(Test Bank) Local Anesthesia for the Dental Hygienist

Logothetis, 2

Nursing

Test Bank

2nd Edition

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Test Bank for Local Anesthesia for the Dental Hygienist, The downloadable file consists of 176 pages, and the total size of the file is 1.56 MB. Purchase now only for highly discounted price.

Author(s): Logothetis

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Local Anesthesia for the Dental Hygienist 2nd Edition Logothetis Test Bank Chapter 01: Local Anesthesia in Dental Hygiene Practice: An Introduction Logothetis: Local Anesthesia for the Dental Hygienist, 2nd Edition MATCHING Match the following word or phrase with the correct drug category. a. ester (E) b. amide (A) c. inhalation drug (I) 1. Ether 2. Lidocaine 3. Prilocaine 4. Procaine 5. Nitrous oxide 6. Halothane 7. Mepivacaine 8. Novocaine 9. Causes more allergic reactions 10. Patients experience fewer allergic reactions 1. ANS: C DIF: Recall REF: 2 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 2. ANS: B DIF: ReNcallR I GREBF:.C2 M OBJ: 1 TOP: NBDHE, 3.0 Planning andUMaSnagNing DTental HOygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 3. ANS: B DIF: Recall REF: 2|3 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 4. ANS: A DIF: Recall REF: 2|3 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 5. ANS: C DIF: Recall REF: 2|4|5|6 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 6. ANS: C DIF: Recall REF: 2|3 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 7. ANS: B DIF: Recall REF: 2|3 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 8. ANS: A DIF: Recall REF: 2|3 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 9. ANS: A DIF: Recall REF: 2|3 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 10. ANS: B DIF: Recall REF: 2|3 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology MULTIPLE CHOICE 1. The first objections to the use of inhalation sedation included which of the following? a. It was viewed as a religious offense b. It was viewed as an unethical practice c. It was viewed as a retardant to the health process d. All options listed ANS: D All options listed. Objections to operating on an unconscious patient included all options listed. Some viewed it as offensive to their religious beliefs; some viewed it as an ethical matter; and some objected because they believed that the relief from pain might actually retard the health process. DIF: Recall REF: 2 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 2. Who was the first dentist to use “laughing gas” for dental procedures? a. William Clarke b. Horace Wells c. Henry Beecher d. Nils Lofgren ANS: B Horace Wells was the first deNnUtisRt StoIuNseG“TlaBug.hCinOg Mgas” for dental p rocedures. William Cla rk is known for his work with ether, Henry Beecher for his observations regarding clinical trials, and Nils Lofgren for the synthesis of lidocaine. DIF: Recall REF: 2| 3 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 3. A highly effective analgesic and antipyretic compound, introduced in 1899 and still used today, is commonly referred to as what? a. Aspirin b. Alcohol c. Novocaine d. Opium ANS: A A new compound, introduced as aspirin in 1899, proved to be remarkably safe and well tolerated by patients. It is a highly effective analgesic and antipyretic. Alcohol and opium were universally popular narcotics used for pain control as was Novocaine (procaine), a local anesthetic. DIF: Recall REF: 2 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology U S N T O 4. Early methods of pain control included which of the following? a. Use of opium b. Scaring off of demons c. Roots, berries, and seeds d. All options listed ANS: D All options listed. Early methods of pain control included all options listed: the use of opium, religious techniques of scaring off demons; and the use of plants and herbs for treating pain. DIF: Recall REF: 2 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 5. Pain threshold is best described as which of the following? a. The physical and emotional response to a particular situation. b. The relationship between human need fulfillment and human behavior. c. A neurologic experience of pain. d. The point at which a sensation starts to be painful and discomfort results. ANS: D Pain threshold is best described as the point at which a sensation starts to be painful and discomfort results. The physical and emotional response to a particular situation describes stress; the relationship between human need fulfillment and human behavior is known as the Human Needs Paradigm; and a neurologic experience of pain describes pain perception. DIF: Recall REF: 6 OBJ: 4 TOP: NBDHE, 3.0 Planning aNnd MRanaIgingGDeBnt.alCHygMiene Care| NBDHE, 3.4 Anxiety and Pain Control 6. The neurologic experience of pain is referred to as what? a. Pain control b. Pain threshold c. Pain perception d. Pain reaction ANS: C Pain perception is the neurologic experience of pain. It differs little between individuals. Pain control refers to the mechanism to alleviate pain; pain threshold is the point at which a sensation starts to be painful and discomfort results; and pain reac tion is the personal interpretation of and response to the pain message and is highly variable between individuals. DIF: Recall REF: 6 OBJ: 4 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 7. An unpleasant sensory and emotional experience is called what? a. Pain b. Pain control c. Pain threshold d. Pain reaction U S N T O ANS: A Pain is an unpleasant sensory and emotional experience. Pain control refers to the mechanism to alleviate pain; pain threshold is the point at which a sensation starts to be painful and discomfort results; and pain reaction is the personal interpretation o f and response to the pain message. DIF: Recall REF: 2 OBJ: 4 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 8. The personal interpretation and response to the pain message is called what? a. Pain b. Pain control c. Pain threshold d. Pain reaction ANS: D The personal interpretation and response to the pain message is called one’s pain reaction. It is highly variable among individuals. Pain is an unpleasant sensory and emotional experience; pain control refers to the mechanism to alleviate pain; and pain threshold is the point at which a sensation starts to be painful and discomfort results. DIF: Recall REF: 6 OBJ: 4 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 9. The creation of the loss of sensation in a circumscribed area, without loss of consciousness, best defines which of the fol lNowiRng?I G B.C M a. Inhalation anesthesia b. Local anesthesia c. General anesthesia d. All options listed ANS: B Local anesthesia creates a numbing feeling or the loss of sensation in a circumscribed area, without loss of consciousness. Inhalation and general anesthesia involve loss of consciousness. DIF: Recall REF: 2|3 OBJ: 4 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 10. The newest amide to arrive on the dental market in the United States is which one of the following? a. Articaine b. Mepivacaine c. Lidocaine d. Bupivacaine ANS: A The newest amide local anesthetic, introduced to the dental field in 2000, is articaine. Mepivacaine and bupivacaine were introduced in 1957, and lidocaine was introduced in 1943. N R I G B.C M DIF: Recall REF: 2| 3 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 11. Lidocaine is said to have revolutionized pain control in dentistry. Why? a. It is more potent than prilocaine. b. It is less potent than procaine. c. Patients experience fewer allergic reactions with lidocaine. d. Some combination of the above ANS: C Lidocaine is said to have revolutionized pain control in dentistry because it is less allergenic and more potent than procaine. Lidocaine is less potent than prilocaine. DIF: Recall REF: 2|3 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 12. Procaine was used extensively in dentist ry for a number of years; however, it was not the ideal local anesthetic. Why not? a. It took a long time to produce the desired anesthetic result. b. It wore off quickly. c. It had a high potential for triggering allergic reactions. d. All options listed ANS: D All options listed. Procaine took a long time to produce the desired anesthetic results and it had a high pot ential for triggerUing SalleNrgicTreactioOns. Procaine wore off quickly. DIF: Recall REF: 2|3 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 13. The first local anesthetic used in dentistry was which of the following? a. Novocaine b. Cocaine c. Procaine d. Lidocaine ANS: B Cocaine was the first anesthetic used in dentistry (in 1884); followed by Novocaine (procaine) in 1905; and later, lidocaine in 1943. DIF: Recall REF: 2|3 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 14. The benefit of local anesthesia is not limited to pain control but could also include which of the following? a. Hemostasis b. Time management U S N T O c. Patient -centered stress reduction d. All options listed ANS: D All options listed. The benefit of local anesthesia is not limited to pain control but could also include hemostasis, achieved via the vasoconstrictor in the anesthetic; time management, because the dental hygienist can administer the anesthesia and obviate the need for the dentist and the patient to wait for anesthesia to take effect; and patient -centered stress reduction, which addresses the relationship between human need fulfillment and human behavior. DIF: Comprehension REF: 3| 7 OBJ: 5 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 15. Jon presents to your dental office in pain with an abscessed tooth. Utilizing the Visual Analog Scale (VAS), Jon indicates that his pain level measures about 95 mm in length from the left hand end of the horizontal line. What is an appropriate translation of this action? a. Jon is experiencing a significant amount of pain. b. Jon is experiencing a moderate amount of pain. c. Jon is uncomfortable but able to tolerate the pain. d. None of the above because the pain scale is subjective. ANS: A Operationally, a VAS is usually a horizontal line, 100 mm in length. The VAS score is determined by measuring in millimeters from the left end of the line to the point that the patient indicates. Since Jon indicated that his pain threshold was close to the definitive end of 100 mm, one can assume that Jon is experiencing a significant amount of pain. The VAS scores would be lower for moNderRate IandGuncBo.mCfortMable levels of pain. Although the scale is subjective, it is nonetheless useful. DIF: Comprehension REF: 6|7 OBJ: 4 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 16. Considering the human needs paradigm, freedom from fear and stress includes which of the following? a. The need to receive appreciation, attention, and respect from others b. The need to be free from emotional discomfort c. The need to feel safe d. All options listed ANS: D All options listed. Considering the human needs paradigm, freedom from fear and stress includes the need to receive appreciation, attention, and respect from others. It also includes the need to be free from emotional discomfort and the need to feel safe. DIF: Recall REF: 7 OBJ: 5 TOP: NBDHE, 1.0 Assessing Patient Characteristics| NBDHE, 1.6 General| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 17. An astute practitioner looks for signs of patient anxiousness. These signs may include which of the following? U S N T O a. Overwillingness to cooperate with clinician b. History of emergency dental care only c. Elevated blood pressure and heart rate d. All options listed ANS: D All options listed. An astute practitioner looks for signs of patient anxiousness. These signs may include an overwillingness to cooperate with clinician, which could be portrayed through nervous conversations and/or quick answers; a history of emergency d ental care only or a history of canceled appointments; and physical symptoms including elevated blood pressure and fast heart rate. DIF: Recall REF: 8 OBJ: 4 TOP: NBDHE, 1.0 Assessing Patient Characteristics| NBDHE, 1.6 General| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 18. The best method to manage an anxious patient is by: a. Prevention b. General sedation c. Referral to an anxiety specialist d. All options listed ANS: A The best method to manage an anxious patient is by prevention. General sedation and referral to an anxiety specialist may be avoided through the use of stress reduction principles. DIF: Comprehension REF: 8 OBJ: 2 TOP: NBDHE, 3.0 Planning aNnd MRanaIgingGDeBnt.alCHygMiene Care| NBDHE, 3.4 Anxiety and Pain Control 19. Performing a complete health history review at every appointment helps practitioners recognize stressors and health conditions that may complicate dental procedures. Taking a patient’s vital signs does not play an important role in assessing a patient’s level of apprehension. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second statement is false. d. The first statement is false; the second statement is true. ANS: C The first statement is true; the second statement is false. Performing a complete health history review at every appointment helps practitioners recognize stressors and health conditions that may complicate dental procedures. Taking vital signs also plays an important role in helping to understand a patient’s total health history and in assessing a patient’s level of apprehension. DIF: Comprehension REF: 8 OBJ: 2 TOP: NBDHE, 1.0 Assessing Patient Characteristics| NBDHE, 1.6 General| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 20. The use of anesthesia as needed is an important key to what? a. Understanding why patients are fearful of dental appointments b. Preventing fear associated with pain c. Understanding the cause of pain d. All options listed ANS: B The use of anesthesia as needed is an important key to preventing the fear associated with pain. Understanding why patients are fearful of dental appointments and the cause of pain assists in implem enting a patient -centered approach to stress reduction. DIF: Comprehension REF: 8 OBJ: 2 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 21. Considerations that have the potential of influencing a dental patient’s pain reaction threshold include which of the following? a. Age b. Culture c. Fatigue d. All options listed ANS: D All options listed. Pain reaction threshold may be influenced by the patient’s emotional state, fatigue, age, culture, and fear and apprehension. DIF: Recall REF: 6|7 OBJ: 4 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 22. Patients who f requently missNdenRtal IappGointBm.enCts bMecause of apprehension often demonstr ate what kind of pain reaction threUsholSd? N T O a. A lower pain reaction threshold, which means that they have a high tolerance for pain b. A lower pain reaction threshold, which means that they have a low tolerance for pain c. A higher pain reaction threshold, which means that they have a high tolerance for pain d. None of the above ANS: B Patients who frequently miss dental appointments because of apprehension will generally demonstrate a lower pain reaction threshold, which means that they have a low tolerance for pain and they will likely experience pain more quickly and/or intensely than if they were calm. Patients who demonstrate a higher pain reaction threshold generally have a higher tolerance to pain. DIF: Comprehension REF: 7 OBJ: 4 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 23. Patients who are overly tired or stressed at the time of their dental appointment will generally demonstrate what kind of pain rea ction threshold? a. A lower pain reaction threshold, which means that they have a high tolerance for pain N R I G B.C M b. A lower pain reaction threshold, which means that they have a low tolerance for pain c. A higher pain reaction threshold, which means that they have a high tolerance for pain d. None of the above ANS: B Patients who are overly tired or stressed at the time of their dental appointment will generally demonstrate a lower pain reaction threshold, which means that they have a low tolerance for pain and they will likely experience pain more quickly and/or inten sely than if they were well rested and calm. Patients who are not overly tired or stressed can demonstrate a higher pain reaction threshold, which means that they will have a higher tolerance for pain. DIF: Comprehension REF: 7 OBJ: 4 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 24. The difference between the legal wording that states that the dental hygienist may monitor nitrous oxide and that the dental hygienist may administer nitrous oxide is best explained by which of the following statements? a. When it is said that the dental hygienist may administer nitrous oxide, this indicates that the hygienist may change the nitrous oxide and/or oxygen settings during the appointment as needed. b. When it is said that the dental hygienist may monitor nitrous oxide, this means that the hygienist may turn on the nitrous oxide and/or oxygen settings during the appointment as needed. c. In legal terms, someone with the authority to monitor nitrous oxide may change the nitrous oxide and/or oxUygeSn seNttingTs; somOeone with the authority to a dminister nitrous oxide may turn on the apparatus. d. In state law the terms monitor and administer can be used interchangeably. ANS: C In legal terms someone with the authority to monitor nitrous oxide may change the nitrous oxide and/or oxygen settings during the appointment as needed; someone with the authority to administer nitrous oxide m ay turn on the nitrous -oxide/oxygen apparatus. DIF: Recall REF: 6 OBJ: 3 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 7.0 Professional Responsibility| NBDHE, 7.2 Regulatory Compliance 25. The most popular dental local anesthetic used in the United States today is which of the following? a. Procaine b. Mepivicaine c. Prilocaine d. Lidocaine ANS: D Lidocaine remains the most popular dental local anesthetic used in the United States today. Procaine is no longer available, but mepivacaine and prilocaine are available in the United States. N R I G B.C M DIF: Recall REF: 2|3 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 26. Which drug, added to dental local anesthetics, is helpful for achieving hemostasis? a. Halothane b. Epinephrine c. Cocaine d. None of the above ANS: B Epinephrine, a vasoconstrictor, may be added to dental local anesthetics and is helpful in achieving hemostasis. Halothane, an inhalation drug, and cocaine, an ester local anesthetic no longer used in dentistry, are not added to dental local anesthetics. DIF: Recall REF: 3 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 27. Dental anxiety may be attributed to which of the following? a. Unpleas ant dental experiences in the past b. Learned dental fear from a parent c. All options listed d. None of the above ANS: C All options listed. Patients who are anxious may have had unpleasant experiences in the past or may have a learn ed fear of dUentaSl caNre. TThe maOjority of studies confirm a relationship between parental and child dental fear. DIF: Recall REF: 7|8 OBJ: 4 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 28. The physical and emotional response to a specific situation is referred to as which of the following? a. Pain reaction b. Stress c. Pain perception d. Pain control ANS: B Stress is a physical and emotional response to a particular situation. Pain reaction refers to the personal interpretation and response to a pain message that differs greatly between individuals; pain perception is a neurologic experience of pain that differs little between individuals; and pain control is the mechanism to alleviate pain. DIF: Recall REF: 7|8 OBJ: 4 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control OBJ: 1 U S N T O 29. In 1842, who was known for assisting a dentist by administering ether to a patient? a. William Clarke b. Horace Wells c. Henry Beecher d. Francesco Di Stafano ANS: A In 1842, it was reported that William Clarke administered ether via a towel to a woman as one of her teeth was extracted by a dentist. Horace Wells is best known for his work with nitrous oxide; Henry Beecher for his observations regarding clinical trials; and Francesco Di Stafano for his work isolating cocaine from coca leaves. DIF: Recall REF: 2 OBJ: 1 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology 30. Opium was used as an early method for pain reduction. Later, when converted to morphine, it became even more effective when injected into the bloodstream. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second statement is false. d. The first statement is false; the second statement is true. ANS: A Both statements are true. Opium was most useful for pain control. In fact, opium proved even more effective when converted into a more potent form, morphine, and injected into the bloodstream. N R I G B.C M DIF: Recall REF: 2 TOP: NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control| NBDHE, 6.0 Pharmacology Chapter 02: Neurophysiology Logothetis: Local Anesthesia for the Dental Hygienist, 2nd Edition MATCHING Match each description with the term that correctly identifies the generation and conduction of the nerve impulse stage. Terms may be used more than once. a. Polarization b. Slow depolarization c. Rapid depolarization d. Repolarization e. Relative refractory period f. Absolute refractory period 1. During this stage, the second action potential is inhibited but not impossible should a larger stimulus be applied. 2. The nerve is stimulated by the minimal threshold level. 3. The electrical potential of the neuron is approximately −70 mV. 4. During this stage, the electrical charge on the outside of the membrane is positive, while the electrical charge on the inside of the membrane is negative. 5. Occurs once the peak of the action potential is reached and the membrane potential begins to move back toward the resting potential. 6. The resting potential of the cell changes to become more negative, but not enough to trigger the firing threshold. 7. The interval during whi ch a sNecoRnd aIctioGn pBot.enCtialMcannot be initiat ed, no matter how l arge a stimulus is applied. U S N T O 8. The outside of the cell contains excess sodium ions at a ratio of 14:1; the inside of the cell contains excess potassium ions. 9. The gated Na+ channels on the resting neuron’s membrane release and open suddenly in order to allow the Na+ in the extracellular fluid to influx into the cell. 10. The impulse moves between the uninsulated nodes of Ranvier that exist between each Schwann cell. 1. ANS: E DIF: Recall REF: 21| 23 OBJ: 8 TOP: 2. ANS: NBDHE, 2.0 Physiology C DIF: Recall REF: 21 OBJ: 8 TOP: NBDHE, 2.0 Physiology 3. ANS: TOP: A DIF: Recall REF: 20 NBDHE, 2.0 Physiology OBJ: 5| 6 4. ANS: TOP: A DIF: Recall REF: 20 NBDHE, 2.0 Physiology OBJ: 8 5. ANS: TOP: D DIF: Recall REF: 21 NBDHE, 2.0 Physiology OBJ: 8 6. ANS: OBJ: B DIF: Comprehension 8 TOP: NBDHE, 2.0 Physiology REF: 21 7. ANS: TOP: F DIF: Recall REF: 21| 23 NBDHE, 2.0 Physiology OBJ: 7 8. ANS: TOP: A DIF: Recall REF: 20 NBDHE, 2.0 Physiology OBJ: 8 9. ANS: TOP: C NBDHE, 2.0 DIF: Recall Physiology REF: 21 OBJ: 8 10. ANS: TOP: C NBDHE, 2.0 DIF: Recall Physiology REF: 21 OBJ: 8 MULTIPLE CHOICE 1. What are the nerves that conduct signals from sensory neurons to the spinal cord or brain called? a. Neurotransmitters b. Electrical synapses c. Afferent nerves d. Efferent nerves ANS: C The nerves that conduct signals from sensory neurons to the spinal cord or brain are called afferent nerves. Neurotransmitters are the endogenous chemicals that transmit signals from a neuron to a target cell across a synapse. Electrical synapses involve gap junctions that allow action potentials to move from cell to cell directly by allowing electrical current to flow between cells. Efferent nerves conduct signals away from the brain or spinal cord. DIF: Recall REF: 14 OBJ: 3 TOP: NBDHE, 2.0 Physiology 2. What are the endogenous chemicals that transmit signals from a neuron to a target cell across a synapse called? a. Neurotransmitters b. Electrical synapses c. Afferent nerves d. Efferent nerves ANS: A NURSINGTB.COM The endogenous chemicals that transmit signals from a neuron to a target cell across a synapse are called neurotransmitters. Electrical synapses involve gap junctions that allow action potentials to move from cell to cell directly by allowing electrical current to flow between cells. Afferent nerves conduct signals from sensory neurons to the spinal cord or brain. Efferent nerves conduct signals away from the brain or spinal cord. DIF: Recall REF: 21 OBJ: 7 TOP: NBDHE, 2.0 Physiology 3. What are the nerves that conduct signals away from the brain or spinal cord called? a. Neurotransmitters b. Electrical synapses c. Afferent nerves d. Efferent nerves ANS: D The nerves that conduct signals away from the brain or spinal cord are called efferent nerves. The endogenous chemicals that transmit signals from a neuron to a target cell across a synapse are called neurotransmitters. Electrical synapses involve gap junc tions that allow action potentials to move from cell to cell directly by allowing electrical current to flow between cells. Afferent nerves conduct signals from sensory neurons to the spinal cord or brain. U S N T O DIF: Recall REF: 14 OBJ: 3 TOP: NBDHE, 2.0 Physiology 4. Local anesthetic agents used in dentistry: a. Cause loss of nociception b. Prevent generation of a nerve impulse c. Prevent conduction of a nerve impulse d. All options listed ANS: D All options listed. A local anesthetic is a drug that causes reversible local anesthesia and a loss of nociception as a result of the depression of excitation in nerve endings or the inhibition of the conduction process in peripheral nerves. Local anesthetic agents used in dentistry prevent both generation an d conduction of a nerve impulse. DIF: Recall REF: 11 OBJ: 9 TOP: NBDHE, 2.0 Physiology| NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 5. Tasks for neurons include receiving, processing, and sending information. They communicate with other neurons through axons and synapses. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second statement is false. d. The first statement is false; the second statement is true. ANS: A Both statements are true. TasNks fRor nIeurGons Bin.clCudeMreceiving, p rocessing, and sending information. They communicate with other neurons through axons and synapses. DIF: Recall REF: 12|13 OBJ: 5 TOP: NBDHE, 2.0 Physiology 6. What is another name for axons? a. Core bundles b. Mantle bundles c. Nerve fibers d. All options listed ANS: D All options listed. Axons are often referred to as nerve fibers. The nerve fibers that are bundled together and located near the outside of the nerve are called mantle bundles. The bundled nerve fibers located near the inside of the nerve are called core bundles. DIF: Comprehension REF: 13 OBJ: 4 TOP: NBDHE, 2.0 Physiology 7. What is the most distal arborization of the nerve endings called? a. Dendritic zone b. Soma c. Axon hillock d. Output zone ANS: A The dendritic zone is the most distal section of the neuron and is an arborization (formation of a treelike shape) of nerve endings. The soma refers to the cell body (located at the input zone); the axon hillock, located at the summation zone, is the part of the axon where it emerges from the soma; and the output zone is located at the distal end of the axon, where nerve impulse triggers the release of neurotransmitters. DIF: Recall REF: 14 OBJ: 4 TOP: NBDHE, 2.0 Physiology 8. What is the name of the portion of the sensory neuron that is easily excited and has the most negative action potential threshold? a. Dendritic zone b. Soma c. Axon hillock d. Output zone ANS: C The axon hillock is the part of the neuron that has the greatest density of voltage -dependent sodium channels (Na+); it easily excited and is the portion of the sensory neuron with the most negative action potential threshold. The dendritic zone is the mos t distal section of the neuron and is an arborization (formation of a treelike shape) of nerve endings. The soma refers to the cell body (located at the input zone); and the output zone is located at the distal end of the axon, where nerve impulse triggers the release of neurotransmitters. DIF: Recall REF: 15 OBJ: 4 TOP: NBDHE, 2.0 Physiology 9. The lipoprotein sheath that surrounds many neurons is called the myelin sheath. The myelin sheath is compos ed of SchwaNnUn RceSllIs. NGTB.COM a. Both statements are true. b. Both statements are false. c. The first statement is true; the second statement is false. d. The first statement is false; the second statement is true. ANS: A Both statements are true. The lipoprotein sheath that surrounds many neurons is called myelin sheath and is composed of Schwann cells. DIF: Recall REF: 16-17 OBJ: 3 TOP: NBDHE, 2.0 Physiology 10. What is the propagation of action potentials along myelinated axons from one node of Ranvier to another called? a. Nonmyelinated b. Saltatory conduction c. Polarization d. Refractory period ANS: B Saltatory conduction is the propagation of action potentials along myelinated axons from one node of Ranvier to another. Nonmyelinated refers to nerve fibers that have no myelin sheath and therefore rely on diffusion of electrolytes along the nerve cell membrane for impulse travel. Polarization refers to the resting state, when the electrical charge on the outside of the membrane is positive while the inside of the membrane is negative. The refractory period refers to the time when the neuron is busy returning sodium and pota ssium ions to their original sides of the nerve membrane. DIF: Recall REF: 16-17| 17 OBJ: 5 TOP: NBDHE, 2.0 Physiology 11. The A alpha nerve fiber type is the smallest and the most numerous nerve fiber. The A delta nerve fiber type is primarily responsib le for dull, aching pain. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second statement is false. d. The first statement is false; the second statement is true. ANS: B Both statements are false. Nerve fiber type C, the smallest and the most numerous nerve fiber, is responsible for dull, aching pain. The A alpha nerve fiber type is the largest and fastest and is responsible for muscle movement and light touch. The A delta nerve fiber type is large, fast, and primarily responsible for sharp pain. DIF: Recall REF: 18-19 OBJ: 6 TOP: NBDHE, 2.0 Physiology 12. Which nerve fiber type is responsible for pain related to temperature? a. A alpha b. A delta c. B d. C ANS: B NURSINGTB.COM Nerve fiber type A delta is responsible for sharp pain . The A alpha nerve fiber type is the largest and fastest and is responsible for muscle movement and light touch. B fibers are lightly myelinated motor fibers; and nerve fiber type C, the smallest and the most numerous nerve fiber, is responsible for dull, aching pain. DIF: Recall REF: 18-19 OBJ: 6 TOP: NBDHE, 2.0 Physiology 13. As the action potential moves down the line, its strength decreases as it moves from one neuron to the next. The action potential in myelinated axons does not propagate as waves as in unmyelinated axons. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second statement is false. d. The first statement is false; the second statement is true. ANS: D The first statement is false; the second statement is true. Once a nerve is excited, the intensity of stimulation does not produce a stronger signal or beco me diminished as it propagates down the line. The action potential in myelinated axons does not propagate as waves as in unmyelinated axons. DIF: Comprehension REF: 19 OBJ: 7 TOP: NBDHE, 2.0 Physiology 14. Which description best describes the mechanism by which local anesthetic drugs work? a. Anesthetic drugs bind to the sodium channels, the influx of sodium is interrupted, the action potential cannot rise, and the signal conduction is inhibited. b. Anesthetic drugs bind to the potassium channels, th e influx of sodium is interrupted, the action potential cannot rise, and the signal conduction is inhibited. c. Anesthetic drugs bind to the sodium channels, the influx of potassium is interrupted, the action potential cannot rise, and the signal conduction is inhibited. d. Anesthetic drugs bind to the sodium channels, the influx of sodium and potassium is interrupted, the action potential cannot rise, and the signal conduction is inhibited. ANS: A Anesthetic drugs bind to the sodium channels, the influx of sodium is interrupted, the action potential cannot rise, and the signal conduction is inhibited. The mechanism does not include local anesthetic drugs binding to potassium channels or the influx of potassium. DIF: Comprehension REF: 23 OBJ: 9 TOP: NBDHE, 2.0 Physiology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control NURSINGTB.COM 15. What is the layer of connective tissue that surrounds each axon within a nerve called? a. Epineurium b. Endoneurium c. Perineurium d. Fascicle ANS: B Within a nerve, each axon is surrounded by a layer of connective tissue called the endoneurium. The epineurium wraps the entire nerve; the perineurium wraps each fascicle (group of nerve fibers). DIF: Recall REF: 13 OBJ: 3 TOP: NBDHE, 2.0 Physiology 16. What is the layer of connective tissue that surrounds the entire nerve called? a. Epineurium b. Endoneurium c. Perineurium d. Fascicle ANS: A The entire nerve is wrapped in a layer of connective tissue called the epineurium . Within a nerve, each axon is surrounded by a layer of connective tissue called the endoneurium; the perineurium wraps each fascicle (group of nerve fibers). U S N T O DIF: Recall REF: 13 OBJ: 3 TOP: NBDHE, 2.0 Physiology 17. The main difference between motor neurons and sensory neurons is the location of which body part? a. Axon b. Dendritic zone c. Cell body d. Terminal arborization ANS: C The main difference between motor neurons and sensory neurons is the location of the cell body. The cell body of the motor (efferent) neuron participates in impulse conduction, and therefore is located at the terminal arborization at the dendritic zone. Th e cell bodies of sensory (afferent) neurons do not participate in nerve conduction and therefore are located off the axon. DIF: Recall REF: 14 OBJ: 4 TOP: NBDHE, 2.0 Physiology 18. The cell body of which neuron participates in impulse conduction and therefore is located at the terminal arborization? a. Sensory neurons b. Motor neurons c. Somatic neurons d. All options listed ANS: B The cell body of the motor neuron participates in impulse conduction and therefore is located at the terminal arborization. TNheRcellIbodGiesBo.f sCensMory (afferent) neurons do not pa rticipate in nerve conduction and therefore are located off the axon. Somatic neurons are associated with the somatic nervous system, a subdivision of the peripheral nervous system. DIF: Recall REF: 14 OBJ: 4 TOP: NBDHE, 2.0 Physiology 19. The difference between the electrical charge on the outside of the cell and that on the inside of the cell is called what? a. Firing threshold b. Membrane potential c. Polarization d. Action potential ANS: B The difference between the electrical charge on the outside of the cell and that on the inside of the cell is called the membrane potential. The nerve’s firing threshold is reached when axoplasm has depolarized approximately 15 -20mV from −70mV, attaining the threshold for impulse generation; polarization refers to the res ting state, when the electrical charge on the outside of the membrane is positive while the inside of the membrane is negative; the action potential is the membrane potential of an active nerve conducting an impulse. DIF: Recall REF: 19 OBJ: 8 TOP: NBDHE, 2.0 Physiology 20. At the synaptic knobs of neuron cells, what type of action is required to have the electrical impulse cross the synapse of one cell to another cell? a. The action of electrical synapses b. The action of chemical synapses c. The action of either electrical or chemical synapses d. Repolarization ANS: C To have the electrical impulse cross the synapse of one cell to another cell requires the action of either electrical synapses or chemical synapses. Repolarization occurs once the peak of the action potential is reached and membrane potential begins to move back toward the resting potential. DIF: Recall REF: 15-16 OBJ: 7 TOP: NBDHE, 2.0 Physiology 21. The nerve cell stage in which potassium returns to the inside of the cell and sodium returns to the outside of the cell is called what? a. All-or-none principle b. Polarization c. Depolarization d. Refractory period ANS: D The refractory period puts everything back to normal: Potassium returns inside, and sodium returns outside the cell membrane. The return to the resting state (polarization) is realized when the electrical charge on the outside of the membrane is positive w hile the inside of the membrane is negative. Depolarization occurs when action potential causes sodium channels to open, allowing an influx of sNodUiuRmSiIonNsGthTatBc.haCnOgeMs the electrochemical gradient, whi ch in turn produces a further rise in the membrane potential. The conduction of nerve impulses is an example of an all -or-none response: that is, once a neuron responds to the minimum threshold level, it must respond completely and will no longer be dependent of the stimulus to continue. DIF: Recall REF: 21 OBJ: 8 TOP: NBDHE, 2.0 Physiology 22. What do local anesthetic drugs inhibit in order to prevent nerve cell stimulation? a. Sodium influx b. Potassium influx c. Chloride excretion d. All options listed ANS: A Local anesthetic drugs act mainly by inhibiting sodium influx through sodium -specific ion channels in the neuronal cell membrane. Local anesthetic drugs do not act by inhibiting potassium influx or chloride excretion. DIF: Comprehension REF: 23 OBJ: 9 TOP: NBDHE, 2.0 Physiology| NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 23. The smaller -diameter nerve fibers associated with supraperiosteal injections are more sensitive to local anesthetics. The larger -diameter nerve fibers of the IA and PSA requir e a larger volume of local anesthetic for successful nerve blockage. a. Both statements are true. b. Both statements are false c. The first statement is true; the second statement is false. d. The first statement is false; the second statement is true. ANS: A Both statements are true. The smaller -diameter nerve fibers associated with supraperiosteal injections are more sensitive to local anesthetics. The larger -diameter nerve fibers of the IA and PSA require a larger volume of local anesthetic for successful ne rve blockage. DIF: Comprehension REF: 23 OBJ: 9 TOP: NBDHE, 2.0 Physiology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 24. The function of the cell body is to transmit impulses. The cell body is responsible for protein synthesis and provides metabolic support for the neuron. a. Both statements are true. b. Both statements are false c. The first statement is true; the second statement is false. d. The first statement is false; the second statement is true. ANS: D The first statement is false; the second statement is true. The cell body is not involved in impulse transmission. The cell body is responsible for protein synthesis and provides metabolic suppo rt for the neuNroUnR. SINGTB.COM DIF: Recall REF: 15 OBJ: 4 TOP: NBDHE, 2.0 Physiology 25. The axon is: a. Made up of cytoplasm b. Surrounded by a multiple lipid membrane c. All options listed d. None of the options listed ANS: C All options listed. The axon is made up of cytoplasm, or axoplasm, and is surrounded by a multilayer lipid membrane. DIF: Recall REF: 15 OBJ: 4 TOP: NBDHE, 2.0 Physiology 26. Which of the following is true regarding the nodes of Ranvier? a. Found along myelinated nerve fibers between adjacent Schwann cells b. Occur at unevenly spaced intervals c. All options listed d. None of the options listed ANS: A The nodes of Ranvier are found along myelinated nerve fibers, gaps in the sheath, and between adjacent Schwann cells, and they occur at evenly spaced intervals. DIF: Recall REF: 16-17 OBJ: 5 TOP: NBDHE, 2.0 Physiology 27. The relationship between relative amounts of ions inside and outside the nerve membrane is known as which of the following? a. Relative refractory period b. Concentration gradient c. Action potential d. Axolemma ANS: B The concentration gradient is the relationship between the relative amounts of ions inside and outside the nerve membrane. Relative refractory period is the interval immediately following the absolute refractory period and before complete reestablishment t o the resting state. Action potential is a nerve impulse. Axolemma is the plasma membrane of the axon. DIF: Recall REF: 19 OBJ: 8 TOP: NBDHE, 2.0 Physiology NURSINGTB.COM U S N T O Chapter 03: Pharmacology of Local Anesthetic Agents Logothetis: Local Anesthesia for the Dental Hygienist, 2nd Edition TRUE/FALSE 1. Prilocaine is biotransformed in the liver only. ANS: F Correct: Prilocaine is biotransformed in the lungs and the liver. DIF: Recall REF: 36| 38 OBJ: 10 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 2. The most potent local anesthetic is bupivacaine, which has the greatest degree of lipid solubility. ANS: T DIF: Comprehension REF: 28| 38 OBJ: 10 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 3. Intravascular injections significantly increase the possibility of an overdose. ANS: T DIF: Comprehension REF: 36| 38 OBJ: 11 TOP: NBDHE, 6.0 PharmacolNogy|RNBIDHEG, 3.B0 .PlCanniMng and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 4. The higher the pK a of an anesthetic, the faster the onset of action. ANS: F Correct: The higher the pKa of the anesthetic, the slower the onset of action. DIF: Recall REF: 29-30| 38 OBJ: 7 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 5. The speed of recovery from local anesthetic is determined by the degree of binding to the receptor site of each anesthetic. ANS: T DIF: Recall REF: 35| 38 OBJ: 10 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 6. Local anesthetics are vasoconstrictors and decrease the absorption of the drug by the blood. ANS: F Correct: Local anesthetics are vasodilators and increase the absorption of the drug by the blood. U S N T O DIF: Compr ehension REF: 35-36| 38 OBJ: 10 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 7. If more anesthetic is needed for a procedure, it is important to reinject the anesthetic after the mantel fibers have fully recovered. ANS: F Correct: If more anesthetic is needed for a procedure, it is important to reinject the anesthetic before the mantel fibers have fully recovered. DIF: Recall REF: 35| 38 OBJ: 10 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 8. Local anesthetics affect the CNS and CVS after biotransformation. ANS: F Correct: Local anesthetics affect the CNS and CVS before biotransformation. DIF: Recall REF: 37| 38 OBJ: 10| 11 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 9. The rate of systemic absorption of local anesthetics depends on the total dose, concentration, route of administration, vascularity of tissues, and presence or absence of a vasoconstrictor. ANS: T DIF: ReNcallR I GREBF:.C35| 3M8 OBJ: 10 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 10. Local anesthetics easily cross the blood –brain barrier. ANS: T DIF: Recall REF: 36| 38 OBJ: 10 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control MULTIPLE CHOICE 1. What is the significant clinical difference between esters and amides? a. Potential for allergic reactions b. Cross -hypersensitivity c. Lipid solubility d. Drug potency ANS: A The significant clinical difference between esters and amides is the potential for allergic reactions. Cross -hypersensitivity between esters and amides is unlikely. Lipid solubility is improved by the lipophilic aromatic ring associated with the local anes thesia molecule. Drug potency is related to lipid solubility in that greater lipid solubility enhances diffusion through the nerve, allowing a lower effective dose. DIF: Comprehension REF: 28 OBJ: 4 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 2. Which component of the local anesthetic molecule improves the lipid solubility, facilitating the penetration of the anesthetic through the lipid-rich membrane where the receptor sites are located? a. Hydrophilic amino group b. Intermediate hydrocarbon ester or amide chain c. Lipophilic aromatic ring d. All options listed ANS: C The lipophilic aromatic ring improves the lipid solubility of the molecule, which facili tates the penetration of the anesthetic through the lipid rich-membrane where the receptor sites are located. The hydrophilic amino group acts as the “on -off’ switch allowing the local anesthetic to exist in either lipid -soluble or water -soluble configurations. The intermediate hydrocarbon ester or amide chain determines if the molecule is an ester or an amide. DIF: Recall REF: 28 OBJ: 3 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 3. Which component of the local anesthetic molecule renders the molecule water soluble? a. Hydrophilic amino group b. Intermediate hydrocarbon ester or amide chain c. Lipophilic aromatic ring d. All options listed ANS: A NURSINGTB.COM The hydrophilic amino group renders the molecule water soluble. The intermediate hydrocarbon ester or amide chain determines if the molecule is an ester or amide. The lipophilic aromatic ring improves the lipid solubility of the molecule. DIF: Recall REF: 28 OBJ: 3 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 4. Dissociation constant refers to which of the following descriptions? a. Determines the portion of administered anesthetic dose in the lipid -soluble state (RN) b. Determines the onset of anesthetic action as the increase of molecules crossing the nerve membrane decreases the time of the anesthetic’s onset c. The pH at which 50% of the molecules exist in the lipid-soluble form and 50% in the water -soluble form d. All options listed ANS: D All options listed. The dissociation constant determines the portion of administered anesthetic dose in the lipid -soluble state (RN); determines the onset of anesthetic action as the increase of molecules crossing the nerve membrane decreases the time of the anesthetic’s onset; and it is the pH at which 50% of the molecules exist in the lipid-soluble form and 50% in the water -soluble form. DIF: Comprehension REF: 29| 30 OBJ: 7 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 5. Why is lipid solubility an important characteristic of local anesthetic drugs? a. A greater lipid solubility enhances the diffusion of the anesthetic drug through the nerve. b. A greater lipid solubility indicates a higher potency of the anesthetic drug. c. A greater lipid solubility allows for a lower effective dose of the local anesthetic drug. d. All options listed. ANS: D All options listed. Lipid solubility is an important characteristic of local anesthetic drugs because a greater lipid solubility enhances the diffusion of the anesthetic through the nerve, indicates a higher potency of the drug, and allows for a lower effe ctive dose. DIF: Comprehension REF: 28| 31 OBJ: 5 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control 6. Why is protein binding an i mNpUorRtaSntIcNhaGraTctBer.isCtiOc oMf local anesthetic drugs? a. Increased protein binding allows more cations (RNH+) to bind to the receptor sites within the sodium channels, prolonging the presence of anesthetic at the site of action. b. Increased protein binding allows more RN molecules to bind to the recepto r sites within the sodium channels, prolonging the presence of anesthetic at the site of action. c. Decreased protein binding allows more cations (RNH+) to bind to the receptor sites within the sodium channels, prolonging the presence of anesthetic at the site of action. d. Decreased protein binding allows more RN molecules to bind to the receptor sites within the sodium channels, prolonging the presence of anesthetic at the site of action. ANS: A Increased protein binding allows more cations (RNH+) to bind to the receptor sites within the sodium channels, prolonging the presence of anesthetic at the site of action. An increase of RN molecules is not associated with increased protein binding or prolonging the presence of anesthetic at the site of action. DIF: Recall REF: 31| 35 OBJ: 10 TOP: NBDHE, 6.0 Pharmacology| NBDHE, 3.0 Planning and Managing Dental Hygiene Care| NBDHE, 3.4 Anxiety and Pain Control