NDAEB - National Dental Assisting Examination Board Patient Care Procedures 2 — Questions and Answers
Question 1: During a procedure, the patient begins to show signs of syncope (fainting) — they appear pale, diaphoretic, and report feeling lightheaded. What is the dental assistant's immediate priority action?
- Administer oxygen via nasal cannula and monitor vital signs
- Lower the patient's head below the level of their heart by reclining the chair and elevating their legs (Correct answer)
- Offer the patient a glass of water and have them sit upright
- Terminate the procedure and contact emergency medical services immediately
Correct answer: Lower the patient's head below the level of their heart by reclining the chair and elevating their legs
Syncope results from a temporary reduction in cerebral blood flow. Reclining the chair and elevating the legs promotes venous return to the heart and restores blood flow to the brain, which is the immediate priority. Oxygen and vital sign monitoring follow once the patient's position is corrected.
Question 2: When documenting a patient's chart entry in a dental office, which of the following practices best reflects proper legal and ethical record-keeping standards?
- Use correction fluid (white-out) to neatly cover any charting errors before rewriting the correct information
- Draw a single line through the error, write the correction beside it, and initial and date the correction (Correct answer)
- Erase the incorrect entry and rewrite it legibly so the record appears clean
- Remove the page containing the error and replace it with a corrected version
Correct answer: Draw a single line through the error, write the correction beside it, and initial and date the correction
Legal dental records must show all original entries. Drawing a single line through an error, then initialing and dating the correction demonstrates transparency and prevents allegations of falsification. Using white-out, erasing, or removing pages can constitute fraudulent alteration of a medical record.
Question 3: A patient returns to the dental office two days after an extraction reporting increasing pain that began the day before, a foul taste, and an empty-appearing socket. Which condition does this presentation most likely indicate, and what is the dental assistant's role?
- Normal post-operative healing; reassure the patient and reschedule for a routine follow-up in one week
- Alveolar osteitis (dry socket); prepare the tray for socket irrigation and medicament placement as directed by the dentist (Correct answer)
- Acute abscess formation; administer antibiotics from the office emergency kit before the dentist arrives
- Post-extraction hematoma; apply a pressure dressing and have the patient bite down firmly
Correct answer: Alveolar osteitis (dry socket); prepare the tray for socket irrigation and medicament placement as directed by the dentist
Alveolar osteitis (dry socket) occurs when the blood clot is lost or dissolves prematurely, exposing the underlying bone. Classic signs are onset of pain 1–3 days post-extraction, empty socket appearance, and foul odour. The dental assistant's role is to prepare for the dentist-directed treatment, which involves gentle irrigation and placement of a medicated dressing.
Question 4: When assisting during a rubber dam placement, the dental assistant passes the rubber dam forceps to the dentist with the clamp already seated on the forceps. Which sequence correctly describes the remaining steps to complete rubber dam isolation?
- Punch the dam, position the frame, place the clamp and dam simultaneously onto the anchor tooth, then thread the dam through the contacts with floss
- Place the frame first, then punch the dam, place the clamp, and tuck the dam edges under the gingival margin
- Punch the dam, place the dam over the clamp bow, position the clamp and dam onto the anchor tooth simultaneously, seat the frame, and use floss to pass the dam through the contacts (Correct answer)
- Place the clamp first without the dam, then stretch the dam over the clamp, seat the frame, and omit interdental flossing
Correct answer: Punch the dam, place the dam over the clamp bow, position the clamp and dam onto the anchor tooth simultaneously, seat the frame, and use floss to pass the dam through the contacts
The correct sequence is: punch the dam, thread the dam through the clamp bow (so the dam is carried onto the tooth with the clamp), seat the frame to hold the dam taut, then use dental floss to work the dam through each interproximal contact. This ensures the clamp is visible through the dam and reduces the risk of the clamp being swallowed if it slips.
Question 5: A dental assistant is preparing a tray for an adult patient requiring a prophylaxis (dental cleaning) appointment. Which of the following instrument selections is most appropriate and complete for this procedure?
- Explorer, periodontal probe, universal curette or sickle scaler, Gracey curettes, rubber cup, prophy paste, floss, and saliva ejector (Correct answer)
- Spoon excavator, hand chisel, matrix band, and amalgam condenser
- Straight elevator, periosteal elevator, extraction forceps, and surgical suction tip
- Shade guide, composite placement instrument, curing light, and polishing strips
Correct answer: Explorer, periodontal probe, universal curette or sickle scaler, Gracey curettes, rubber cup, prophy paste, floss, and saliva ejector
A prophylaxis tray requires instruments for examination (explorer, periodontal probe), calculus removal (scalers and curettes), and polishing (rubber prophy cup, paste, floss). The other options describe instrumentation for restorative, surgical, or other procedures unrelated to a preventive cleaning appointment.
Question 6: During a composite resin restoration, the dentist instructs the dental assistant to perform selective etching on enamel margins only. What material is used, and how long should it be applied to enamel before rinsing?
- Dentin bonding agent applied for 60 seconds, then light-cured in place without rinsing
- 37% phosphoric acid (etchant) applied to enamel for 15–30 seconds, then thoroughly rinsed and lightly air-dried (Correct answer)
- 10% citric acid applied for 5 seconds, blot-dried, then immediately covered with resin
- Zinc polycarboxylate conditioner applied for 10 seconds and wiped away with a damp gauze
Correct answer: 37% phosphoric acid (etchant) applied to enamel for 15–30 seconds, then thoroughly rinsed and lightly air-dried
Selective etching uses 37% phosphoric acid gel applied to enamel margins for 15–30 seconds to create microporosity that improves mechanical bonding of the resin. The etchant must be thoroughly rinsed to remove all acid, and the surface lightly dried (avoiding desiccation of dentin) before the bonding agent is applied.
NDAEB - National Dental Assisting Examination Board Patient Care Procedures 2
During a procedure, the patient begins to show signs of syncope (fainting) — they appear pale, diaphoretic, and report feeling lightheaded.
What is the dental assistant's immediate priority action?