each of the following structures EXCEPT one. Which one is the EXCEPTION?
A. Maxillary sinus membrane in the molar region
B. Second and third molar teeth and a portion of the first molar tooth
C. Buccal alveolar bone, soft tissue and periodontium in the posterior maxilla 72.
D. Soft palate mucosa on the side of the injection
Which of the following is the most serious result of digoxin intoxication?
A. Bradycardia B. Renal failure C. Atrial tachycardia D. Atrial fibrillation E. Ventricular fibrillation
Each of the following represents an advantage of oral sedation EXCEPT one. Which one is the EXCEPTION?
67. Which areas should be avoided for an IM injection before a child can walk?
A. B. C. D.
Gluteal muscles Ventrogluteal Vastus lateralis Deltoid area
A. Need for specialized training and equipment B. High incidence and severity of adverse
reactions C. Erratic and incomplete absorption of drugs
from the Gl tract D. Short duration of action
73. The depth of light penetration into the tooth or restoration before it is reflected outward is the
68. Adrenal insufficiency during major stress results in
A. gingival hyperplasia. B. cardiovascular collapse. C. hypotension. D. ketoacidosis.
A. metamerism. B. degree of translucency. C. color perception. D. value.
69. A patient that is having general anesthesia using an IV barbiturate rapidly passes through
74. In young patients, stains are usually more prominent in which areas of the teeth?
A. B. C. D.
Stage I. Stage II. Stage III. Stage IV
A. B. C. D.
Incisal Occlusal Cervical Facial
70. Which of the following antibiotics has been implicated in the vast majority of cases of oral contraceptive failure during antibiotic use?
75. The character and individuality of teeth are largely determined by
When the dentist enters the operatory, the patient,
who is new to the office, stands close to the wall,
has his arms folded, and is looking at the floor. The
dentist should initiate communication by saying
which of the following?
A. Let's get going, I've got a lot to do. B. What are you angry about? C. Didn't my assistant get you seated? D. You seem uncomfortable; did you have a
bad dental experience? E. Hi, I'm Doctor Wilson, what brings you here
today?
Which of the following antibiotics is the substitute
of choice for penicillin in the penicillin-sensitive
molar. This molar has a necrotic pulp. Which of the
following represents the treatment of choice?
A. B. C. D.
Pulpectomy Pulpotomy Extraction Pulp cap
Which of the following is an outstanding advantage of phenytoin over phenobarbital in the treatment of grand mal epilepsy?
A. Exerts less sedation for a given degree of motor cortex depression
B. Is effective in a greater percentage of cases C. Needs to be given much less frequently D. Does not cause gastric distress E. Has a longer duration of action
8 1 . The outstanding advantage of phenytoin over
phenobarbital in the treatment of epilepsy is that
phenytoin
A. does not bring about dependence. B. has a longer duration of action. C. is effective against both grand and petit mal. D. produces less sedation for a given degree of
motor cortex depression.
82. The main function of the liner used in a casting
ring is to
A. provide venting of the mold. B. help prevent shrinkage porosity. C. provide easy divesting of the casting. D. provide additional water to the investment
mix. E. allow uniform and uninhibited setting
expansion of the investment.
83 . The use of a rubber dam is considered an
essential component of endodontic
armamentarium.
Exception to its use in a given situation is acceptable if the patient is informed and consents.
A. Both statements are true. B. Both statements are false. C. The first statement is true, the second is
false. D. The first statement is false, the second is
true.
84. The Occupational Safety and Health
Administration's (OSHA) "Bloodborne Pathogens
Standard" deals with each of the following
EXCEPT one. Which one is the EXCEPTION?
A. Disposal of medical waste B. Exposure Control Plan C. Hepatitis B vaccination D. Instrument sterilization and storage E. Material Safety Data Sheets (MSDS)
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85. A 20-year-old patient presents with an upper maxillary centra) incisor previously treated for endodontic fractures at the level of the alveolar crest. Which of the following represents the first necessary step to restore and maintain the tooth's esthetics?
A. Orthodontically extrude remaining tooth structure
B. Extract remaining tooth structure C. Fabricate FPD over the remaining root D. Fabricate RPD over the remaining root
86. Shrinkage porosity in a gold casting is associated with
A. the use of excessive flux. B. the use of no flux. C. sprue diameter. D. alloy oxidation. E. excessive burnout time.
87. Which of the following is an acronym for a marketing strategy to use for reluctant patients?
90. Back pressure porosity is
A. B. C. D.
SUCCESS RECRUIT OPTIMEM EIEIO
91.
A. B. C.
D.
the same as occluded gas porosity. the result of using an oxidizing flame. most likely when the wax pattern is positioned very close to the open end of the ring. often evidenced by rounded margins on the casting, the same as suck-back porosity.
Which of the following explains why a properly designed rest on the lingual surface of a canine is preferred to a properly designed rest on the incisal surface?
A. The enamel is thicker on the lingual surface. B. Less leverage is exerted against the tooth by
the lingual rest. C. The visibility of, as well as access to, the
lingual surface is better. D. The cingulum of the canine provides a
natural surface for the recess.
92. The most potent antitubercular drug is
A. isoniazid. B. vancomycin. C. trimethoprim. D. sulfamethoxazole.
88.
89.
Spontaneous gingival hemorrhage or acute stomatitis, observed in a pediatric patient under treatment for absence seizures, indicates withdrawal of which ofthe following anticonvulsant drugs?
93. The main metabolite of ingested isopropyl alcohol
At the try-in appointment for a 3-unit posterior gold FPD, the proximal contacts, fit, occlusion, contour, and surface finish have been determined to b8 acceptable. Which ofthe following represents what step is accomplished next with this FPD?
A. Soldering index B. Copalite preparations C. Temporary cementation D. Mix zinc phosphate cement
14
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95.
96.
Larger condensers and laterally applied condensation forces are recommended to ensure complete condensation of which of the following amalgam types?
Proposed modes of action for the oral antidiabetic agents include each of the following EXCEPT one. Which one is the EXCEPTION?
A. Blockade of glucagon release from pancreas B. Blockade of catecholamine release from
adrenal medulla C. Stimulation of insulin release from pancreatic
beta cells D. Action as direct receptor agonists for the
insulin receptor E. Increase affinity of tissues for utilization of
available plasma glucose
100. With respect to temperature, the processing cycle of a denture is designed to
A. attain development of color. B. prevent boiling of the monomer. C. prevent breakdown of the initiator. D. volatilize the hydroquinone inhibitor.
101. Alcoholic euphoria results from
A. increased activity of the cerebrum. B. increased activity of thalamic areas. C. increased activity of limbic synapses. D. decreased activity of medullary centers. E. removal of the inhibitory effect of the cortex.
102. The portion of an artificial tooth that is found only in porcelain anterior teeth is
A. the pin. B. the collar. C. the finish line. D. the diatoric. E. None of the above.
97. Compressing the acrylic resin in a rubbery stage will probably result in
A. an open bite or open pin. B. porosity of the finished acrylic. C. incomplete filling of the mold details. D. large amounts of excess that is difficult to
trim.
98.
99.
103. The casting shrinkage of cobalt-chromium alloys is approximately
A. B. C. D.
1.25% 1.75% 2.2%. 3.2%.
Which of the following statements concerning ethyl alcohol is true?
A. It produces a true stimulation of the central nervous system.
B. It protects individuals against exposure to cold by preventing heat loss.
C. It is metabolized primarily by the lungs. D. It is partially absorbed in the stomach. E. It possesses anticholinergic properties.
The most likely cause of failure in the pre-ceramic soldering technique is
A. underheating the parts to be joined. B. overheating the parts to be joined. C. using an incompatible solder. D. using phosphate as the soldering
investment. E. preheating the soldering assembly.
104. Which of the following is a disadvantage of glass ionomer cement?
A. Difficulty in mixing B. Irritation of the pulp C. Low bond strength to dentin D. Moisture sensitivity during initial set
105. Which of the following will result when using a thinner mix of a gypsum-bonded casting investment?
A. Produce a smoother casting B. Increase setting expansion C. Decrease setting expansion D. Increase thermal expansion E. Decrease required burn-out temperature
Which of the following oral bacteria have been implicated as periodontal pathogens?
A. Porphyromonas gingivalis, Eubacterium sp., and Campylobacter recta
B. Streptococcus gordonii, Streptococcus mutans, and Gemella sp.
C. Lactobacillus casei and Veillonella sp. D. Streptococcus mitior, Streptococcus gordonii
and Bacteroides gracilis
The base of the incision in the gingivectomy technique is located
A. in the alveolar mucosa. B. at the mucogingival junction. C. above the mucogingival junction. D. coronal to the periodontal pocket. E. at the level of the cementoenamel junction.
Which of the following is the most important factor
affecting pulpal response?
A. Heat B. Depth to which dentinal tubules are cut C. Desiccation D. Invasion of bacteria
Primary herpetic gingivostomatitis is most likely to occur in which of the following age groups?
112. Allowing the ultrasonic-sealer tip to remain on the tooth surface too long will
A. damage the tooth surface. B. dull the tip of the instrument. C. burnish the calculus onto the tooth surface. D. cause irreversible pulpal damage.
113. The most important anticoagulant effect of heparin is to interfere with the conversion of
A. PTA to PTC. B. PTC to Factor VIII. C. fibrinogen to fibrin. D. prothrombin to thrombin. E. proaccelerin to accelerin.
114.
115.
A. B. C. D. E.
1 -5 years 6-10 years 11-15 years 16-20 years 21-25 years
Which of the following filling materials is least desirable for use as Preventive Resin Restoration?
A. A trough B. A dehiscence C. A hemiseptum D. An interdental crater
Dental phobias are very hard to eliminate because they
A. are ego-syntonic. B. cannot be seen. C. become habitual. D. are self-reinforcing.
Which of the following describes a material with high compressive strength but low tensile strength?
A. B. C. D.
Resilient Brittle Ductile Malleable
116. The Occupational Safety and Health Administration (OSHA) is concerned with regulated waste within the office.
OSHA regulates the transportation of waste from the office.
A. Both statements are true. B. Both statements are false. C. T h e f irst s ta temen t is l i ue , the s e c o n d is
false. D. The first statement is false, the second is
true.
117. One can accelerate the setting time of zinc oxide-eugenol impression pastes by adding a small amount of
A. B. C. D.
water, glycerin, petrolatum, plaster of paris.
16
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118. What percentage ofthe U.S. population does not have dental insurance?
119.
120.
A. B. C. D.
35-40% 45-50% 55-60% 65-70%
A patient works at a nuclear power plant. He is frequently exposed to a small amount of radiation, although the dose he receives is below the occupational limits. Which of the following best explains why this patient need not wear his employee film badge while he is having dental radiographs made?
A. His badge records only gamma-radiation, not x rays.
B. His film badge must be used only to measure occupational doses.
C. It is unlikely that the current dose will rise above his occupational limit.
D. The dose from the dental radiographs is too low to be measured accurately by the badge.
A 5-year-old child has a posterior unilateral crossbite that is accompanied by a functional shift of the mandible. When should this crossbite be corrected?
A. Immediately, without waiting for the eruption of permanent first molars
B. When all the primary teeth have exfoliated C. After the permanent first molars have fully
erupted D. When the child is approximately 9 years of
age
121. When determining the appropriate dose of systemic fluoride supplement for a child, it is. most important for the dentist to consider which of the following?
A. The fluoride content of the drinking water B. The child's diet and caries activity C. The child's age and the fluoride content of
the drinking water D. The child's weight and the fluoride content of
the drinking water
122. The drug of choice to treat overdosage with tricyclic antidepressants is
A. atropine. B. phenytoin. C. physostigmine. D. pentobarbital. E. an amphetamine.
123. Chlortetracycline acts by interfering with
A. cell wall synthesis. B. nucleic acid synthesis. C. protein synthesis on bacterial but not
mammalian ribosomes. D. protein synthesis on mammalian but not
bacterial ribosomes.
124.
125.
126.
The toxic impurity that can theoretically be found in nitrous oxide gas is
How many hours per day should a cervical pull headgear be worn to achieve the most effective results?
A. 6 B. 8 C. 10 D. 12 E. 14
Drug interaction resulting in serious adverse cardiovascular events, including death, might occur between erythromycin and which of the following antihistamine drugs?
1 3 1 . Inhalation of amyl nitrite can result in each of the following EXCEPT one. Which is the EXCEPTION?
A. Tachycardia B. Coronary artery dilation C. Peripheral arteriolar dilation D. A decrease in arterial blood pressure E. Increased motility of the small bowel
137. What percent of the blood alcohol level is the most likely to produce a lethal effect in 50 per cent of the population?
A. aplastic anemia. B. thrombocytopenia. C. granulocytopenia. D. methemoglobinemia. E. hypoprothrombinemia.
The thinnest portion of the wax pattern should be placed
A. against the ring for support. B. in the deepest part of the ring. C. opposite the direction of rotation of the
casting arm. D. in the same direction as the rotation of the
casting arm.
Which of the following statements is true concerning anticholinesterase?
A. Agents such as DEP inhibit only plasma cholinesterase.
B. Organophosphates are readily absorbed through the skin.
C. Agents may cause paroxysmal supraventricular tachycardia.
D. Reactivators such as 2-PAM reactivate ACHE which has undergone "aging".
E. Alkaloid physostigmine has the greatest number of side effects unrelated to ACHE inhibition.
140.
141. In developing a canine-protected articulation where the anterior vertical overlap is determined to be less than 2 mm, the posterior cusp height should be kept shallow because the buccal cusps of the posterior teeth will have to assist in protrusive disclusion.
A. Both the statement and the reason are correct and related.
B. Both the statement and the reason are correct but NOT related.
C. The statement is correct but the reason is NOT
D. The statement is NOT correct, but the reason is correct.
E. NEITHER the statement NOR the reason is correct.
142. Which of the following best describes adjunctive orthodontic treatment?
A. Orthodontic therapy performed only with removable appliances
B. Limited orthodontic treatment to align the front teeth for maximum esthetics
C. Orthodontic treatment to enhance restorative and periodontal rehabilitation
D. Early treatment of orthodontic problems to prevent more serious malocclusion
143. Which of the following drug groups is currently the mainstay of treatment in depressive psychoneurotic disease?
A. Amphetamines B. Phenothiazines C. Benzodiazepines D. Monoamine oxidase inhibitors E. Tricyclic (imipramine-like) antidepressants
144. Each of the following is a symptom of poisoning by an organophosphate insecticide EXCEPT one. Which one is the EXCEPTION?
A. Diarrhea B. Hot, dry skin C. Excessive salivation D. Increased lacrimation E. Skeletal muscle fasciculation
145. Digitalis should be given to patients with atrial fibrillation who require quinidine to avoid
A. hypokalemia. B. thromboembolism. C. sino-atrial bradycardia. D. ventricular tachyarrhythmias. E. prolongation of P-R interval of the ECG.
146. The presence of Ag in metal-ceramic alloys contributes to which of the following?
A. Increases melting temperature B. Increases alloy strength C. Increases alloy corrosion resistance D. May cause green discoloration of the
147. Having had a complete radiographic survey made 12 months ago, an asymptomatic adult patient presents for a recall appointment. There is no clinical evidence of caries or periodontal disease. The United States Food and Drug Administration would recommend which of the following for this adult?
A. No radiographs B. Bite-wing radiographs only C. Panoramic radiograph only D. Panoramic and bite-wing radiographs E. Full-mouth survey including bite-wing
radiographs
148. When high gold content alloys are compared to base metal alloys, the base metal alloys exhibit
A. a higher melting point, increased specific gravity, and generally higher yield strength and hardness.
B. a higher melting point, decreased specific gravity, and generally higher yield strength and hardness.
C. a higher melting point, generally higher yield strength and hardness, and more consistent bonding to porcelain.
D. increased specific gravity, generally lower yield strength, and more consistent bonding to porcelain.
E. decreased specific gravity, generally higher yield strength and hardness, and more consistent bonding to porcelain.
149. The central skeletal muscle relaxation produced by depressing the polysynaptic reflex arcs is brought about by all of the following drugs EXCEPT
A. diazepam (Valium®).
B. lorazepam (Ativan®).
C. meprobamate (Equanil®).
D. d-tubocurarine (Tubarine®).
150. Which of the following statements best describes why L dopa eventually becomes ineffective in the treatment of Parkinson's disease?
A. L-dopa absorption slows with aging. B. Dopa decarboxylase activity increases with
age. C. Dietary intake of pyridoxine speeds L-dopa
metabolism. D. Patients gradually develop tolerance
because L-dopa induces liver enzyme activity.
E. Neuronal cell loss in the substantia nigra is progressive and continuous over the course of the disease.
151. The "S" in DMFS signifies which of the following?
A. B. C. D. E.
Score Standard Surfaces Simplified Significant
152.
153.
Each of the following pharmacologic effects is produced by ethanol EXCEPT one. Which one is the EXCEPTION?
A. Diuresis B. CNS depression C. Enzyme induction D. Cutaneous vasoconstriction E. Increased gastric acid secretion
The cardiac glycosides will reduce the concentration of which ion in an active heart muscle cell?
A. B. C. D. E.
Sodium Calcium Chloride Potassium Magnesium
154. Which of the following antihypertensive agents acts directly on arterial smooth muscle to cause vasodilation?
A.
B.
C.
D. E.
Methyldopa (Aldomet®)
Clonidine (Catapres®)
Guanethidine (Ismelin®)
Metoprolol (Lopressor®)
Hydralazine (Apresoline®)
155.
156.
The combination of a Schedule II narcotic with an antipsychotic drug produces which ofthe following?
A. Neuroleptic analgesia B. Conscious sedation C. Dissociative anesthesia D. Psychotomimetic analgesia
Which ofthe following drugs is excreted primarily by renal tubular secretion?
157. Excessive vertical dimension of occlusion may result in which of the following?
A. Poor denture retention B. Increased interocclusal distance C Drooping of the corners of the mouth D. Creases and wrinkles around the lips E. Trauma to underlying supporting tissues
162. In pursuit of what the dentist believes is best for the patient, the dentist attempts to control patient behavior. This is known as
A. B. C. D.
autonomy, competence, maleficence, paternalism.
158. Which of the following represents the cause of death in poisoning from an irreversible anticholinesterase, such as diisopropylfluo-rophosphate?
A. Cardiac failure, resulting from excessive vagal stimulation
B. Dehydration, resulting from hypermotility of the gastrointestinal tract
C. Asphyxia, resulting from increased airway resistance
D. Respiratory failure, resulting from paralysis ofthe intercostals and the diaphragm
E. Central nervous system depression, following prolonged excitation
159. Treatment with sulfonamides is less likely to be accompanied by crystalluria if
A. a mixture of sulfonamides is used. B. cortisone is administered concurrently. C. probenecid is administered concurrently. D. the urine is acidified with ammonium
chloride. E. para-aminosalicylic acid is administered
concurrently.
160. Which of the following is the most common reason for a cast crown not to seat on a patient's tooth?
A. Overextended margins B. Excessive proximal contact C. Undercut areas on the preparation D. Casting too wide bucco-lingually E. Porosity within the inner surface of the
crown
161. Loss of a primary right molar in a 3-year-old child requires placement of a
A. band and loop. B. distal shoe. C. removable acrylic appliance. D. None of the above.
163. When 50 mg. of chlorpromazine (Thorazine®) is administered to a patient, on standing the patient might experience a fall in blood pressure due to which of the following?
A. Anticholinergic action B. Decrease in heart rate C. Alpha-adrenergic blockade D. Negative inotropic action E. Stimulation of autonomic ganglia
164. Which ofthe following represents an amphetamine-like drug that is widely used in the treatment of hyperkinetic children?
A. Doxapram (Dopram®)
B. Hydroxyzine (Atarax®)
C. Theophylline (Theobid®)
D. Methylphenidate (Ritalin®)
165. Metabolism of a drug will usually result in conversion to each of the following EXCEPT one. Which one is the EXCEPTION?
A. Inactive form B. More active compound C. Less active compound D. More water-soluble compound E. Less ionized compound
166. The disk sensitivity assay for antibiotic activity is used because
A. the results are obtainable in a few minutes. B. it distinguishes between bacteriostatic and
bactericidal drugs. C. it indicates whether or not an antibiotic has
good oral absorption. D. it allows for routine testing of sensitivity to a
167. Which of the following agents is the least effective in producing topical anesthesia?
A. Tetracaine (Pontocaine®)
B. Butacaine (Butyn®)
C. Procaine (Novocaine®)
D. Lidocaine (Xylocaine®) E. Benzocaine
168. Which of the following routes of administration exhibits the slowest rate of absorption?
A. B. C. D.
Oral Sublingual Subcutaneous Intramuscular
169. Which ofthe following sedatives is most likely to cause a dry mouth?
A. Buspirone (BuSpar®)
B. Hydroxyzine (Vistaril®)
C. Chloral hydrate (Noctec®)
D. Phenobarbital (Luminal®)
173. Nystatin (Mycostatin®) is used in the treatment of infections caused by
A. Peptostreptococci spp. B. Bacteroides spp. C. Candida albicans. D. Streptococcus mutans. E. Pseudomonas aeruginosa.
174. Which ofthe following analgesics can be given either orally or by intramuscular injection?
A. Aspirin
B. Acetaminophen (Tylenol®)
C. Ibuprofen (Motrin®, Advil®)
D. Ketorolac (Toradol®)
E. Naproxen (Naprosyn®, Aleve®)
175. A cast gold restoration might be indicated for the replacement of a faulty amalgam to obtain
A. better margins. B. more ideal contours. C. less trauma to the pulp. D. less removal of tooth structure.
170. Barbiturates taken in combination with very high doses of ethanol exhibit an interaction best described as which of the following?
A. Potentiation B. Protein bumping C. Negative synergism D. Competitive inhibition E. Enterohepatic circulation
176. During a soldering procedure, flux serves to
A.
B.
C.
D.
provide an oxidizing environment in the area to be soldered. displace gases and dissolve corrosion products. remove any debris that may remain in the area to be soldered. hold the solder in place during heating.
171.
172.
Which of the following erythromycins is both enteric coated and long acting?
A. B. C. D.
ERYC E.E.S. Erythrocin llosone
Each of the following is a characteristic of tramadol
(Ultram®) EXCEPT one. Which one is the EXCEPTION?
A. Centrally acting analgesic B. Structurally similar to morphine C. Binds to the mu-opioid receptor D. Biotransformed into a more active metabolite E. Inhibits uptake of norepinephrine and
serotonin
177. Excessive heating of the acrylic resin during processing should be avoided to prevent
A. exothermic heat buildup. B. acrylic resin shrinkage. C. evaporation of the monomer. D. excessive acrylic resin expansion. E. discoloration ofthe acrylic resin.
178. Following compression of acrylic into the denture flasks, placing the flasks into the processing tanks at curing temperature is delayed to
A. assure complete flow of acrylic into the mold. B. allow the monomer to permeate all polymer
crystals. C. establish an equalized and uniform pressure
in the molds. D. allow the flasks and the acrylic to reach a
stable temperature.
22
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Case A #'s 179-187 184. Which of the following represents the best initial
restorative treatment for tooth #4?
179.
180.
181.
182.
183.
I
(see page 26) The plaques on this patient's lower labial mucosa most likely represent which of the following?
Which o f the following represents the structure indicated by the arrows on the radiograph?
A. B. C. D. E.
Innominate line Lateral border of the orbit Pterygoid plate of the sphenoid Zygomatic process of the maxilla Posterior border of the maxillary sinus
Prior to undergoing scaling and root planing, how should this patient be treated?
A.
B.
C.
D.
E.
Amoxicillin (Amoxil®), 2 gm, 1 hour prior to procedure
Cephalexin (Keflex®), 3 gm, 1 hour prior to procedure
Clarithromycin (Biaxin®), 600 mg, 1 hour prior to procedure
Clindamycin (Cleocin®), 2 gm, 1 hour prior to procedure No antibiotic treatment is necessary.
Which of the following risk factors is most likely to contribute to future attachment loss in this patient?
A. B. C. D. E.
Probing depths greater than 3 mm Insulin administration Occlusion Nutrition Smoking
There is a vertical defect on the mesial of tooth #2.
There is a crater defect between tooth #2 and tooth #3.
A. B. C.
D.
Both statements are true. Both statements are false. The first statement is true, the second is false. The first statement is false, the second is true.
A. Place porcelain fused to metal crown B. Restore with conservative MO amalgam C. Treat mesial caries with composite resin D. Place mesial glass ionomer restoration to
restore root caries lesion E. No treatment is necessary.
185. Each of the following statements is true concerning impacted teeth #17 and #32 EXCEPT one. Which one is the EXCEPTION?
A. Alveolar osteitis in the removal of bony impactions might occur (5-20%).
B. The alveolar nerve is not likely to be injured during this extraction.
C. Horizontally impacted teeth are considered the most difficult mandibular impactions.
D. Asymptomatic bony impactions are not recommended for extraction in patients over 35 years-of-age.
186. The position of tooth #26 will complicate the design of a maxillary prosthesis.
Maxillary tuberosity reduction on the patient's left side would facilitate prosthesis fabrication.
A. Both statements are true. B. Both statements are false. C. The first statement is true, the second is
false. D. The first statement is false, the second is
true.
187. Prior to dental treatment using local anesthesia without sedation the patient should be instructed to take his usual dose of insulin and eat a normal diet.
If the patient is to have local anesthesia with sedation, the patient should be instructed to reduce the usual dose of insulin and not eat.
A. Both statements are true. B. Both statements are false. C. The first statement is true, the second is
false. D. The first statement is false, the second is
(see page 31) 188. Which of the following is the most likely periodontal
diagnosis for this patient?
A. Plaque-induced gingivitis B. Chronic periodontitis C. Aggressive periodontitis D. Necrotizing ulcerative periodontitis
189. Which ofthe following is the strongest radiographic evidence that tooth #10 requires endodontic treatment?
A. Pulp chamber calcification B. Periodontal bone loss coronally C. Extent of coronal restoration D. Widened apical periodontal ligament space
190. Which of the following is the best, most conservative restorative treatment for teeth #6 and #11?
A. All-ceramic crowns B. Porcelain fused to metal crowns C. Restore proximal surfaces as needed with
composite resin D. Apply fluoride
191. Which of the following treatments will achieve the best esthetic results for teeth #7, #8, #9 and #10?
A. Place all-ceramic crowns on all four teeth B. Place ceramic crown on tooth #7, and place
composite resin restorations on teeth #8 -#10
C. Place all-ceramic crowns on teeth #7 and #9, replace MI composite resin restoration on tooth #8, remove facial caries on tooth #10 and restore with composite
D. Restore caries on the facial surface of tooth #7, polish composite resin restorations on teeth #8 and #9, and place crown on tooth #10
E. Place porcelain fused to metal crowns on teeth #7, #9, and #10. and restore the mesial surface of tooth #8 with composite
192. Which ofthe following is the best means to evaluate the pulpal vitality of tooth #13?
A. Application of cold to teeth #12 and #13 B. Percussion testing on teeth #5 and #13 C. Electric pulp testing of teeth #12 and #13 D. Palpation in the buccal vestibule from teeth
#12-#14
194.
195.
196.
Which of the following is the most likely diagnosis for the radiolucency distal to the apical third of the root of tooth #13?
A. Metastatic carcinoma B. Lateral periodontal cyst C. Chronic periradicular periodontitis D. Extension of the maxillary sinus
Which of the following is the most appropriate restorative therapy for the patient's lower incisors?
A. B.
C. D.
Splint together with composite resin Remove failing margins and rough surfaces, and place new composite restorations where indicated Place porcelain fused to metal crowns No treatment is indicated.
Which of the following approaches would be best in determining why the patient has had infrequent dental care in the past?
A. "Why haven't you gone to the dentist more often? The more you avoid the dentist the worse your dental fear will become."
B. "It is costly to have two daughters in college, you should go to the dentist more often or you will need expensive dental treatment."
C. "Can you tell me why someone with a medical history as bad as yours has stayed away from the dentist for so long?"
D. "You have had many dental problems in the past. If you had seen the dentist regularly as you should have you wouldn't have had as many. What could possibly have kept you away?"
E. "Could you tell me more about your past dental experiences and present dental concerns?"
Following root canal therapy on tooth #10, which of the following foundation options, prior to crown preparation, is most appropriate?
A. Bonded composite resin B. Pin retained composite resin C. Prefabricated post and composite resin core D. Composite resin into canal continuous with
core
24
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197. Which of the following options is the best to replace the missing mandibular teeth?
A. Mandibular removable partial denture B. Fixed partial denture teeth #20 to #22 and
removable partial denture C. Fixed partial denture teeth #28 to #31 and
removable partial denture D. Fixed partial denture teeth #18 to #22 and
fixed partial denture #28 to #31
198. Which of the following is the best diagnosis for the radiolucency apical to teeth #23-#26?
A. Mental fossa B. Coalesced periapical granulomas C. Periapical cemental dysplasia D. Central giant cell granuloma E. Traumatic bone cyst
199. Following initial therapy, oral hygiene is good and there is a 1 mm reduction in probing depths. Periodontal treatment ofthe mandibular anterior teeth would include
A. another round of scaling and root planning. B. flap surgery. C. soft tissue grafting. D. regenerative therapy. E. periodontal maintenance therapy only.
200. In addition to oral hygiene instructions and scaling and root planing, which ofthe following course of actions is most appropriate during initial periodontal therapy?
A. Systemic tetracycline administration for 10 days
B. Subgingival irrigation with 0.12% chlorhexidine
C. Consultation with physician concerning diabetes mellitus
D. Tooth grinding for occlusal adjustment and equilibration ofthe dentition
25
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PART 2 KEY The key below may be used to determine correct and incorrect answers; howevnr, for this item set, it is not possible to convert a raw score numher correct to a standard score or associated pass/foil status