We can Help on: Chapter 51: Cognitively and Developmentally Challenged Persons

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Darby & Walsh: Dental Hygiene: Theory and Practice, 4th Edition
MULTIPLE CHOICE
1. Down syndrome is the most common and frequently observed chromosomal abnormality in humans and incidence is correlated with increased maternal age.
a.
Both statements are true.
b.
Both statements are false.
c.
The first statement is true, and the second statement is false.
d.
The first statement is false, and the second statement is true.
ANS: A
Down syndrome is the most common and frequently observed chromosomal abnormality in humans and incidence is correlated with increased maternal age.
REF: 923
2. _____ is a form of autism that develops in children who initially seem normal; after at least 2 years of normal development, the child exhibits a dramatic loss of vocabulary, language, motor, and social skills.
a.
Autistic disorder (classic autism)
b.
Childhood disintegrative disorder
c.
Rett syndrome
d.
Asperger’s syndrome
ANS: B
Childhood disintegrative disorder is a form of autism that develops in children who initially seem normal; after at least 2 years of normal development, the child exhibits a dramatic loss of vocabulary, language, motor, and social skills.
REF: 931
3. The dental hygienist must determine the need for prophylactic antibiotic premedication based on current guidelines in persons with Down syndrome, because congenital heart disease is common in this population.
a.
Both statements are true.
b.
Both statements are false.
c.
The first statement is true, and the second statement is false.
d.
The first statement is false, and the second statement is true.
ANS: A
The dental hygienist must determine the need for prophylactic antibiotic premedication based on current guidelines in persons with Down syndrome because congenital heart disease is common in this population.
REF: 936
4. Prevalence of periodontal disease in the intellectual disability (ID) population is attributed to:
a.
lack of professional care.
b.
lack of funds to support care.
c.
increased susceptibility.
d.
poor oral hygiene.
e.
all of the above.
ANS: E
Prevalence of periodontal disease in the ID population is attributed to risk factors such as lack of professional care, lack of funds to support or access care, host susceptibility and poor oral hygiene.
REF: 922
5. The language of children with autism spectrum disorder (ASD) consists mainly of naming nouns and adjectives that identify objects and indicating colors and numbers that represent nothing specific. This type of language is referred to as:
a.
articulation disorder.
b.
stuttering.
c.
excellent rote memory.
d.
apraxia.
ANS: C
Children with ASD are usually devoid of speech or have abnormal language. Their language consists mainly of naming nouns and adjectives that identify objects and indicating colors and numbers that represent nothing specific. This type of language is referred to as excellent rote memory.
REF: 931
6. When treating ASD children, the dental hygienist should try to alleviate fear of dental instruments by:
a.
distracting conversation not related to procedure.
b.
remaining silent during treatment.
c.
explaining each procedure and the use of each instrument to the client.
d.
allowing them to touch the instruments.
ANS: C
ASD children are not afraid of people but of the objects they acquire. Dental hygienists should try to alleviate a fear of dental instruments by explaining each procedure and the use of each instrument to the client.
REF: 932
7. Clients with mild ID are not educable, so explain and demonstrate oral hygiene instructions based on activities instead of concepts.
a.
Both parts of the statement are true.
b.
Both parts of the statement are false.
c.
The first part of the statement is true, and the second part of the statement is false.
d.
The first part of the statement is false, and the second part of the statement is true.
ANS: D
Clients with mild ID are educable, so explain and demonstrate oral hygiene instructions based on activities instead of concepts.
REF: 920
8. Employing the show-tell-do method of teaching fundamental skills is recommended for clients with:
a.
mild ID.
b.
moderate ID.
c.
severe ID.
d.
all of the above.
e.
none of the above.
ANS: B
Persons with moderate ID have poor hand and finger coordination; therefore, clients should be taught only the fundamental skills via the show-and-tell method.
REF: 921
9. When planning oral hygiene interventions for clients with severe or profound ID, the caregiver should be included. Clients with severe ID can learn by habit training but need follow-up by the caregiver.
a.
Both statements are true.
b.
Both statements are false.
c.
The first statement is true, and the second statement is false.
d.
The first statement is false, and the second statement is true.
ANS: A
When planning oral hygiene interventions for clients with severe or profound ID, the caregiver should be included. Clients with severe ID can learn by habit training but need follow-up by the caregiver
REF: 936
10. The American Dental Hygienists Association (ADHA) Code of Ethics states that clients should be treated without discrimination. Dental hygienists who are ill-prepared to treat these clients should seek continuing education opportunities and/or refer the client so that high-quality care can be rendered.
a.
Both statements are true.
b.
Both statements are false.
c.
The first statement is true, and the second statement is false.
d.
The first statement is false, and the second statement is true.
ANS: A
The ADHA Code of Ethics states that clients should be treated without discrimination. Dental hygienists who are ill-prepared to treat these clients should seek continuing education opportunities and/or refer the client so that high-quality care can be rendered.
REF: 936
11. Many persons with intellectual and developmental disabilities rely on government-funded sources for income and financing healthcare; therefore, access to care is a real problem.
a.
Both parts of the statement are true.
b.
Both parts of the statement are false.
c.
The first part of the statement is true, and the second part of the statement is false.
d.
The first part of the statement is false, and the second part of the statement is true.
ANS: A
Many persons with intellectual and developmental disabilities rely on government-funded sources for income and financing healthcare; therefore access to care is a real problem.
REF: 935
12. All of the following are strategies for establishing a trusting relationship with ID clientsexcept:
a.
keep the first appointment short and nonthreatening.
b.
explain instructions quickly.
c.
reward positive behavior.
d.
familiarize client with surroundings.
ANS: B
Strategies for establishing a trusting relationship include familiarizing client with surroundings, give explanations slowly one instruction at a time, keep the first appointment short and nonthreatening and reward positive behavior.
REF: 923
13. All of the following are oral manifestations that can be observed in clients with Down syndromeexcept:
a.
microdontia.
b.
periodontal disease.
c.
hypersalivation.
d.
low caries risk.
ANS: C
Clients with Down syndrome often exhibit periodontal disease, low caries risk and microdontia. Hypersalivation is not a characteristic seen in this population.
REF: 928
14. All of the following are oral manifestations that can be observed in clients with intellectual disabilitiesexcept:
a.
dental attrition.
b.
bruxism.
c.
delayed tooth eruption.
d.
heavy oral biofilm.
e.
excellent home care.
ANS: E
Oral manifestations that can be observed in clients with intellectual disabilities include dental attrition, bruxism, delayed tooth eruption and heavy oral biofilm. Most of these clients lack good home care regimes.
REF: 922
15. Rewards can be used to reinforce positive behavior in clients with Intellectual disabilities, all of the following are examples of social rewards except:
a.
going to a party.
b.
attention.
c.
affection.
d.
praise.
ANS: A
Social rewards include attention, affection, and praise. Going to a party is an example of an activity reward.
REF: 921
16. Individuals with Down syndrome have a high incidence of periodontal disease that can begin as early as age 6, and by adulthood nearly all people with Down syndrome are affected.
a.
Both parts of the statement are true.
b.
Both parts of the statement are false.
c.
The first part of the statement is true, and the second part of the statement is false.
d.
The first part of the statement is false, and the second part of the statement is true.
ANS: A
Individuals with Down syndrome have a high incidence of periodontal disease that can begin as early as age 6, and by adulthood nearly all people with Down syndrome are affected.
REF: 928-929
17. Malocclusion is rarely corrected in patients with Down syndrome because if a cross-bite is corrected, an earlier tissue breakdown may occur as a result of the underdeveloped maxilla and its relation to basal bone. Lingual movement of mandibular teeth is difficult because of their large, protruding tongues.
a.
Both the statement and the reason are correct, and they are related.
b.
Both the statement and the reason are correct, but they are 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.
ANS: A
Malocclusion is rarely corrected in patients with Down syndrome because if a cross-bite is corrected, an earlier tissue breakdown may occur as a result of the underdeveloped maxilla and its relation to basal bone. Lingual movement of mandibular teeth is difficult because of their large, protruding tongues.
REF: 928
18. Almost all clients with Down syndrome must be preoperatively medicated prior to dental treatment. When care requires a general anesthetic agent, a thorough health history review is imperative, and all possible needs should be met while the person is anesthetized.
a.
Both statements are true.
b.
Both statements are false.
c.
The first statement is true, and the second statement is false.
d.
The first statement is false, and the second statement is true.
ANS: D
Clients with Down syndrome can be preoperatively medicated prior to dental treatment if they are unmanageable. When care requires a general anesthetic agent, a thorough health history review is imperative, and all possible needs should be met while the person is anesthetized.
REF: 929
19. The most severe form of autism in which the person has difficulty talking and relating to others and the environment and displays compulsive, ritualistic behaviors are referred to as:
a.
autistic disorder (classic autism).
b.
childhood disintegrative disorder.
c.
Rett syndrome.
d.
Asperger’s syndrome.
ANS: A
Autistic disorder (classic autism) is the most severe form of autism in which the person has difficulty talking and relating to others and the environment and displays compulsive, ritualistic behaviors.
REF: 929
20. _____ is a mild form of autism characterized by impairment in social interactions without significant problems in language, cognitive ability, or age-appropriate developmental skills; persons are socially awkward, do not understand the use of gestures, lack empathy, avoid eye contact, and seem unengaged.
a.
Autistic disorder (classic autism)
b.
Childhood disintegrative disorder
c.
Rett syndrome
d.
Asperger’s syndrome
ANS: D
Asperger’s syndrome is a mild form of autism characterized by impairment in social interactions without significant problems in language, cognitive ability, or age-appropriate developmental skills; persons are socially awkward, do not understand the use of gestures, lack empathy, avoid eye contact, and seem unengaged.
REF: 929
21. Caregivers are encouraged to be present during treatment for clients with autism spectrum disorders, because a familiar face may be necessary and particularly if immobilization is needed for behavior control.
a.
Both the statement and the reason are correct, and they are related.
b.
Both the statement and the reason are correct, but they are 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.
ANS: A
Caregivers are encouraged to be present during treatment for clients with autism spectrum disorders because a familiar face may be necessary and particularly if immobilization is needed for behavior control.
REF: 932
22. When formulating a care plan for clients with profound ID, the dental hygienist must educate the caregiver about the daily oral care regime and his or her own oral self-care, because a caregiver is usually responsible for the client’s daily general and oral care.
a.
Both the statement and the reason are correct, and they are related.
b.
Both the statement and the reason are correct, but they are 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.
ANS: A
When formulating a care plan for clients with profound ID, the dental hygienist must educate the caregiver about the daily oral care regime and his or her own oral self-care, because a caregiver is usually responsible for the client’s daily general and oral care.
REF: 921
23. When developing oral hygiene skills in a client with ID, teach based on the client’s chronologic age, not mental age.
a.
Both parts of the statement are true.
b.
Both parts of the statement are false.
c.
The first part of the statement is true, and the second part of the statement is false.
d.
The first part of the statement is false, and the second part of the statement is true.
ANS: B
When developing oral hygiene skills in a client with ID, teach based on the client’s mental age not chronological age.
REF: 922-923
24. The use of 0.12% chlorhexidine gluconate mouth rinse is commonly prescribed for clients with disabilities to help control oral biofilm and gingivitis. It can be administered via an oral irrigator, a spray, or a swab.
a.
Both statements are true.
b.
Both statements are false.
c.
The first statement is true, and the second statement is false.
d.
The first statement is false, and the second statement is true.
ANS: A
The use of 0.12% chlorhexidine gluconate mouth rinse is commonly prescribed for clients with disabilities to help control oral biofilm and gingivitis. It can be administered via an oral irrigator, a spray, or a swab.
REF: 935
25. A severe gag reflex may be managed by eliminating the use of toothpaste to reduce gagging and provide better vision for the caregiver. Water, an ADA-accepted antimicrobial mouth rinse, or an ingestible or low-foaming dentifrice can be used in place of toothpaste.
a.
Both statements are true.
b.
Both statements are false.
c.
The first statement is true, and the second statement is false.
d.
The first statement is false, and the second statement is true.
ANS: A
A severe gag reflex may be managed by eliminating the use of toothpaste to reduce gagging and provide better vision for the caregiver. Water, an ADA-accepted antimicrobial mouth rinse, or an ingestible or low-foaming dentifrice can be used in place of toothpaste.
REF: 935
26. When selecting a toothbrush for clients with disabilities the dental hygienist must take into account all of the followingexcept:
a.
grip problems.
b.
use of fine motor skills.
c.
client’s ability to open.
d.
food allergies.
ANS: D
When selecting a toothbrush for clients with disabilities the dental hygienist must take into account a person’s grip problems, use of fine motor skills and their ability to open their mouth. Food allergies in unrelated to toothbrush selection.
REF: 935
27. Most children with ASD avoid communicating with:
a.
facial expressions.
b.
eye contact.
c.
nonverbal communication.
d.
all of the above.
ANS: D
Most children with ASD avoid facial expressions, eye contact, and nonverbal communication.
REF: 931
28. _____ is considered an atypical form of autism in which some but not all classic signs are observed, therefore not meeting the criteria for a specific diagnosis; characterized by varying degrees of impairment in communication skills and social interactions, sensitivities to sights and sounds, and restricted, repetitive, and stereotyped patterns of behavior
a.
Autistic disorder (classic autism)
b.
Childhood disintegrative disorder
c.
Rett syndrome
d.
Asperger’s syndrome
e.
Pervasive developmental disorder not otherwise specified
ANS: E
Pervasive developmental disorder not otherwise specified is considered an atypical form of autism in which some but not all classic signs are observed, therefore not meeting the criteria for a specific diagnosis; characterized by varying degrees of impairment in communication skills and social interactions, sensitivities to sights and sounds, and restricted, repetitive, and stereotyped patterns of behavior
REF: 931
29. Clients with Down syndrome are given the same treatment options as other clients. Treatment objectives must be limited simply because the client has Down syndrome.
a.
Both statements are true.
b.
Both statements are false.
c.
The first statement is true, and the second statement is false.
d.
The first statement is false, and the second statement is true.
ANS: C
Clients with Down syndrome are given the same treatment options as other clients. Treatment objectives must not be limited simply because the client has Down syndrome
REF: 928
30. Effective communication leads to a trusting relationship, which in turn allows the oral healthcare experience to be successful for both client and clinician. Frequently caregivers are able to suggest behavioral guidance to achieve a pleasant dental experience.
a.
Both statements are true.
b.
Both statements are false.
c.
The first statement is true, and the second statement is false.
d.
The first statement is false, and the second statement is true
ANS: A
Effective communication leads to a trusting relationship, which in turn allows the oral healthcare experience to be successful for both client and clinician. Frequently caregivers are able to suggest behavioral guidance to achieve a pleasant dental experience.
REF: 923

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