TEST BANK for Ethics and Law in Dental Hygiene 3rd Edition by Phyllis Beemsterboer

Ethics and Law in Dental Hygiene 3rd Edition Beemsterboer Test Bank Chapter 01: Ethics and Professionalism Beemsterboer: Ethics and Law in Dental Hygiene, 3rd Edition MULTIPLE CHOICE 1. When was the inception of the profession of dental hygiene? a. In ancient Greece b. In the early 1800s c. In the early 1900s d. In 1979 ANS: C

The scope of practice of a dental hygienist was first established by law in Connecticut in 1915. Alfred C. Fones taught his dental assistant, Irene Newman, to treat patients and to teach them to maintain their mouths in a clean state. In 1913, Fones established the first school for dental hygienists in Bridgeport, Connecticut. The first oath written for dental hygienists called upon Apollo and Hygeia, who were the Greek god and goddess of health, respectively. A modernized version of the first oath was adopted by the Board of Trustees of the American Dental Hygienists’ Association (ADHA) in 1979.

DIF: Recall REF: p. 3 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 2. Which member of the dental team is the primary oral preventive therapist? a. Dentist b. Dental hygienist c. Dental assistant d. Receptionist ANS: B

The dental hygienist is the oral preventive therapist in the dental office. The dentists who pioneered this special field of endeavor had a vision of the day when dental disease could be prevented by following a system of treatment and cleanliness. The dentist is primarily concerned with restorative treatment, although he or she also shares in preventing oral disease.

The dental assistant assists the dentist and may assist the dental hygienist as well. The receptionist greets patients and may help with the business and financial aspects of the practice.

DIF: Recall REF: p. 4 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.4 General 3. The dental hygiene oath is revised by action of which of the following professional

organizations? a. The American Dental Association (ADA) b. The American Dental Hygienists’ Association (ADHA) c. The Occupational Safety and Health Administration (OSHA) d. The Organization for Safety, Asepsis, and Prevention (OSAP) e. The Food and Drug Administration (FDA) ANS: B

The first dental hygiene oath was adopted by the Board of Trustees of the American Dental Hygienists’ Association (ADHA) in 1979 and is still in use today. The oath may be seen at the following website (www.adha.org/aboutadha/dhoath.htm). The American Dental Association has an oath for dentists. A copy of each oath may be found in the textbook.

DIF: Recall REF: p. 3 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.4 General 4. Society recognizes that health care providers are held to a higher standard than legislative

mandate. These higher standards are expressed in professional codes of ethics and are enforced by the legal system. 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

Health care providers are held to a higher standard than can be expressed exclusively by legislative mandate. While it is true that these higher standards are expressed in professional codes of ethics, they are enforced by those within the profession rather than by the legal system. Important components of this enforcement include self-regulation and submission to peer review.

DIF: Comprehension REF: p. 4 TOP: 7.0 Professional Responsibility | 7.4 General

OBJ: 1

5. Success is measured by financial gain in the corporate world; however, for the health care

professional the patient’s wTeElfS arTe B isApNlaKceSdEaLbL ovEeRp. roCfiO t.M a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

Because the welfare of the patient is more important than profit, society has granted the health care professional a certain status that carries prestige, power, and the right to apply special knowledge and skills.

DIF: Comprehension REF: p. 4 TOP: 7.0 Professional Responsibility | 7.4 General

OBJ: 2

6. Which of the following is regarded as the most important aspect of the delivery of health care

services? a. Technical skill b. Appropriate knowledge c. Critical judgment d. Caring ANS: D

Although all of the choices are important, caring is regarded as the most important. Patients perceive this essence of caring and respond to it. Trust is the critical foundation for the relationship between the person seeking services and the health care provider. The caring that the patient seeks also gives the provider the greatest opportunity for professional service and satisfaction.

DIF: Recall REF: p. 4 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.4 General 7. The publication “Medical Professionalism in the New Millennium: A Physician Charter” set

out three fundamental principles, including patient welfare, patient autonomy, and the principle of social justice, because it is thought this will reinvigorate the value of professionalism. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

The Physician Charter sets out three fundamental principles that are not new but reinforce the foundation of the medical profession as one of service to others. The ethical principles of the primacy of patient welfare (beneficence and nonmaleficence) and patient autonomy are listed first; the principle of social justice is the third main tenet. The desired goal was to reinvigorate the value of professionalism that includes social responsibility, the ethic of care, and access to that care, for all members of society.

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REF: p. 5 DIF: Comprehension TOP: 7.0 Professional Responsibility | 7.4 General

OBJ: 3

8. Each of the following is a requirement for licensure of a dental hygienist in the United States

EXCEPT one. Which one is the EXCEPTION? a. Completion of a higher education accredited program b. Graduation from a college or university c. Passed a written national board examination d. Passed a clinical national board examination ANS: D

There is no clinical national board examination. The dental hygiene candidate for licensure must pass a state or regional clinical examination. Examples of regional boards include the Council of Interstate Testing Agencies (CITA), the Central Regional Dental Testing Services, Inc. (CRDTS), the Commission on Dental Competency Assessments (CDCA), the Southern Regional Testing Agency, Inc. (SRTA), and the Western Regional Examining Board (WERB).

DIF: Comprehension REF: p. 5 TOP: 7.0 Professional Responsibility | 7.4 General

OBJ: 3

9. Which of the following characteristics is used to separate the professional from the layperson? a. Competency b. Quality performance

c. A specialized body of knowledge and skill of value to society d. A code of ethics ANS: C

To be considered a profession, a specific field or area of study traditionally must have several characteristics. These include a specialized body of knowledge and skill of value to society, an intensive academic course of study, set standards of practice determined and regulated by the group, external recognition by society, a code of ethics, an organized association, and a service ethic. What separates the professional from the layperson is specialized knowledge, which is exclusive to the professional group.

DIF: Recall REF: p. 5 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 10. Each of the following is considered to be a true profession EXCEPT one. Which one is the

EXCEPTION? a. Law b. Medicine c. Dentistry d. Culinary chef e. Ministry ANS: D

Because being a professional is desirable, many careers and occupations aspire to this level.

Real estate agents, auto mechanics, and culinary chefs all use the term professional to indicate a desired level of competency and quality performance. However, the true professions are still considered to be medicine, dentistry, ministry, and law because they possess all the characteristics previously lT isE teS d,TiB ncAluNdK inSgEaLspLeEciRal.izCeO dM body of knowledge and skill of value to society, an intensive academic course of study, set standards of practice determined and regulated by the group, external recognition by society, a code of ethics, an organized association, and a service ethic.

DIF: Recall REF: p. 6 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 11. Professionalism is demonstrated through a foundation of clinical competence, communication

skills, and ethical and legal understanding. Upon this foundation is built the aspiration to and wise application of the principles of professionalism. 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

The principles of professionalism are excellence, humanism, accountability, and altruism.

Highlights of the Standards for Clinical Dental Hygiene Practice include assessment, dental hygiene diagnosis, planning, implementation, evaluation, and documentation. Professional traits of the dental hygienist include honesty and integrity, caring and compassion, reliability and responsibility, maturity and self-analysis, loyalty, interpersonal communication, respect for others, and respect for self.

DIF: Recall REF: p. 6 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 12. Which of the following models or professionalism presents dentistry as an all-knowing

profession? a. Commercial b. Guild c. Interactive ANS: B

It is called the guild model because it resembles the medieval guild of old in which those who were members of the group controlled knowledge, skill, and competency. In this model the patient has dental needs and the dentist provides care to meet the needs of that patient, who is uninformed and passive in the process. The commercial model describes a relationship in which dentistry is a commodity, a simple selling and buying of services. In the interactive model, the patient and dentist are equals and have roles of equal moral status in the process of the delivery of dental care.

DIF: Recall REF: p. 6 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 13. Which of the practice models described by Ozar is considered most desirable? a. Guild b. Interactive c. Commercial ANS: B

According to the interactivT eE mSoT deBl,ApN atKieSnE tsLdL etE erR m.inCeOthMeir own needs and health care choices on the basis of their personal values and priorities but seek the care of the dentist because of his or her knowledge and skill. This model is preferable because it presents the patient and provider as partners who make different contributions to the partnership. This equal moral status creates an obligation for equal respect as partners working together toward attaining and maintaining oral health.

DIF: Comprehension REF: p. 6 TOP: 7.0 Professional Responsibility | 7.4 General

OBJ: 3

14. Which of the following is an example of interprofessional education (IPE) in an academic

health center involving two different health education organizations? a. Nursing students learn about nursing bottle caries along with dental hygiene students. b. Dental students learn about preventive fluoride along with dental hygiene students. c. Dental students learn about dental restorative procedures along with dental hygiene students. d. Dental hygiene students learn about dental preventive procedures along with dental assisting students.

ANS: A

The term IPE refers to occasions when students from two or more health professions learn together during all or part of their professional training with the objective of cultivating collaborative practice to improve the quality of patient care at the individual and population level. The Interprofessional Education Collaborative (IPEC) includes six major health education organizations: the American Association of Colleges of Nursing, American Association of Colleges of Osteopathic Medicine, American Association of Colleges of Pharmacy, American Dental Education Association, Association of American Medical Colleges, and Association of Schools of Public Health.

DIF: Comprehension REF: p. 7 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.3 Patient and Professional Communication 15. Which of the following organizations is recognized by the United States Department of

Education to accredit programs for dental hygiene in the United States? a. The college or university with the dental hygiene program b. The American Dental Hygiene Association (ADHA) c. The State Board of Dentistry for the respective state d. The Commission on Dental Accreditation (CODA) ANS: D

The Commission on Dental Accreditation (CODA) is the specialized accrediting agency recognized by the United States Department of Education to accredit programs that provide basic preparation for licensure in dentistry, dental hygiene, and all related dental disciplines.

The commission consists of 30 members and includes a representative of the ADHA. All accredited programs participate in an accreditation review every 7 years. The program prepares a self-analysis and self-study report with information about program resources, curriculum, policies, and sT taE ndSaT rdBs.ATNhK isSreEpLoL rt E isRs. ubCmOiM tted to the CODA in preparation for an on-site review by CODA team members. The members of the commission interview administrators, faculty, staff, and students to verify the information contained in the self-study. Next, the CODA team members create a site visit report for both the institution and the Commission. The Commission reviews the report and makes a decision to offer accreditation status without a reporting requirement or accreditation status with a reporting requirement. Programs must demonstrate compliance with Commission recommendations or risk loss of accreditation.

DIF: Recall REF: p. 9 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.4 General 16. How often must a dental hygiene program undergo a formal, on-site review by the accrediting

body? a. Every 10 years b. Every 7 years c. Every 3 years d. Only once, when the program is first created ANS: B

A formal, on-site review is conducted every 7 years by the Commission on Dental Accreditation of the American Dental Association. All accredited dental programs have accreditation every 7 years, except for oral and maxillofacial surgery programs. These programs are reviewed every 5 years.

DIF: Recall REF: p. 9 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.4 General 17. Which of the following is the correct sequence for the stages of mastery learning according to

the competency continuum? a. Novice, proficient, competent b. Master, competent, novice c. Novice, competent, proficient d. Proficient, novice, competent e. Competent, novice, master ANS: C

Educational theory categorizes the process of skill performance into five stages of mastery learning, also termed the competency continuum. The five stages are novice, beginner, competent, proficient, and master. The student is a novice or advanced beginner when he or she begins preclinical activities and progresses to caring for clinical patients under the supervision of faculty. The student will have achieved competency at or before graduation, meaning that he or she has the ability to perform clinical skills without faculty supervision.

After graduation, the dental hygienist works toward proficiency and continues working throughout his or her professional life, toward becoming an expert.

DIF: Recall REF: p. 9 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.4 General 18. Each of the following is one of the American Dental Hygiene Association (ADHA) standards

for clinical dental hygiene practice EXCEPT one. Which one is the EXCEPTION? a. Implementation b. Documentation c. Recapitulation d. Assessment e. Dental hygiene diagnosis ANS: C

The six ADHA standards of practice are assessment, dental hygiene diagnosis, planning, implementation, evaluation, and documentation. Implementation is the delivery of dental hygiene services to the patient. Modification of care often occurs to minimize risk, thus optimizing the outcome of the care plan. Documentation is the accurate recording of collected data, treatment planned and provided during patient care, is entered to create a permanent document. Assessment is the systematic collection, analysis, and documentation of oral and general health status and patient needs. It is comprised of patient history collection, performing a clinical evaluation, and measuring risk assessment. Dental hygiene diagnosis is the identification of an existing or potential oral health problem that the hygienist is educationally qualified and licensed to treat. Establishing, reviewing, revising, and publishing these standards are professional responsibilities that the ADHA assumes for its members to ensure that professional practice is based on the best and most scientifically accurate evidence and practice approaches.

DIF: Recall REF: p. 9 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.4 General

19. Which of the following terms is used to describe that core of health care that places the needs

of the patient or client ahead of those of the provider? a. Autonomy b. Justice c. Beneficence d. Nonmaleficence e. Veracity ANS: C

The professional traits of a successful dental hygienist are found in the basics of professionalism. All of the traits are rooted in beneficence: the core of health care that places the needs of the patient or client ahead of those of the provider. Autonomy is self-determination and the ability to be self-governing and self-directing. The principle of justice is concerned with providing individuals or groups with what is owed, due, or deserved.

Nonmaleficence declares that a health care provider’s first obligation to the patient is to do no harm. Veracity is defined as being honest and telling the truth.

DIF: Recall REF: p. 10 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.4 General 20. An individual who demonstrates certain attributes, traits, and behaviors that embrace the best

qualities of care and service is known as a a. professional. b. technician. c. vendor. d. supplier.

ANS: A

From the perspective of the general population, the term professional has evolved to mean an individual who demonstrates certain attributes, traits, and behaviors that embrace the best qualities of care and service. According to the Merriam-Webster dictionary, a technician is a person with a job related to the practical use of machines or science in industry or medicine, a vendor is a person who sells things, especially on the street, and a supplier is a person or entity that is a source for goods or services.

DIF: Recall REF: p. 10 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.4 General 21. According to the ethicist Laurence McCullough the two virtues required in a professional

person are a. honesty and integrity. b. self-effacement and self-sacrifice. c. caring and compassion. d. maturity and self-analysis.

ANS: B

Laurence McCullough has stated that there are two virtues required in a professional person.

The first is self-effacement, which means putting aside all notions of self as better educated, socially superior, or more economically well off and focusing on the needs of the patient. The second is self-sacrifice, or putting aside or giving up one’s own interests and concerns.

Honesty and integrity, caring and compassion, and maturity and self-analysis are professional traits of the dental hygienist; however, they are not the two virtues mentioned by Laurence McCullough.

DIF: Recall REF: p. 10 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 22. Which of the following professional traits of the dental hygienist ensures that the patient

should be confident that information given in written and verbal form is held in confidence and handled appropriately? a. Caring and compassion b. Reliability and responsibility c. Maturity and self-analysis d. Honesty and integrity ANS: D

While it is true that all of the choices are professional traits, a relationship of trust is essential to providing care when personal health information is shared. Patients and colleagues must be able to depend on the words and actions of individuals who treat and work with them.

Professional integrity is a commitment to upholding the code of ethics and the standards of care. p. 11 OBJ: 7 DIF: Recall REF: TESTBANKSELLER.COM TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 23. Which of the following terms means demonstrating the empathy necessary to comfort and

guide the patient in the health promotion process? a. Caring b. Reliability c. Tolerance d. Loyalty e. Honesty ANS: A

The ability to care for and be compassionate to each and every patient is a critical trait expected of all individuals who seek a career in a health care profession. Persons who are compassionate are merciful to all patients, including those who are unlike themselves or who are possibly difficult to understand and treat.

DIF: Recall REF: p. 11 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 24. Most states have a legal requirement for continuing education for those who hold a dental

hygiene or dental license because mandated continuing education helps ensure optimal health services to the public. a. Both that statement and reason are correct and related. b. Both the statement and 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.

ANS: A

The goal of mandated continuing education is to ensure optimal health services to the public by fostering continued competence. It is critical for a practitioner to be aware of the continuing education requirements for the state in which he or she practices because they vary from state to state. Information about state requirements may be found on the American Dental Hygiene Association website or on individual state dental board websites.

DIF: Comprehension REF: p. 12 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 25. The trait in which the dental hygienist assesses his or her skills and takes responsibility for

changing and improving those skills when necessary is called a. integrity. b. self-analysis. c. loyalty. d. reliability. e. interpersonal communication.

ANS: B

Self-analysis is assessment of skills and taking responsibility for changing and improving them when necessary. Professional integrity is a commitment to upholding the code of ethics and the standards of care. Loyalty is protecting and promoting the interests of a person, group, or organization. Reliability is meeting the obligations of time and duty, keeping appointments and meeting established scT heEdS ulTeB s. A TN heKfSoE unLdL atE ioRn.oC f tOruMst lies in communication and the ability of the patient to speak and be heard.

DIF: Recall REF: p. 11 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 26. Loyalty is defined as a. to treat all patients without discrimination. b. to work toward the goals of attaining and maintaining oral health for each patient. c. protecting and promoting the interests of a person, group, or organization. d. a commitment to upholding the code of ethics and the standards of care.

ANS: C

Any relationship between a health care provider and a patient is a special affiliation; all professional decisions must be unencumbered by conflicting personal interests. To treat all patients without discrimination is an example of tolerance. A mature individual works efficiently and effectively toward the goals of attaining and maintaining oral health for each patient. Honesty and integrity are exemplified by a commitment to uphold the code of ethics and the standards of care.

DIF: Comprehension REF: p. 11 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent

27. When a license to practice dental hygiene is granted, that person is responsible for knowing

and upholding the laws established by the state dental practice act. If a portion of the code is changed subsequent to the date of licensure, that person is not responsible for practicing according to revisions in the law. 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 person must practice according to the current laws. Ignorance of a portion of the law or code is not an excuse for noncompliance by a dental hygienist or any other health care provider. The ADHA Code of Ethics for Standards of Professional Responsibility (To Ourselves as Professionals) states that a dental hygienist should “enhance professional competencies through continuous learning in order to practice according to high standards of care.” It also states (To Scientific Investigation) “Be knowledgeable concerning currently accepted preventive and therapeutic methods, products, and technology and their application to our practice.”

DIF: Comprehension REF: p. 12 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 28. A license to practice as a dental hygienist is granted by a. The American Dental Association b. The American Dental Hygienists’ Association c. The State Board of Dentistry d. The school of matriculation, meaning where the student graduated

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ANS: C

Licenses are granted by the state. All state boards, as well as those in the Virgin Islands and Puerto Rico, grant a license to practice to the dental hygienist. The responsibility and power for legislative protection of the public rest with each individual state or territory. Licensure is designed to enforce practice codes, establish standards, and sanction incompetent practitioners.

DIF: Comprehension REF: p. 12 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 29. Which of the following individuals is regarded as the father of dental hygiene? a. Dr. David T. Ozar b. Dr. Laurence McCullough c. Dr. A. C. Fones d. Dr. Carl Rogers ANS: C

Dr. Fones is regarded as the father of dental hygiene. The scope of practice of a dental hygienist was first established by law in Connecticut in 1915 at the urging of Dr. Fones. The Connecticut dental law served as a model for the states that later adopted similar legislation.

Dr. Ozar is credited with developing the three models of professionalism. Dr. McCullough stated that two virtues are required in a professional person. Dr. Rogers was a famous humanistic psychologist.

DIF: Recall REF: p. 12 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.4 General 30. Most legislative changes related to dental health care are driven by individuals in the dental or

dental hygiene profession. For the most part the public remains unaware of the intricacies of the process. 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

Some of the factors that influence legislative changes in a state include the need and demand for dental care, the distribution of dental health care providers, federal health legislation, and the goals of organized dental and dental hygiene association’s advocacy groups.

DIF: Recall REF: p. 12 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.4 General 31. Which of the following is regarded as an expanded function for a dental hygienist rather than

a traditional duty? a. Scaling and root planing b. Patient education c. Exposing dental radiographs d. Administration of an injection ANS: D

Examples of expanded functions include administration of injectable local anesthesia or placement of restorative material. Some states have implemented an additional practice level for dental hygienists. Individuals pursuing this level of practice must complete additional training in periodontal or restorative functions and be sanctioned to perform these skills by the particular state in which they practice.

DIF: Recall REF: p. 13 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 32. A dental hygienist can practice independently of a dentist in all states, because several states

have adopted mechanisms to allow practice without the supervision of a dentist after gaining a special license or credential. a. Both that statement and reason are correct and related. b. Both the statement and 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.

ANS: D

It is true that several states have adopted mechanisms to allow a dental hygienist to practice without the supervision of a dentist after gaining a special license or credential. But states differ in which services are permitted and the level of supervision required, and only duties or functions allowed in a particular state may be performed, even if an individual is trained and licensed in another state when the dental practice act is more expansive.

DIF: Comprehension REF: p. 13 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

Chapter 02: Ethical Theory and Philosophy Beemsterboer: Ethics and Law in Dental Hygiene, 3rd Edition MULTIPLE CHOICE 1. Ethical decision making is a behavior and can be done well or done poorly. It is inherent and

is not taught or learned. 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

Ethical decision making is something that can be done well or done poorly and it is something that can be taught and learned. Many problems are situations in which we can easily determine what to do, but in other situations determining what is the ethical action takes careful reflection. An introduction to the foundation of ethical theory can guide ethical decision making and assist in understanding the process by which such decisions are made.

DIF: Comprehension REF: p. 15 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 2. Moral development is thought to be a process, because moral development has been shown to

typically occur in progressive steps or stages. a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related.

TESTBANKSELLER.COM 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

Just as each individual develops physically and intellectually, moral development also has been shown to typically occur in progressive steps or stages. Some researchers have related age, maturation of components of personality, and increased experience with moral development, whereas others have stressed that moral development has a cognitive component as well.

DIF: Comprehension REF: p. 15 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 3. Which of the following is thought to be one of the strongest and most consistent correlates

with development of moral judgment? a. Age b. Years of formal education c. Social status d. Income ANS: B

Years of formal education is one of the strongest and most consistent correlates with development of moral judgment. It is even stronger than chronologic age. For many people moral development continues as long as the person is in a formal environment, but then plateaus upon leaving school.

DIF: Recall REF: p. 16 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 4. Moral education programs seem to be most effective among which of the following members

of society? a. Infants b. Children c. Adolescents d. Adults ANS: D

Adults seemed to gain more from such programs than did younger children, most likely because a wider range of life experiences typically enriches a person’s awareness of the moral aspects of situations. A review of moral education programs revealed that almost half were effective in promoting moral development, especially if the program lasted longer than a few weeks and if the program involved the participants in discussions of controversial moral dilemmas.

DIF: Recall REF: p. 16 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 5. The capacity for moral judgment is rigid, because a person’s cognitive moral development

and his or her ability to emTpE loS yT wB haAtNhK eS orEsL heLuEnRd. erC stO anMds peaks at a certain age. a. Both that statement and reason are correct and related. b. Both the statement and 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.

ANS: E

Findings suggest that the capacity for moral judgment is not as rigid as some have argued.

Neither a person’s cognitive moral development nor his or her ability to employ what he or she understands in actual decisions is frozen at some specified age. Individuals can continue to learn, and research has supported the idea that adults make greater gains than children.

DIF: Comprehension REF: p. 16 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 6. According to Piaget’s four-stage model of moral development, the egocentric stage is found in

individuals of which of the following ages? a. 0-2 years old b. 2-7 years old c. 7-12 years old d. 12 years old and older ANS: B

The egocentric stage is from ages 2 to 7 years old. Children in this age group are thought to bend rules and react instinctively to the environment. The amoral stage is from ages 0 to 2 years. The heteronomous stage is from ages 7 to 12 years. Children in this age group accept the moral authority of others. Persons 12 years old and older are thought to be autonomous and have a morality of self based on cooperation; rules and regulations become internalized.

DIF: Recall REF: p. 17 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 7. According to Piaget, rules are tested and become internalized during which of the following

stages of moral development? a. Amoral stage b. Egocentric stage c. Heteronomous stage d. Autonomous stage ANS: D

Rules become internalized during the autonomous stage of moral development. The egocentric stage is characterized by bending rules and instinctive reaction to the environment.

The heteronomous stage is typified by acceptance of the moral authority of others. Each stage in the process of cognitive moral development involves judgment skills that are more complex, comprehensive, and differentiated from the preceding stage.

DIF: Recall REF: p. 17 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 8. Which of the following is the most basic stage of Kohlberg’s three-level model of moral

development? a. Interpersonal concordance orientation b. Law and order orientation c. Punishment and obedience orientation d. Instrumental relativist orientation e. Social contract legalistic orientation ANS: C

Kohlberg’s theory focuses primarily on cognitive processes. He defined six stages, of which punishment and obedience orientation is first. This stage is followed by Stage 2: instrumental relativist orientation, Stage 3: interpersonal concordance orientation, Stage 4: law and order orientation, Stage 5: social contract legalistic orientation, and Stage 6: universal ethical principle orientation.

DIF: Recall REF: p. 17 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 9. Which of the following stages of Kohlberg’s three-level model of moral development is

considered to be conventional reasoning, in which expectations of family and groups are maintained and where loyalty and conformity are considered important? a. Law and order orientation b. Instrumental relativist orientation c. Social contract legalistic orientation d. Universal ethical principle orientation

e. Punishment and obedience orientation ANS: A

Conventional reasoning involves interpersonal concordance orientation and law and order orientation. Preconventional reasoning involves punishment and obedience orientation and instrumental relativist orientation. Postconventional or principled reasoning involves social contract legalistic orientation and universal ethical principle orientation.

DIF: Recall REF: p. 17 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 10. Which of the following theorists of cognitive moral development created the concept of the

ethic of care? a. Lawrence Kohlberg b. Jean Piaget c. Carol Gilligan ANS: C

Carol Gilligan worked with Lawrence Kohlberg but wrote that his model reflects a male-oriented perspective of morality. She stated that women tend to see morality in the context of a relationship that she called the ethic of care. She proposed that feminine moral reasoning is typically different from masculine moral reasoning. Gilligan believes that complete moral development occurs in the context of two moral orientations—a male justice orientation and a female ethic of care—and therefore that Kohlberg’s measurement of moral development only in a justice-oriented scoring system is biased toward the male.

DIF: Recall REF: pp. 17-18 OBJ: 2 TOP: 7.0 Professional RespT onEsiS biT liB tyA| 7N.1KE hiL caL lP in. ciC plO esM , including informed consent StE ErR 11. Which of the following is an example where avoiding hurt becomes the moral guide

governing all moral reasoning according to Gilligan’s model of moral development? a. Orientation to individual survival b. Goodness as self-sacrifice c. Morality of nonviolence ANS: C

The morality of nonviolence is the highest level of moral development according to Gilligan.

The most basic level of moral development is orientation to individual survival, which is surviving by being submissive to society. The intermediate level is goodness as self-sacrifice, in which being moral is first not hurting others with no thought of hurt to self.

DIF: Comprehension REF: p. 18 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 12. People operate on their experiences to make sense of them. The experiences, as we make

sense of them, change the basic conceptual structures by which people construct meanings. 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

This is the basic tenet of cognitive theory. Researchers studying the relation between moral judgment and behavior can see that many factors determine behavior. For example, studies link moral perception with actual, real-life behavior as well as moral judgment.

DIF: Recall REF: p. 18 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 13. According to Rest and his co-workers, people who love to learn; seek challenges; and are

reflective, set goals, take risks, and profit from stimulating and challenging environments are those who develop in which of the following characteristics? a. Longevity b. Advanced education c. Moral judgment d. High remuneration ANS: C

Studies link moral perception with actual, real-life behavior as well as moral judgment. These characteristics are frequently found in professional students who are working hard to become excellent professionals.

DIF: Recall REF: p. 18 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 14. The cognitive aspects of moral development are only part of the story, because incorporating

the skill of differentiating right from wrong into life is a matter of building habits. a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related. c. The statement is correcTt,EbS utTtB heArN eaKsS onEiL sL NE OR T. . COM d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

One of the best ways to appreciate the value of a habit is to see how it operates in someone we admire. This is the fruition of development of habits such as carefully perceiving, carefully judging, and consistently acting in accordance with one’s moral judgments.

DIF: Comprehension REF: p. 19 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 15. In the academic world, examining the different ways in which moral thinking can be done is

called a study of a. humanity. b. moral or ethical theory. c. behavior. d. operant conditioning. e. reasoning.

ANS: B

An ethical or moral question is a question in which a person’s well-being or rights or duties are at issue or at stake. Because the meanings of “ethical” and “moral” are not carefully distinguished in a manner that is widely and consistently used, these terms often are treated as synonyms and used interchangeably.

DIF: Recall REF: p. 19 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 16. Which of the following views of moral reasoning is predicated on the idea that the rightness

or wrongness of any action is determined and justified by the consequences of the act being considered? a. Consequentialism b. Nonconsequentialism c. Virtue ethics d. Deontology ANS: A

This type of thinking is always comparative because it aims at maximizing good consequences. Consequentialists consider the consequences of each important alternative course of action available to them in the situation before deciding the right action.

Nonconsequentialism or deontology argues that some acts are right or wrong independent of their consequences.

DIF: Recall REF: p. 19 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 17. You are at a party and notice that a friend has consumed more alcohol than usual and appears

inebriated. At you watch her weave to her car, you wrestle with intervening, and many questions go through your mind. You wonder if she will be angry and resent it later on if you try to stop her but fear that she will not make it home safely if you do not. You wrestle whether or not to grab her keys and call a cab. This is an example of which of the following types of ethics? a. Consequentialist ethics b. Nonconsequentialist ethics c. Virtue ethics d. None of the above ANS: A

You are weighing the potential outcomes or consequences of your decisions. Doing moral thinking in this way means considering all relevant consequences of potential actions in the situation, identifying and evaluating them in terms of benefit and harm in order to determine the action(s) that, compared with the alternatives, yield the best outcomes, before making a choice about which action to take.

DIF: Comprehension REF: pp. 19-20 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 18. John Stuart Mill was a proponent of utilitarianism, which states that an action should be

judged to be moral on its capacity to provide the greatest good for the largest number of people. 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

John Stuart Mill was one of the most famous proponents of utilitarianism. Mill often is described as saying that an action should be judged to be moral on its capacity to provide the greatest good for the largest number of people. However, his teacher Jeremy Bentham said that, not Mill, and Bentham himself eventually repudiated the phrase because it misled people into thinking that, for a utilitarian, whatever benefited the majority was the right thing to do.

Both men did teach that the moral action is the one that maximizes good and minimizes harm when the consequences for every affected person are considered.

DIF: Comprehension REF: p. 20 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 19. Who was a proponent of utilitarianism? a. Immanuel Kant b. Plato c. John Stuart Mill d. Aristotle ANS: C

John Stuart Mill was a proponent of utilitarianism, a version of the consequentialist approach to moral decision making who stressed that, in consequentialist reasoning, every person affected by an action should be considered. Immanuel Kant is credited for establishing one of the most detailed nonconsequentialist or deontological theories of ethical thinking. Plato and Aristotle articulated the Greek tradition of virtue ethics and emphasized that the cultivation of virtuous traits of character is the primary function of morality.

DIF: Recall REF: p. 20 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 20. Adding fluoride to a community water system is a good example of the application of which

of the following types of ethical reasoning? a. Consequentialism or utilitarian ethics b. Deontology or nonconsequentialism c. Virtue ethics d. None of the above ANS: A

This is one of the best examples of utilitarianism in dentistry. The consequence is a benefit to society through caries reduction, provided at a relatively low cost and available to all members of a community regardless of social status or income, and with almost no possibility of causing harm. Nonconsequentialism would say that an action is right or wrong regardless of the consequences.

DIF: Recall REF: p. 20 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 21. Which of the following ethical theories regards an action as right when it conforms to a

principle or rule of conduct that meets a requirement of some overriding duty? a. Consequentialism b. Nonconsequentialism c. Virtue ethics d. Deontology

ANS: B

Deontologists or nonconsequentialists state that some actions are required by the rightness or wrongness of the action, regardless of the consequences of the action. Whereas consequentialists focus on the consequences of an act, deontologists argue that some acts are right or wrong independent of their consequences.

DIF: Recall REF: p. 20 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 22. Immanuel Kant is associated with which of the following theories of ethical thinking? a. Virtue ethics b. Consequentialism c. Nonconsequentialism d. None of the above ANS: C

Immanuel Kant is credited for establishing one of the most detailed nonconsequentialist or deontological theories of ethical thinking. Plato and Aristotle are associated with virtue ethics.

John Stuart Mill is associated with consequentialism.

DIF: Recall REF: p. 21 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 23. Which of the following ethical types of reasoning would be most likely to say that a physician

should be honest in telling a cancer patient that he or she only has a short time to live, even if he or she knew the patient would live longer if he or she did not know the truth? a. Consequentialist ethics b. Nonconsequentialist ethics c. Virtue ethics ANS: B

With this view, a professional’s duty to tell the truth to a patient is not founded on the consequences of telling the patient the truth, but on the belief either that an absolute duty exists never to lie or that the patient is entitled by reason of a fundamental right to receive the truth.

DIF: Comprehension REF: p. 21 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 24. According to Immanuel Kant, the test for a universal law is whether an action is related to

(a/an) a. overriding duty. b. moral compass. c. desirable outcome. d. benefit for the majority.

ANS: A

Kant held that the test of any rule of conduct is whether it can be a duty for all human beings to act on. That test is what tells us whether an action is directly related to an overriding duty.

This school of thought has had a significant effect on biomedical ethics.

DIF: Recall REF: p. 21 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 25. Immanuel Kant’s test for correct moral reasoning is called the categorical imperative, which

means a a. designation of the reasoning according to four criteria. b. stable pattern of perceiving, thinking, and acting rightly. c. rule or standard of conduct that is binding for all human beings. d. consequence of an alternative course of action in a given situation.

ANS: C

This rule or standard of conduct is absolutely binding for all human beings under all circumstances in which the rule or standard applies. Sometimes Kant’s Categoric Imperative is compared with the golden rule. Kant did not develop the categorical imperative according to four criteria. Stable patterns of perceiving, thinking, and acting rightly are definitions of character, or virtue. Analysis of consequences is associated with consequentialist ethics, whereas Kant and his philosophies are associated with nonconsequentialism.

DIF: Comprehension REF: p. 21 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 26. According to Kant, helping an elderly person cross the street is (a/an) a. categorical imperative. b. perfect duty. c. imperfect duty. d. moral obligation. e. universal law.

ANS: C

An imperfect duty is an obligation to help another person in need or to be compassionate. It is a matter of moral judgment that a person must carefully make to determine for whom and in which situations to fulfill this duty. A categorical imperative is a rule or standard of conduct that is absolutely binding for all human beings under all circumstances in which the rule or standard applies.

DIF: Comprehension REF: p. 21 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 27. Some moral philosophers have advocated that correct moral thinking should be like solving a

simple mathematical equation. Theories of moral development have been offered to help understand how easy making good moral decisions can be. 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

No moral philosopher has ever claimed that moral thinking is like solving a simple equation in mathematics. One reason theories have been offered is to help us understand how complex making good moral decisions can be and then to try to help us think about them more clearly.

DIF: Comprehension

REF: p. 22

OBJ: 4

TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 28. Which of the following types of ethical philosophies is based upon good patterns of

perceiving, thinking, and acting rightly? a. Consequentialist ethics b. Nonconsequentialist ethics c. Virtue ethics d. None of the above ANS: C

If those patterns are perceiving, thinking, and acting rightly we call them virtues and we say the person has a “good character” or is a “good person.” Consequentialism refers to the kind of moral thinking that is predicated on the idea that the rightness or wrongness of any action is determined and justified by the consequences of the act being considered.

Nonconsequentialist ethics argue that some acts are right or wrong independent of their consequences.

DIF: Recall REF: p. 22 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 29. Which of the following is the focus of virtue ethics? a. Our perfect duties and our imperfect duties b. To reflect on what kind of person we ought to be c. The consequences of our actions d. Our duties and rights rather than the consequences of our actions ANS: B

Rather than focusing first oTnEcS onTsB eqAuNenKcSesEoLrLnE onRc. onCsO eqMuentialist factors such as duty or rights, philosophers of virtue ethics urge us to reflect on what kind of person we ought to be and not the ethical characteristics of the acts we ought to do. Perfect duties and imperfect duties are part of Immanuel Kant’s nonconsequentialist or deontological theories of ethical thinking rather than virtue ethics.

DIF: Recall REF: p. 23 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent

Chapter 03: Ethical Principles and Values Beemsterboer: Ethics and Law in Dental Hygiene, 3rd Edition MULTIPLE CHOICE 1. Each of the following is one of the main normative principles in health care EXCEPT one.

Which one is the EXCEPTION? a. Nonmaleficence b. Beneficence c. Autonomy d. Justice e. Veracity ANS: E

Veracity is not one of the main normative principles. The main normative principles in health care are nonmaleficence, beneficence, autonomy, and justice. These principles provide direction about what should and should not be done in specific situations.

DIF: Recall REF: p. 25 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 2. Normative ethical principles are linked to commonly expected behaviors, because they are

based on shared standards of thinking and behaving. a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related. c. The statement is correct, but the reason is NOT. TESTBANKSELLER.COM d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Normative principles provide a cognitive framework for analyzing moral questions and problems. These principles are associated with expectations for behavior and provide guidelines for dealing with right and wrong actions.

DIF: Recall REF: p. 25 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 3. An ethical dilemma occurs when one or more ethical principles a. are in conflict. b. are involved. c. are additive with one another. d. cancel each other out.

ANS: A

It occurs when one or more ethical principles are in conflict. Weighing and balancing ethical principles are the major tasks involved in ethical decision making. What is in the patient’s best interest may be open to question depending on whose perspective is being considered.

DIF: Recall REF: p. 25 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent

4. The principle that the first obligation of a health care provider is to do no harm is known as

which of the following? a. Integrity b. Justice c. Beneficence d. Nonmaleficence ANS: D

Patients place themselves in the care of another person and, at a minimum, should expect that no additional harm will result from that act. The patient grants another person the privilege of access to a portion of his or her body for an explicit purpose, a privilege founded in trust.

Fundamental to that trust is that the health care provider will do no harm to the patient.

Whereas nonmaleficence is concerned with doing no harm to a patient beneficence requires that existing harm be removed. Professional integrity is a commitment to upholding the Code of Ethics and the standards of care. The principle of justice is concerned with providing individuals or groups with what is owed, due, or deserved.

DIF: Recall REF: p. 25 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 5. Dental hygienists are required to maintain their level of knowledge and skill through

participation in which of the following? a. Graduation from an accredited institution where dental hygiene is taught b. Appropriate continuing education programs c. Using standardized operating procedures d. Using top quality rather than inferior quality materials ANS: B

Practitioners are required to maintain their level of knowledge and skill through participation in appropriate continuing education programs. Someone could have graduated from an accredited institution and use standardized operating procedures and good quality materials; however, they need to stay current with changes in treatment procedures and regulations. A dental hygienist who is unfamiliar with sealant placement procedures or local anesthesia techniques should defer performing that service until achieving competency.

DIF: Recall REF: p. 26 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 6. A health care provider may not always be able to avoid harm, because causing some degree of

harm when that harm will lead to a greater good may be necessary. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

This conflict is referred to as The Principle of Double Effect and it requires the health care provider to consider the risks and benefits whenever treatment is provided. The hierarchy of nonmaleficence and beneficence provides the clinician with a guideline to follow in sorting out dilemmas in practice. Avoiding all harm and promoting good are not always possible in the practice of dental hygiene and dentistry.

DIF: Comprehension REF: p. 26 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 7. All of the following statements are true; however, which one takes precedence over the rest? a. One ought not to inflict harm. b. One ought to prevent harm. c. One ought to remove harm. d. One ought to do or promote good.

ANS: A

Nonmaleficence, the avoidance of harm, takes precedence over the rest of the choices, which define beneficence, or the promotion of good. Not inflicting harm takes precedence over preventing harm, and removing harm is a higher priority than promoting good.

DIF: Recall REF: p. 27 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 8. Which of the following refers to the most basic, historic principle of nonmaleficence rather

than beneficence? a. One ought to do or promote good. b. One ought to prevent harm. c. One ought to remove hT arEmS. TBANKSELLER.COM d. One ought not to inflict harm.

ANS: D

The first obligation is to do no harm. The Hippocratic Oath requires that the health care provider promise to keep the sick from harm and injustice. The American Dental Association’s (ADA) publication, Principles of Ethics and Code of Professional Conduct, states that “the principle expresses the concept that professionals have a duty to protect the patient from harm.” Over time the definition of nonmaleficence has evolved to include preventing and removing harm. Beneficence focuses on doing good for the patient.

DIF: Recall REF: p. 27 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 9. Nonmaleficence is concerned with doing no harm to a patient. Beneficence requires that

existing harm be removed. 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

Beneficence focuses on “doing good” for the patient. Doing good requires taking all appropriate actions to restore patients to good health. Health care providers, based on their knowledge and skill, use all reasonable means to benefit the patient. Beneficence and nonmaleficence are linked because they are both founded in the Hippocratic tradition, which requires the physician to do what will best benefit the patient.

DIF: Recall REF: p. 27 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 10. The promotion of good for the public can be difficult, because good is defined according to

differing values and belief systems. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

The teaching of careful oral hygiene self-care to maintain health and function is an example of promotion of good to many people. However, the removal of all carious teeth to eliminate pain and suffering may be considered promoting good to other individuals.

DIF: Recall REF: p. 27 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 11. Which of the following principles is self-determination and the ability to be self-governing

and self-directing? a. Beneficence b. Autonomy c. Justice d. Paternalism e. Veracity ANS: B

An autonomous person chooses thoughts and actions relevant to his or her needs, independent from the will of others. In health care autonomy gives rise to the concept of permitting individuals to make decisions about their own health. Beneficence is directed toward the practitioner and focuses on removing existing harm and doing good for the patient. Justice is concerned with providing individuals or groups with what is owed, due, or deserved.

Paternalism means that the health care professional acts as a parent and makes decisions for the patient on the basis of what the professional believes is in the best interest of the patient.

Veracity is being honest and telling the truth.

DIF: Recall REF: p. 28 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 12. The application of patient autonomy is based upon which of the following theories of ethical

thinking? a. Virtue ethics b. Consequentialism c. Nonconsequentialism

ANS: C

The application of autonomy is founded in deontology and is based on respect for persons.

The deontologist holds that the health care provider has a duty to allow patients to make decisions about actions that will affect their bodies. The health care provider also has a duty to provide patients with all the unbiased information they would need to make a decision about treatment options.

DIF: Recall REF: p. 28 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 13. A practitioner must provide the treatment chosen by a patient even if he or she does not agree

with it, because the patient has a right to choose based on the principle of autonomy. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: D

This is an area where potential for conflict exists between what the dentist and/or dental hygienist believes is in the best interest of the patient and what the patient believes is in his or her best interest. Sometimes what the professional believes is best for the patient is not what the patient elects to do. As long as the patient selects from treatment options that are consistent with accepted standards of care, the professional may ethically act on the patient’s choice. However, the professional practitioner also has the autonomy not to provide a service requested by the patient if the service is in conflict with the standards of patient care.

DIF: Comprehension REF: p. 28 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 14. Which of the following principles is concerned with providing individuals or groups with

what is owed, due, or deserved? a. Nonmaleficence b. Beneficence c. Autonomy d. Justice ANS: D

The principle of justice is concerned with providing individuals or groups with what is owed, due, or deserved. The foundation of justice has frequently been described as the principle of equality. Nonmaleficence is to avoid doing harm and beneficence is to do good. Autonomy is self-determination and the ability to be self-governing and self-directing.

DIF: Recall REF: p. 28 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 15. Fundamental to the principle of justice is an effort to treat people who have similar needs in a

similar or identical manner. All patients who seek treatment for the prevention of periodontal disease should receive the same level of care and attention from the dental hygienist regardless of personal or social characteristics. 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

Regardless of age, gender, social status, religion, or other distinguishing factors, each person should be entitled to the same oral health care options when a similar health care need exists.

This is stated in the American Dental Hygienists’ Association Code of Ethics for Dental Hygienists four Basic Beliefs “All people should have access to health care, including oral health care.” Seven Standards of Professional Responsibility to Clients “Serve all clients without discrimination and avoid action toward any individual or group that may be interpreted as discriminatory.”

DIF: Recall REF: p. 28 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 16. Which of the following terms is used to describe the allocation of resources in large social

systems? a. Autonomy b. Distributive justice c. Prima facie duty d. Primum non nocere ANS: B

Every society must address the problem of how its resources will be distributed because every society has a scarcity of resources. Resources are scarce whether referring to materials, specially trained individuals, money, or time. Autonomy is a principle of self-determination and the ability to be self-goTvEerSnT inB gAanNdKsSelEf-L dL ireEcR tin.gC. O PrMima facie duty is a duty that must be done before any other considerations enter the picture. Primum non nocere means to first do no harm.

DIF: Recall REF: p. 28 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 17. The provision of dental care is applied equally in the United States. People who present for

treatment are granted access based on their dental needs. 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

The provision of dental care is applied unequally. No legal mandate exists for medical and dental care to be available to all persons, and decisions are made daily according to the ability of the patient to pay for the services rendered. People who present for treatment are, for the most part, granted access to care based on their economic ability and not their dental needs.

DIF: Comprehension REF: p. 28 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent

18. Charitable service meets the needs of those who cannot access dental care for economic

reasons, because many dental hygienists and dentists recognize their obligation to serve society. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: D

Charitable service does not come close to meeting the needs of those who cannot access dental care. Many dental hygienists and dentists provide charitable services on a regular basis, either in a private practice office or through participation in a community-based service clinic, because of their recognition of their obligation to serve society. This is stated in the ADHA Code of Ethics.

DIF: Comprehension REF: p. 29 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 19. Which of the following means that the health care professional acts as a parent and makes

decisions for the patient? a. Veracity b. Informed consent c. Paternalism d. Confidentiality ANS: C

Paternalism means the heaT lthES caT reBpAroNfK esS siE onLaL lE acRts.aC sO aM parent and makes decisions for the patient on the basis of what the professional believes is in the best interest of the patient.

Paternalism should never be applied primarily to benefit the professional at the expense of the patient. Veracity is defined as being honest and telling the truth. Informed consent requires the professional to provide the patient with all relevant information needed to make a decision. It also allows the patient to make the decision on the basis of the information provided.

Confidentiality is related to respect for persons and involves the patient exercising his or her autonomy in providing information to the professional.

DIF: Recall REF: pp. 29-30 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 20. Which of the following ethical values and concepts is thought to be in the most conflict with

autonomy? a. Paternalism b. Veracity c. Informed consent d. Confidentiality ANS: A

Paternalism should never be applied primarily to benefit the professional at the expense of the patient. Many would argue that paternalism should never be applied because it subverts the autonomous wishes of the patient. A dentist or dental hygienist cannot unilaterally act on behalf of the patient without denying the patient’s right to exercise autonomy.

DIF: Recall REF: p. 30 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 21. Paternalism was more prevalent in health care in the past because the health care provider had

superior knowledge and skills and because the patient expected the health care provider to make decisions in the best interest of the patient. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

Patients often had no knowledge that alternative care options were available. Even if patients did know other options existed, many placed the professional in a parental role by asking the professional what they should do. The historic benchmark for refuting paternalism was a political philosophy essay written by Mills in the mid-1800s.

DIF: Recall REF: p. 30 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 22. Educating the patient about the balance of benefits and risks of treatment often creates a

conflict between autonomy and a. paternalism. b. justice. c. beneficence. d. veracity.

ANS: C

This aspect of providing ethical care is most important and requires the dental hygienist to take the time and effort to ensure that the patient has all the knowledge required to make health decisions. A dental hygienist or dentist can also refuse to perform a procedure that he or she considers to not be in the best interest of the patient.

DIF: Comprehension REF: p. 30 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 23. Veracity is being honest and telling the truth. Honesty on the part of patient and clinician

allows the patient to use his or her autonomy to make decisions in his or her own best interest. 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

Veracity is defined as being honest and telling the truth. Patients are expected to be truthful about their medical history, treatment expectations, and other relevant facts. Clinicians must be truthful about the diagnosis, treatment options, benefits and disadvantages of each treatment option, cost of treatment, and the longevity afforded by the various treatment options. This allows patients to use their autonomy to make decisions in their own best interest.

DIF: Comprehension REF: p. 30 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 24. Benevolent deception is supported by most codes of ethics because benevolent deception is in

the tradition of the Hippocratic Oath. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: D

Benevolent deception is the name given to the practice of withholding information from a patient because of the clinician’s belief that the information may harm the individual. This practice is in the tradition of the Hippocratic Oath but is not supported by most codes of ethics and then only in extraordinary circumstances. The interactive health care relationship between patient and clinician functions most effectively when both parties are truthful and adhere to all promises made in the process.

DIF: Comprehension REF: pp. 30-31 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 25. The right of the patient to assess all the information provided by the professional yet still

make a choice that is not the one most valued by the professional is known as a. cognitive dissonance. b. informed refusal. c. a fork in the road. d. independent thinking.

ANS: B

Accepting the decision of the patient when it is in conflict with what the health care provider would most likely recommend is extremely difficult for the dental professional. Dentists and dental hygienists must recognize that the patient has a right to informed consent as well as a right to make an informed refusal. Respecting the autonomy of individuals as self-determining agents recognizes their right to make their own choices and determine their own destiny.

DIF: Comprehension REF: p. 31 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 26. Each of the following circumstances requires informed consent prior to treatment EXCEPT

one. Which one is the EXCEPTION? a. A patient who is a child b. A patient mentally disabled person c. A patient with a language barrier d. A patient whose life is in danger ANS: D

It is an exception to a requirement for informed consent if a patient’s life is in danger and an immediate procedure is required to save that life. Children and people who are mentally disabled typically have a parent or caregiver who assumes the function of informed consent.

Informed consent when the patient does not understand because of a language barrier is not possible, and steps must be taken to remedy the situation. The use of a translator, family member, or other communication option must be pursued to ensure that the patient fully understands the choices and consequences.

DIF: Recall REF: pp. 31-32 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 27. The term used to describe a person’s ability to understand his or her health care conditions,

treatment options, and ability to make his or her own decisions is a. judgment. b. free will. c. capacity. d. cognition.

ANS: C

Capacity is a clinical term used to describe the ability to understand one’s health care conditions, treatment options, and ability to make decisions. Capacity or competence is a prerequisite for an individual to make informed consent.

DIF: Recall REF: p. 32 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 28. Which of the following is the recommended method of assuring that a patient has the capacity

to make an informed conseTnE t?STBANKSELLER.COM a. Using language at the sixth-grade level b. Providing written instructions c. Speaking very slowly while looking directly at the patient d. Reaching out to the family, primary care physician, or surrogate decision maker ANS: D

It is not uncommon for an individual to have transient or diminished capacity, which is the ability to express his or her wishes on one day and not the next. Being aware of the issues of capacity will assist the dental hygienist in providing ethical and legal oral health treatment to geriatric populations.

DIF: Comprehension REF: p. 32 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 29. What percentage of Americans will be 65 years of age or older by the year 2030? a. 10 b. 20 c. 30 d. 40 ANS: B

The Census Bureau predicts that one-in-five Americans will be 65 years of age or older by the year 2030. Older individuals are not only becoming a larger percentage of the population but they are also living longer. This fact will have far-reaching consequences for the delivery of health care.

DIF: Recall REF: p. 32 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 30. Which of the following values and concepts is related to respect for persons and involves the

patient exercising his or her autonomy in providing information to the professional? a. Veracity b. Capacity c. Confidentiality d. Paternalism ANS: C

Confidentiality is a critical aspect of trust and has a long history of use in the healing arts. The requirement for confidentiality is mentioned in all codes of ethics as well as the Hippocratic Oath. A patient has a right to privacy concerning his or her medical and dental history, examination findings, discussion of treatment options and treatment choices, and all records pertaining to dental and dental hygiene care.

DIF: Recall REF: p. 32 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 31. It is illegal for a dentist to report suspected child abuse to authorities because it is a violation

of confidentiality. a. Both the statement andTrE eaSsoTnBaA reNcKoS rrE ecLt L anEdRre.laCtO edM. b. Both the statement and 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.

ANS: D

Reporting suspected child abuse, which is required in most states, is a violation of confidentiality. Conflicts and exceptions arise surrounding the principle of confidentiality. In dealing with minor children, divulging confidential information to the parents may be necessary to protect the child from harm.

DIF: Comprehension REF: p. 32 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 32. The dental hygienist who suspects child abuse should place the welfare of the child over the

autonomy of the parent. The stronger duty in this instance is the good of the child, not the right of the parent. 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

Prima facie duties, with supporting principles and values, can provide the dental hygienist guidance in the decision-making process. They do not automatically provide correct ethical decisions because they sometimes are in conflict with each other. A choice must be made regarding which rule or value has precedence.

DIF: Comprehension REF: p. 33 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 33. Which of the following fundamental principles of the American Dental Hygiene Association

is a characteristic that states that if two or more people consider the same action or trait in the same situation, the same conclusion would be drawn? a. Community b. Complementarity c. Responsibility d. Universality e. Ethics ANS: D

If a given situation were duplicated, it would lead to the same evaluative result each time.

Complementarity can be described as doing the greatest good for the greatest number of persons.

DIF: Recall REF: p. 33 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 34. Which of the following principles is found in the American Dental Hygiene Association code

but not in the American Dental Association code? a. Beneficence b. Nonmaleficence c. Veracity d. Societal trust ANS: D

Societal trust and confidentiality are found in the ADHA Code but not in the ADA Code.

Autonomy, beneficence, nonmaleficence, justice, and veracity are found in both codes.

DIF: Comprehension REF: p. 34 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent

Chapter 03: Ethical Principles and Values Beemsterboer: Ethics and Law in Dental Hygiene, 3rd Edition MULTIPLE CHOICE 1. Each of the following is one of the main normative principles in health care EXCEPT one.

Which one is the EXCEPTION? a. Nonmaleficence b. Beneficence c. Autonomy d. Justice e. Veracity ANS: E

Veracity is not one of the main normative principles. The main normative principles in health care are nonmaleficence, beneficence, autonomy, and justice. These principles provide direction about what should and should not be done in specific situations.

DIF: Recall REF: p. 25 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 2. Normative ethical principles are linked to commonly expected behaviors, because they are

based on shared standards of thinking and behaving. a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related. c. The statement is correct, but the reason is NOT. TESTBANKSELLER.COM d. The statement is NOT correct, but the reason is correct. e. NEITHER the statement NOR the reason is correct.

ANS: A

Normative principles provide a cognitive framework for analyzing moral questions and problems. These principles are associated with expectations for behavior and provide guidelines for dealing with right and wrong actions.

DIF: Recall REF: p. 25 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 3. An ethical dilemma occurs when one or more ethical principles a. are in conflict. b. are involved. c. are additive with one another. d. cancel each other out.

ANS: A

It occurs when one or more ethical principles are in conflict. Weighing and balancing ethical principles are the major tasks involved in ethical decision making. What is in the patient’s best interest may be open to question depending on whose perspective is being considered.

DIF: Recall REF: p. 25 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent

4. The principle that the first obligation of a health care provider is to do no harm is known as

which of the following? a. Integrity b. Justice c. Beneficence d. Nonmaleficence ANS: D

Patients place themselves in the care of another person and, at a minimum, should expect that no additional harm will result from that act. The patient grants another person the privilege of access to a portion of his or her body for an explicit purpose, a privilege founded in trust.

Fundamental to that trust is that the health care provider will do no harm to the patient.

Whereas nonmaleficence is concerned with doing no harm to a patient beneficence requires that existing harm be removed. Professional integrity is a commitment to upholding the Code of Ethics and the standards of care. The principle of justice is concerned with providing individuals or groups with what is owed, due, or deserved.

DIF: Recall REF: p. 25 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 5. Dental hygienists are required to maintain their level of knowledge and skill through

participation in which of the following? a. Graduation from an accredited institution where dental hygiene is taught b. Appropriate continuing education programs c. Using standardized operating procedures d. Using top quality rather than inferior quality materials ANS: B

Practitioners are required to maintain their level of knowledge and skill through participation in appropriate continuing education programs. Someone could have graduated from an accredited institution and use standardized operating procedures and good quality materials; however, they need to stay current with changes in treatment procedures and regulations. A dental hygienist who is unfamiliar with sealant placement procedures or local anesthesia techniques should defer performing that service until achieving competency.

DIF: Recall REF: p. 26 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 6. A health care provider may not always be able to avoid harm, because causing some degree of

harm when that harm will lead to a greater good may be necessary. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

This conflict is referred to as The Principle of Double Effect and it requires the health care provider to consider the risks and benefits whenever treatment is provided. The hierarchy of nonmaleficence and beneficence provides the clinician with a guideline to follow in sorting out dilemmas in practice. Avoiding all harm and promoting good are not always possible in the practice of dental hygiene and dentistry.

DIF: Comprehension REF: p. 26 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 7. All of the following statements are true; however, which one takes precedence over the rest? a. One ought not to inflict harm. b. One ought to prevent harm. c. One ought to remove harm. d. One ought to do or promote good.

ANS: A

Nonmaleficence, the avoidance of harm, takes precedence over the rest of the choices, which define beneficence, or the promotion of good. Not inflicting harm takes precedence over preventing harm, and removing harm is a higher priority than promoting good.

DIF: Recall REF: p. 27 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 8. Which of the following refers to the most basic, historic principle of nonmaleficence rather

than beneficence? a. One ought to do or promote good. b. One ought to prevent harm. c. One ought to remove hT arEmS. TBANKSELLER.COM d. One ought not to inflict harm.

ANS: D

The first obligation is to do no harm. The Hippocratic Oath requires that the health care provider promise to keep the sick from harm and injustice. The American Dental Association’s (ADA) publication, Principles of Ethics and Code of Professional Conduct, states that “the principle expresses the concept that professionals have a duty to protect the patient from harm.” Over time the definition of nonmaleficence has evolved to include preventing and removing harm. Beneficence focuses on doing good for the patient.

DIF: Recall REF: p. 27 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 9. Nonmaleficence is concerned with doing no harm to a patient. Beneficence requires that

existing harm be removed. 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

Beneficence focuses on “doing good” for the patient. Doing good requires taking all appropriate actions to restore patients to good health. Health care providers, based on their knowledge and skill, use all reasonable means to benefit the patient. Beneficence and nonmaleficence are linked because they are both founded in the Hippocratic tradition, which requires the physician to do what will best benefit the patient.

DIF: Recall REF: p. 27 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 10. The promotion of good for the public can be difficult, because good is defined according to

differing values and belief systems. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

The teaching of careful oral hygiene self-care to maintain health and function is an example of promotion of good to many people. However, the removal of all carious teeth to eliminate pain and suffering may be considered promoting good to other individuals.

DIF: Recall REF: p. 27 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 11. Which of the following principles is self-determination and the ability to be self-governing

and self-directing? a. Beneficence b. Autonomy c. Justice d. Paternalism e. Veracity ANS: B

An autonomous person chooses thoughts and actions relevant to his or her needs, independent from the will of others. In health care autonomy gives rise to the concept of permitting individuals to make decisions about their own health. Beneficence is directed toward the practitioner and focuses on removing existing harm and doing good for the patient. Justice is concerned with providing individuals or groups with what is owed, due, or deserved.

Paternalism means that the health care professional acts as a parent and makes decisions for the patient on the basis of what the professional believes is in the best interest of the patient.

Veracity is being honest and telling the truth.

DIF: Recall REF: p. 28 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 12. The application of patient autonomy is based upon which of the following theories of ethical

thinking? a. Virtue ethics b. Consequentialism c. Nonconsequentialism

ANS: C

The application of autonomy is founded in deontology and is based on respect for persons.

The deontologist holds that the health care provider has a duty to allow patients to make decisions about actions that will affect their bodies. The health care provider also has a duty to provide patients with all the unbiased information they would need to make a decision about treatment options.

DIF: Recall REF: p. 28 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 13. A practitioner must provide the treatment chosen by a patient even if he or she does not agree

with it, because the patient has a right to choose based on the principle of autonomy. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: D

This is an area where potential for conflict exists between what the dentist and/or dental hygienist believes is in the best interest of the patient and what the patient believes is in his or her best interest. Sometimes what the professional believes is best for the patient is not what the patient elects to do. As long as the patient selects from treatment options that are consistent with accepted standards of care, the professional may ethically act on the patient’s choice. However, the professional practitioner also has the autonomy not to provide a service requested by the patient if the service is in conflict with the standards of patient care.

DIF: Comprehension REF: p. 28 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 14. Which of the following principles is concerned with providing individuals or groups with

what is owed, due, or deserved? a. Nonmaleficence b. Beneficence c. Autonomy d. Justice ANS: D

The principle of justice is concerned with providing individuals or groups with what is owed, due, or deserved. The foundation of justice has frequently been described as the principle of equality. Nonmaleficence is to avoid doing harm and beneficence is to do good. Autonomy is self-determination and the ability to be self-governing and self-directing.

DIF: Recall REF: p. 28 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 15. Fundamental to the principle of justice is an effort to treat people who have similar needs in a

similar or identical manner. All patients who seek treatment for the prevention of periodontal disease should receive the same level of care and attention from the dental hygienist regardless of personal or social characteristics. 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

Regardless of age, gender, social status, religion, or other distinguishing factors, each person should be entitled to the same oral health care options when a similar health care need exists.

This is stated in the American Dental Hygienists’ Association Code of Ethics for Dental Hygienists four Basic Beliefs “All people should have access to health care, including oral health care.” Seven Standards of Professional Responsibility to Clients “Serve all clients without discrimination and avoid action toward any individual or group that may be interpreted as discriminatory.”

DIF: Recall REF: p. 28 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 16. Which of the following terms is used to describe the allocation of resources in large social

systems? a. Autonomy b. Distributive justice c. Prima facie duty d. Primum non nocere ANS: B

Every society must address the problem of how its resources will be distributed because every society has a scarcity of resources. Resources are scarce whether referring to materials, specially trained individuals, money, or time. Autonomy is a principle of self-determination and the ability to be self-goTvEerSnT inB gAanNdKsSelEf-L dL ireEcR tin.gC. O PrMima facie duty is a duty that must be done before any other considerations enter the picture. Primum non nocere means to first do no harm.

DIF: Recall REF: p. 28 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 17. The provision of dental care is applied equally in the United States. People who present for

treatment are granted access based on their dental needs. 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

The provision of dental care is applied unequally. No legal mandate exists for medical and dental care to be available to all persons, and decisions are made daily according to the ability of the patient to pay for the services rendered. People who present for treatment are, for the most part, granted access to care based on their economic ability and not their dental needs.

DIF: Comprehension REF: p. 28 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent

18. Charitable service meets the needs of those who cannot access dental care for economic

reasons, because many dental hygienists and dentists recognize their obligation to serve society. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: D

Charitable service does not come close to meeting the needs of those who cannot access dental care. Many dental hygienists and dentists provide charitable services on a regular basis, either in a private practice office or through participation in a community-based service clinic, because of their recognition of their obligation to serve society. This is stated in the ADHA Code of Ethics.

DIF: Comprehension REF: p. 29 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 19. Which of the following means that the health care professional acts as a parent and makes

decisions for the patient? a. Veracity b. Informed consent c. Paternalism d. Confidentiality ANS: C

Paternalism means the heaT lthES caT reBpAroNfK esS siE onLaL lE acRts.aC sO aM parent and makes decisions for the patient on the basis of what the professional believes is in the best interest of the patient.

Paternalism should never be applied primarily to benefit the professional at the expense of the patient. Veracity is defined as being honest and telling the truth. Informed consent requires the professional to provide the patient with all relevant information needed to make a decision. It also allows the patient to make the decision on the basis of the information provided.

Confidentiality is related to respect for persons and involves the patient exercising his or her autonomy in providing information to the professional.

DIF: Recall REF: pp. 29-30 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 20. Which of the following ethical values and concepts is thought to be in the most conflict with

autonomy? a. Paternalism b. Veracity c. Informed consent d. Confidentiality ANS: A

Paternalism should never be applied primarily to benefit the professional at the expense of the patient. Many would argue that paternalism should never be applied because it subverts the autonomous wishes of the patient. A dentist or dental hygienist cannot unilaterally act on behalf of the patient without denying the patient’s right to exercise autonomy.

DIF: Recall REF: p. 30 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 21. Paternalism was more prevalent in health care in the past because the health care provider had

superior knowledge and skills and because the patient expected the health care provider to make decisions in the best interest of the patient. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

Patients often had no knowledge that alternative care options were available. Even if patients did know other options existed, many placed the professional in a parental role by asking the professional what they should do. The historic benchmark for refuting paternalism was a political philosophy essay written by Mill in the mid-1800s.

DIF: Recall REF: p. 30 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 22. Educating the patient about the balance of benefits and risks of treatment often creates a

conflict between autonomy and a. paternalism. b. justice. c. beneficence. d. veracity.

ANS: C

This aspect of providing ethical care is most important and requires the dental hygienist to take the time and effort to ensure that the patient has all the knowledge required to make health decisions. A dental hygienist or dentist can also refuse to perform a procedure that he or she considers to not be in the best interest of the patient.

DIF: Comprehension REF: p. 30 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 23. Veracity is being honest and telling the truth. Honesty on the part of patient and clinician

allows the patient to use his or her autonomy to make decisions in his or her own best interest. 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

Veracity is defined as being honest and telling the truth. Patients are expected to be truthful about their medical history, treatment expectations, and other relevant facts. Clinicians must be truthful about the diagnosis, treatment options, benefits and disadvantages of each treatment option, cost of treatment, and the longevity afforded by the various treatment options. This allows patients to use their autonomy to make decisions in their own best interest.

DIF: Comprehension REF: p. 30 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 24. Benevolent deception is supported by most codes of ethics because benevolent deception is in

the tradition of the Hippocratic Oath. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: D

Benevolent deception is the name given to the practice of withholding information from a patient because of the clinician’s belief that the information may harm the individual. This practice is in the tradition of the Hippocratic Oath but is not supported by most codes of ethics and then only in extraordinary circumstances. The interactive health care relationship between patient and clinician functions most effectively when both parties are truthful and adhere to all promises made in the process.

DIF: Comprehension REF: pp. 30-31 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 25. The right of the patient to assess all the information provided by the professional yet still

make a choice that is not the one most valued by the professional is known as a. cognitive dissonance. b. informed refusal. c. a fork in the road. d. independent thinking.

ANS: B

Accepting the decision of the patient when it is in conflict with what the health care provider would most likely recommend is extremely difficult for the dental professional. Dentists and dental hygienists must recognize that the patient has a right to informed consent as well as a right to make an informed refusal. Respecting the autonomy of individuals as self-determining agents recognizes their right to make their own choices and determine their own destiny.

DIF: Comprehension REF: p. 31 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 26. Each of the following circumstances requires informed consent prior to treatment EXCEPT

one. Which one is the EXCEPTION? a. A patient who is a child b. A patient mentally disabled person c. A patient with a language barrier d. A patient whose life is in danger ANS: D

It is an exception to a requirement for informed consent if a patient’s life is in danger and an immediate procedure is required to save that life. Children and people who are mentally disabled typically have a parent or caregiver who assumes the function of informed consent.

Informed consent when the patient does not understand because of a language barrier is not possible, and steps must be taken to remedy the situation. The use of a translator, family member, or other communication option must be pursued to ensure that the patient fully understands the choices and consequences.

DIF: Recall REF: pp. 31-32 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 27. The term used to describe a person’s ability to understand his or her health care conditions,

treatment options, and ability to make his or her own decisions is a. judgment. b. free will. c. capacity. d. cognition.

ANS: C

Capacity is a clinical term used to describe the ability to understand one’s health care conditions, treatment options, and ability to make decisions. Capacity or competence is a prerequisite for an individual to make informed consent.

DIF: Recall REF: p. 32 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 28. Which of the following is the recommended method of assuring that a patient has the capacity

to make an informed conseTnE t?STBANKSELLER.COM a. Using language at the sixth-grade level b. Providing written instructions c. Speaking very slowly while looking directly at the patient d. Reaching out to the family, primary care physician, or surrogate decision maker ANS: D

It is not uncommon for an individual to have transient or diminished capacity, which is the ability to express his or her wishes on one day and not the next. Being aware of the issues of capacity will assist the dental hygienist in providing ethical and legal oral health treatment to geriatric populations.

DIF: Comprehension REF: p. 32 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 29. What percentage of Americans will be 65 years of age or older by the year 2030? a. 10 b. 20 c. 30 d. 40 ANS: B

The Census Bureau predicts that one-in-five Americans will be 65 years of age or older by the year 2030. Older individuals are not only becoming a larger percentage of the population but they are also living longer. This fact will have far-reaching consequences for the delivery of health care.

DIF: Recall REF: p. 32 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 30. Which of the following values and concepts is related to respect for persons and involves the

patient exercising his or her autonomy in providing information to the professional? a. Veracity b. Capacity c. Confidentiality d. Paternalism ANS: C

Confidentiality is a critical aspect of trust and has a long history of use in the healing arts. The requirement for confidentiality is mentioned in all codes of ethics as well as the Hippocratic Oath. A patient has a right to privacy concerning his or her medical and dental history, examination findings, discussion of treatment options and treatment choices, and all records pertaining to dental and dental hygiene care.

DIF: Recall REF: p. 32 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 31. It is illegal for a dentist to report suspected child abuse to authorities because it is a violation

of confidentiality. a. Both the statement andTrE eaSsoTnBaA reNcKoS rrE ecLt L anEdRre.laCtO edM. b. Both the statement and 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.

ANS: D

Reporting suspected child abuse, which is required in most states, is a violation of confidentiality. Conflicts and exceptions arise surrounding the principle of confidentiality. In dealing with minor children, divulging confidential information to the parents may be necessary to protect the child from harm.

DIF: Comprehension REF: p. 32 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 32. The dental hygienist who suspects child abuse should place the welfare of the child over the

autonomy of the parent. The stronger duty in this instance is the good of the child, not the right of the parent. 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

Prima facie duties, with supporting principles and values, can provide the dental hygienist guidance in the decision-making process. They do not automatically provide correct ethical decisions because they sometimes are in conflict with each other. A choice must be made regarding which rule or value has precedence.

DIF: Comprehension REF: p. 33 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 33. Which of the following fundamental principles of the American Dental Hygiene Association

is a characteristic that states that if two or more people consider the same action or trait in the same situation, the same conclusion would be drawn? a. Community b. Complementarity c. Responsibility d. Universality e. Ethics ANS: D

If a given situation were duplicated, it would lead to the same evaluative result each time.

Complementarity can be described as doing the greatest good for the greatest number of persons.

DIF: Recall REF: p. 33 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 34. Which of the following principles is found in the American Dental Hygiene Association code

but not in the American Dental Association code? a. Beneficence b. Nonmaleficence c. Veracity d. Societal trust ANS: D

Societal trust and confidentiality are found in the ADHA Code but not in the ADA Code.

Autonomy, beneficence, nonmaleficence, justice, and veracity are found in both codes.

DIF: Comprehension REF: p. 34 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent

Chapter 04: Social Responsibility Beemsterboer: Ethics and Law in Dental Hygiene, 3rd Edition MULTIPLE CHOICE 1. When was the first Surgeon General’s Report on Oral Health published? a. 1850 b. 1900 c. 1950 d. 2000 ANS: D

It was published in 2000. This landmark report described the meaning of oral health and explained why oral health is essential to general health and well-being. After the publication of more than 50 surgeon general reports, to have one specifically on oral health was a major event and highlighted how much progress had been made in understanding common oral diseases. The report established that oral health is integral to general health and that the two should not be looked at separately.

DIF: Recall REF: p. 35 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 2.

The use of “oral health” and not “dental health” was a deliberate choice of words in the first Surgeon General’s Report on Oral Health because oral health is equivalent to healthy teeth. a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related.

TESTBANKSELLER.COM 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: C

The use of “oral health” was a deliberate choice because oral health means more than healthy teeth. The report included conditions and diseases such as oral cancers, lesions of the head and neck, birth defects, and facial pain. Oral health is a critical component of overall health.

DIF: Comprehension REF: p. 35 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 3. Disparities and inequalities in oral health care affect the most vulnerable populations. These

groups cannot access care for financial reasons, but lack of access also can be caused by fear and complex psychosocial or cultural assumptions. 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

How to address this need is a social responsibility of all health care professionals working with public and private agencies. It is a complex and challenging problem in which the dental hygienist is well suited to be an active participant. There are many factors besides finances that must be identified when determining why certain populations become patients and others do not. Social, political, economic, and cultural factors clearly underlie the complex social problem of inequality. Although these problems are not new, they continue to confound and frustrate.

DIF: Comprehension REF: p. 36 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 4. It is expected that racial and ethnic minority groups will constitute the emerging majority of

the U.S. population by a. 2030. b. 2040. c. 2050. d. 2060.

ANS: C

What was the minority will become the majority. Various populations have different perceptions and expectations of health care delivery and will utilize health services in different ways. This shift will have far-reaching implications for the delivery of health care.

DIF: Recall REF: p. 36 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 5. More than how many people in the United States are estimated to be underinsured or have no

health insurance? a. 26 million b. 37 million c. 47 million d. 57 million ANS: C

This is a great concern for the public health and well-being of the country. An even larger percentage of the population does not have dental insurance or has minimal dental benefits.

People are more likely to utilize health care services when they have benefits. Unfortunately, the outcome of no insurance or underinsurance is that people are less likely to receive services and are more likely to wait to receive services until the situation is urgent and the solution is more extensive and expensive.

DIF: Recall REF: p. 36 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 6. How does dental hygiene fit with the goals of health promotion that have been established by

the U.S. Department of Health and Human Services? a. Dental hygienists are focused on prevention. b. Dental hygienists are well-respected professionals. c. Dental hygienists are licensed by their respective State Board of Dentistry. d. Dental hygienists can collaborate with fellow health care professionals.

ANS: A

All of the statements are true, however, according to the text, "(D)ental hygienists are focused on prevention, a focus that fits well with the goals of health promotion that have been established by the U.S. Department of Health and Human Services." Dental hygienists are the primary preventive therapists in the dental office. It is the focus on prevention the fits with the goals of health promotion.

DIF: Comprehension REF: p. 36 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 7. The concept of service and the aspirations for professionalism in dental hygiene are

established in which of the following documents? a. Guidelines for Infection Control in Dental Health-Care Settings—Centers for Disease Control b. The American Dental Hygiene Association (ADHA) Code of Ethics c. The American Dental Association (ADA) Code of Ethics d. The State Board of Dentistry for the respective state ANS: B

Listed under Standards of Professional Responsibility, Community, and Society are several points that include increasing access to care, promoting public health, supporting justice, and recognizing an obligation to provide pro bono service. The Guidelines for Infection Control in Dental Health-Care Settings contains recommendations for preventing and controlling infectious diseases and managing health and safety concerns for people in dental health care settings. The American Dental Association Code of Ethics is a similar publication for dentists.

The State Board of Dentistry governs the practice of dentistry for the state according to legislative mandate.

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OBJ: 1 DIF: Recall REF: p. 37 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 8. Listed under the American Dental Hygiene Association (ADHA) Standards of Professional

Responsibility, Community, and Society are several points that include all of the following EXCEPT one. Which one is the EXCEPTION? a. Increasing access to care b. Promoting public health c. Recognizing an obligation to provide pro bono service d. Veracity ANS: D

Veracity is one of the Core Values rather than Standards of Professional Responsibility. As a group, dental hygienists aspire to make a contribution to the public and to enhance for all the ability to seek and receive dental care resources.

DIF: Recall REF: p. 37 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 9. How the dental hygienist uses his or her skills and knowledge to advance the public good is

part of the obligation laid out in which of the following? a. Code of Ethics b. Curriculum vitae c. Prima facie duties

d. Res gestae ANS: A

It is part of the obligation in the Code of Ethics and embraced in the essence of a professional person. We must consider our obligations as a group, not just individuals who are members of a group, by honoring the principle in the Code of Ethics and sharing ethical concerns as a moral community. A curriculum vitae is used during the process of applying for employment.

Prima facie duties are things that must be done before other considerations. Res gestae is a legal term for things done.

DIF: Recall REF: p. 37 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 10. Which of the following is an ethical principle that focuses on the individual rather than

society? a. Stewardship b. Justice c. Autonomy d. Caring ANS: C

The values of caring, stewardship, and justice are of great importance for achieving ethical goals in health care, the goals that focus on society. These are different from the ethical principles that focus on the individual, such as autonomy and self-determination.

DIF: Recall REF: p. 37 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 11. Defining basic dental care is a daunting task that challenges communities and the federal

government. The goal of improving the health of the population is a societal greater good benefiting society at large. 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

It is difficult to define basic dental care. Does basic dental care mean extractions only? For children, are fluoride treatments and sealants considered basic? For adults, are full-mouth images and restorations considered basic? What about restorative treatment without periodontal treatment? We also have a responsibility to those who are unaware of need, do not seek it, cannot get to it, or are afraid of it.

DIF: Comprehension REF: p. 37 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 12. Two Institute of Medicine reports in the early 2000s advocated increased professionalism and

which of the following as a part of improving quality and bridging gaps in health care? a. More federal funding b. Development of a nationalized dental delivery system c. Social justice d. Increased delivery of sealants

ANS: C

It advocated increased professionalism and social justice as a part of improving quality and bridging the gaps in health care. Numerous authors and national experts have addressed the importance of teaching social responsibility as part of professionalism. The majority of practitioners prefer to practice in urban or suburban areas rather than rural locations. Some communities have offered to repay student debt as an incentive for a clinician to practice in their location for a time following matriculation from professional school.

DIF: Recall REF: p. 38 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 13. In 2003, the American Dental Education Association (ADEA) published a report that

advocated which of the following? a. Preparing future dental professionals to commit to delivering oral health care to all populations b. Establishing student loan forgiveness programs c. Recommending that restorable teeth receive periodontal treatment rather than extraction d. Redistribution of recent graduates to underserved areas ANS: A

The American Dental Education Association defined its role and responsibility with its member institutions in improving the oral health status of all Americans in a report in 2003 and is now an established association policy. The findings stressed the importance of increasing the diversity of the oral health workforce and teaching and exhibiting values that prepare future dental professionals to commit to delivering oral health care to all populations, LLthEeRh.eaCltOhMcare professions is that including the underserved.TTEhS eT mB esAsaNgK eS frE om professionalism includes social responsibility, an ethic of caring and access to that care for all members of society.

DIF: Recall REF: p. 38 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 14. According to the text, a dentist’s decision to participate or not in a safety net program such as

Medicaid can be viewed as fulfillment of which of the following? a. Establishing adequate reimbursement levels b. The social contract c. Providing a broad range of services d. Ensuring a good practitioner to patient ratio ANS: B

It can be viewed as fulfillment of the social contract and maintaining a social justice perspective. Since only 26.4% of dentists nationally accept Medicaid patients, this can pose a challenge for the dental hygienist who believes in a social purpose perspective. The reasons why dentists choose not to participate in Medicaid are complex and involve more than reimbursement.

DIF: Comprehension REF: p. 38 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent

Chapter 05: Codes of Ethics Beemsterboer: Ethics and Law in Dental Hygiene, 3rd Edition MULTIPLE CHOICE 1. A code of ethics is one of the essential characteristics of a true profession. It is a guideline for

members of a professional group used for self-regulation of the group. 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

A major purpose of a professional code of ethics is to bind the members of a group together by expressing their goals and aspirations, as well as define expected standards of behavior.

The code is the contract the profession makes with society outlining the standards it will adhere to and uphold.

DIF: Recall REF: p. 41 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 2. Ethical codes address each of the following areas EXCEPT one. Which one is the

EXCEPTION? a. Personal integrity b. Dedication c. Hours of continuing education required TESTBANKSELLER.COM d. Principled behavior ANS: C

Ethical codes address the areas of personal integrity, dedication, and principled behavior. The hours of continuing education required are defined by the State Board in the respective state.

It is very important for a practitioner to be aware of the specific requirement for the state in which he or she practices because the hours and subjects required vary from one state to another. The ethical codes do make general statements regarding the need to keep current with professional knowledge and skills. According to the ADHA—7 Standards of Professional Responsibility to Ourselves as Professionals “Enhance professional competencies through continuous learning in order to practice according to high standards of care.” Similarly, it is stated in the ADA Code of Professional Conduct. 2A. Education: “All dentists, therefore, have the obligation of keeping their knowledge and skill current.”

DIF: Comprehension REF: p. 41 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 3. Which of the following types of ethical theories is thought to be of the most influence in

screening applicants for professional schools of health care? a. Consequentialism b. Nonconsequentialism c. Virtue ethics ANS: C

Admission committees aim to select candidates who are the best qualified academically as well as candidates of good character. Part of the selection process often focuses on identifying virtue in the character of applicants. Consequentialism is based upon the thought that whether an action is correct or not is determined and justified by the consequences of the act. The central claim of nonconsequentialist ethics is that an action is right when it conforms to a principle or rule of conduct that meets a requirement of some overriding duty.

DIF: Recall REF: p. 42 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 4. Learning what is expected of a professional reinforces character traits in the developing

student professional through each of the following EXCEPT one. Which one is the EXCEPTION? a. Introducing students to the institution’s code of conduct b. Assuming the entering student does not have the character traits needed to be a true professional c. Familiarizing students with the profession’s code of ethics and professional conduct d. Enforcing adherence to expected professional behaviors when professional codes have been violated ANS: B

Each entering student, until proven otherwise, must be assumed to have the character traits needed to be a true professional. Educational institutions actively seek to indoctrinate students to the goals of the profession and expected professional behaviors. Learning what is expected of that professional person reinforces character traits in the developing professional. This often is accomplished by inTtE roS duTcBinAgNsK tuS deEnL tsLtoER th. eC inO stM itution’s code of conduct, by familiarizing them with the profession’s code of ethics and professional conduct, by faculty serving as positive role models, and by enforcing adherence to expected professional behaviors when professional codes have been violated.

DIF: Comprehension REF: p. 42 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 5. It is the obligation of professionals to help regulate their profession, because the reputation of

the profession and the well-being of the public ultimately rest on a willingness to engage in meaningful self-policing of the profession. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

When violations occur, members of the profession who become aware of these violations have a duty to intervene in a substantive way. The degree to which codes are effective remains a difficult question to answer completely. One view is that the public has given responsibility to the profession, because it is difficult for a layperson to determine appropriate behavior given the technical knowledge required. This responsibility is ceded with the caveat that the profession will self-regulate and that if it does not, the public will resume control.

DIF: Comprehension REF: p. 42 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 6. Which of the following statements about codes of ethics is most accurate? a. It is easy to determine the degree to which codes of ethics are effective. b. It is reasonable to assume that the professions find codes of ethics to be extremely

valuable. c. The professions cannot do anything about it if someone does not behave with

integrity. d. There is no way to judge acceptable parameters of behavior according to a code of

ethics.

ANS: B

Because health professions invest so much effort in the development and propagation of codes of ethics and standards of professional behavior, an assumption that professions find them to be extremely valuable is reasonable. The profession is empowered to take action to resolve the problem when violations of the code occur. Although codes alone do not guarantee that everyone will behave with integrity, they do provide guidance and standards by which professionals can be judged. Codes also serve as a touchstone by which all members of a profession can judge the acceptable parameters of behavior.

DIF: Comprehension REF: p. 42 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 7. Where was the first ethical code developed? a. Assyria b. Greece c. Italy d. United States e. France ANS: B

The first ethical code dates back to the time of the Greek physician Hippocrates. The influence of the Hippocratic Oath is still seen in modern versions of ethical codes. The first code of ethics for dental hygienists was created at the inception of the American Dental Hygienists’ Association (ADHA) in 1927.

DIF: Recall REF: p. 42 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 8. Traditional medical codes of ethics emphasize all of the following EXCEPT one. Which one

is the exception? a. Obligation to each other b. Duties in the individual patient–physician relationship c. The use of a patient’s bill of rights in health care settings d. Authority and duty of beneficence ANS: C

Traditional medical codes of ethics emphasize the physician’s (1) duties in the individual patient–physician relationship, including the obligation of confidentiality; (2) authority and duty of beneficence (i.e., acting for the patient’s good); and (3) obligation to each other. Most codes stress the obligation of health care professionals rather than describe the rights of those receiving health care services. The current use of a patient’s bill of rights in health care settings is an attempt to address the discrepancy.

DIF: Recall REF: p. 42 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 9. Power and prestige is granted to the professions, because a code of ethics is a promise to

society to uphold certain values and standards in the practice of the profession. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

Codes of ethics are not legal mandates, however, they cannot be easily dismissed if there is a formal structure for self-regulation. In recent years evidence is increasing that state dental boards, which usually have the authority over both dentists and dental hygienists, are sanctioning practitioners for legal violations as well as ethical violations. Because these boards typically have the authority to suspend or terminate a professional’s right to practice, the fact that more attention is being given to ethical behavior makes the relation between ethical codes and enforcement stronger.

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REF: p. 42 DIF: Comprehension OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 10. Ideally, ethical codes should create a relationship among members of a profession that is

similar to ties in which of the following types of relationships? a. A high school or collegiate athletic team b. A family c. A club or organization where members have similar interests d. A group of people who are working together in a restaurant ANS: B

A family relationship obviates the need for enforcement outside the group. Professionals’ obligations to each other, to patients, and to society should be similar to the strong obligations and emotional feelings that attend belonging to a family with the behavior of members being monitored by the membership.

DIF: Comprehension REF: p. 43 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 11. The first principle function of a code of ethics is to provide an enforceable standard of

minimally decent conduct for those who fall below that standard. The second principle function is to address every situation that may occur. 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 code of ethics has two principle functions. First, it provides an enforceable standard of minimally decent conduct for those who fall below that standard. Second, it indicates in general terms some of the ethical considerations a professional must consider when deciding on conduct. The code of ethics can and does serve as a tool in the function of self-regulation; however, it does have some limitations. Not every situation can be addressed in an ethical code or fully explained in an accompanying interpretation.

DIF: Comprehension REF: p. 43 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 12. How can the American Dental Hygienists’ Association (ADHA) Code of Ethics for Dental

Hygienists be amended? a. If changes are approved by a majority of state dental hygiene associations. b. If changes are approved at any meeting of the ADHA House of Delegates by a majority of the group. c. If changes are approved at any meeting of the ADHA House of Delegates by a two-thirds vote of the group. d. The ADHA Code of Ethics for Dental Hygienists cannot be modified. It can only be replaced.

ANS: C

All professional codes are evolving documents that embody the contract between a particular profession and the public. The dental hygiene code is maintained by the professional BoAnNitK organization (the ADHA) T anEdSisTm orS edEbLyLtE heRe.xC ecOuM tive staff of the organization. When deemed necessary, the officers of the association appoint a committee of members to review and revise the document. The code can be amended at any meeting of the ADHA House of Delegates by a two-thirds vote of that group. ADHA and all health care professional organizations have, as a condition of membership, an agreement to uphold the profession’s code of ethics.

DIF: Recall REF: p. 44 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 13. Which of the following is found as a core value in the American Dental Hygienists’

Association (ADHA) Code but are not found as fundamental principles in the American Dental Association (ADA) Code of Ethics? a. Autonomy b. Nonmaleficence and beneficence c. Societal trust d. Veracity ANS: C

The ADA code refers to five fundamental principles: autonomy, beneficence, nonmaleficence, justice, and veracity. The ADHA code identifies seven core values, adding confidentiality and societal trust as essential to the foundation of the code.

DIF: Recall

REF: p. 46

OBJ: 5

TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 14. Which of the following principles of the American Dental Hygiene Association (ADHA)

Code of Ethics recognizes the existence of an obligation to justice and basic human rights? a. Universality b. Complementarity c. Ethics d. Community e. Responsibility ANS: B

In all relationships, complementarity requires considering the values and perspectives of others before making decisions or taking actions affecting them. Universality expects that, if one individual judges an action to be right or wrong in a given situation, other people considering the same action in the same situation would make the same judgment. Ethics are general standards of right and wrong that guide behavior within society. Community expresses our concern for the bond between individuals, the community, and society in general. Responsibility is accepting the consequences of our actions or the failure to act and being willing to make ethical choices and publicly affirming them.

DIF: Recall REF: p. 48 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 15. Which of the following core values of the American Dental Hygienists’ Association (ADHA)

Code of Ethics states that “we accept our fundamental obligation to provide services in a manner that protects all clients and minimizes harm to them and others involved in their treatment”? a. Societal trust b. Confidentiality c. Beneficence d. Nonmaleficence e. Veracity ANS: D

Nonmaleficence means to do no harm. Societal trust means that we understand that public trust in our profession is based on our actions and behavior. Confidentiality means we respect the confidentiality of client information and relationships as a demonstration of the value we place on individual autonomy. Beneficence means we have a primary role in promoting the well-being of individuals and the public by engaging in health promotion/disease prevention activities. Veracity means we accept our obligation to tell the truth and expect that others will do the same.

DIF: Recall REF: p. 48 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 16. Each of the following is true according to the American Dental Hygienists’ Association

(ADAH) Standards of Professional Responsibility to the Community and Society EXCEPT one. Which one is the EXCEPTION? a. Report the use of illicit drugs by a patient to responsible authorities. b. Use peer review as a mechanism for identifying substandard care by dental hygienists.

c. Promote access to dental hygiene services for all. d. Recognize and uphold our obligation to provide pro bono service.

ANS: A

A dental hygienist is not required to report the use of illicit drugs as this would violate confidentiality. A dental hygienist is required to document and report inappropriate, inadequate, or substandard care and/or illegal activities by a health care provider to the responsible authorities. A dental hygienist is expected to use peer review as a mechanism for identifying inappropriate, inadequate, or substandard care provided by dental hygienists. A dental hygienist is expected to promote access to dental hygiene services for all, supporting justice and fairness in the distribution of health care resources. A dental hygienist is expected to recognize and uphold the obligation to provide pro bono service.

DIF: Recall REF: p. 48 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 17. Which of the following is associated with the American Dental Association (ADA) Code of

Ethics? a. Five core values b. Five fundamental principles c. Seven core values d. Seven fundamental principles ANS: B

The ADA code is divided into three components: principles of ethics, code of professional conduct, and advisory opinions. The principles of ethics component sets out the aspirational goals of the dental profession, which are similar to the aspirational goals for the dental hygiene profession. The AT DE AScT odBeA , hNoKwSeE veLr,LrE efR er. sC toOfM ive fundamental principles, whereas the ADHA code identifies seven core values, adding confidentiality and societal trust as essential to the foundation of the code.

DIF: Recall REF: p. 46 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent

Chapter 06: Ethical Decision Making in Dental Hygiene and Dentistry Beemsterboer: Ethics and Law in Dental Hygiene, 3rd Edition MULTIPLE CHOICE 1. Which of the following is associated with making a choice rather than resolving a dilemma? a. Careful decision making b. Issues of right and wrong c. Weighing options d. A variety of answers, each of which has an element of rightness ANS: B

The dental hygienist is faced with many choices and dilemmas. Some of these choices will be simple issues of right or wrong, whereas others may be ethical dilemmas that require careful decision making. Ethical problems arise when the hygienist is caught between two competing obligations. Professionals face situations that require carefully weighing options. Often no right or wrong answer exists. Instead a variety of answers may be possible, each of which has an element of rightness about it.

DIF: Recall REF: p. 53 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 2. The two aspects that are involved in ethics are the ability to discern right from wrong and a. complying with laws enacted by the state legislature. b. complying with rules established by the state board of dentistry. c. the commitment to act on a decision.

TESTBANKSELLER.COM d. maintaining the status quo.

ANS: C

It is the commitment to act on a decision. Although they may utilize information regarding laws and rules established by state legislatures and boards of dentistry, many ethical decisions are instead made in the context of professional, social, and economic pressures. Often, the decision requires resisting the status quo. According to the text, “courageous professionals are encouraged to persevere in standing up for what is right even when it means they may do so alone.”

DIF: Comprehension REF: p. 53 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 3. The goal for the curricula established in 1989 by the American Dental Educational

Association (ADEA) was to develop a commitment by students to a. moral principles. b. moral distress. c. ethical dilemmas. d. moral dilemmas.

ANS: A

The guidelines stated that the curriculum should provide opportunities for refining skills of ethical analysis so students are able to apply ethical principles to new and emerging problems in the profession. The goal was to develop a commitment by the students to the moral principles that are the basis for the profession’s contract with society. Moreover, students should be encouraged to develop an attitude that ethical decision making is a process involving lifelong learning and commitment.

DIF: Recall REF: p. 53 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 4. Ethical decision making is a. inherently understood by children. b. learned in curriculum in professional school. c. acquired through continuing education classes following the period of formal

education. d. learned throughout a lifetime.

ANS: D

Ethical decision making is a process involving lifelong learning and commitment. Childhood experiences, professional curriculum, and continuing education are not sufficient because people and perceptions of society change over time. Additional types of dilemmas and ethical problems can and will arise. Major advances in technology and the changes in delivery and payment systems in dentistry will further alter the scope and depth of ethical challenges facing dental hygienists and dentists.

DIF: Comprehension REF: p. 54 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 5. The ethical awareness of an individual is called moral a. dilemma. b. distress. c. sensitivity. d. uncertainty. e. weakness.

ANS: C

How the dental hygienist responds to ethical issues that arise in practice depends on the ethical awareness of the individual, known as moral sensitivity. A situation can be perceived by one individual as having an ethical component but not by another. Campbell and Rogers categorized moral problems as moral weakness, moral uncertainty, or moral dilemmas.

DIF: Recall REF: p. 54 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 6. Which of the types of moral problems categorized by Campbell and Rogers exists when

obligations or responsibilities are in conflict? a. Moral uncertainty b. Moral dilemma c. Moral weakness d. Moral distress ANS: B

A moral dilemma exists when obligations or responsibilities are in conflict. A large portion of the bioethics literature deals with moral dilemmas that often involve matters of life and death.

A moral uncertainly is defined as the question of whether a moral obligation exists and its scope. A moral weakness exists when moral responsibilities point in one direction and personal inclinations in another.

DIF: Recall REF: p. 55 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 7. Each of the following is categorized by Campbell and Rogers as one of the three categories of

moral problems EXCEPT one. Which one is the EXCEPTION? a. Moral dilemma b. Moral distress c. Moral weakness d. Moral uncertainty ANS: B

Moral distress has been added for situations in which the health care provider is frustrated from feelings of powerlessness when a perceived wrong is occurring but he or she is unable to act. It is the feeling experienced when an individual cannot do what he or she believes ought to be done because of a system issue, resistance of a powerful person, or a restraint in the situation. The use of this term came from the nursing profession to describe situations in which the nurse feels powerless to act ethically.

DIF: Recall REF: p. 55 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent

NhKiS 8. According to Campbell anT dE RS ogTeB rsA ,w chEoLf L thEeRfo.llCoO wM ing terms is used to describe a situation where moral responsibilities point in one direction and personal inclination in another? a. Moral distress b. Moral dilemma c. Moral weakness d. Moral uncertainty ANS: C

An example would be the dental hygienist who wants to go to lunch early and forgoes providing a patient with needed dental health education. Moral distress is not one of the original categories of moral problems. It occurs when a perceived wrong is occurring, but the health care provider is not able to act. Obligations and responsibilities are in conflict when there is a moral dilemma. Moral uncertainty occurs when there is a question of whether a moral obligation exists and its scope.

DIF: Recall REF: p. 54 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 9. Each of the following is one of the “four A’s” of The American Association of Critical Care

Nurses (AACCN) EXCEPT one. Which one is the EXCEPTION? a. Act b. Affirm c. Assess

d. Associate e. Ask ANS: D

The “four A’s” to rise above moral distress are ask, affirm, assess, and act. The goal in this model is to preserve the integrity and authenticity of the health care provider.

DIF: Recall REF: p. 55 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 10. Which of the following is the first of Dr. John S. Murray’s seven critical checkpoints to use in

ethical decision making? a. Ascertain what principles need to be expressed and defended in the situation—focus on one or two of the more critical values. b. Evaluate the circumstances to establish whether moral courage is needed in the situation. c. Consider the possible adverse consequences/risks associated with taking action. d. Determine what moral values and ethical principles are at risk or in question of being compromised.

ANS: B

The correct order is: (1) Evaluate the circumstances to establish whether moral courage is needed in the situation, (2) Determine what moral values and ethical principles are at risk or in question of being compromised, (3) Ascertain what principles need to be expressed and defended in the situation—focus on one or two of the more critical values, and (4) Consider the possible adverse consequences/risks associated with taking action. The rest of the seven are: (5) Assess whether or not the adversity can be endured—determine what LE support/resources are availT abEleS,T(6B)AANvK oiS dE stL um blR in.gCbO loM cks that might restrain moral courage, such as apprehension or other reflection leading to reasoning oneself out of being morally courageous in the situation, and (7) Continue to develop moral courage through education, training, and practice.

DIF: Comprehension REF: p. 55 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 11. The goal of an ethical decision-making model is to a. provide a cookbook process for determining a solution to a problem. b. provide a framework for making the best decision in a particular situation. c. provide a matrix for determining the solution so the provider does not have to

think about the situation. d. make a decision about right and wrong.

ANS: B

The goal is to provide a framework for making the best decision in a particular situation with which the health care provider is confronted. An ethical decision-making model is a tool to help develop the ability to think through an ethical dilemma and arrive at an ethical decision.

A number of models are presented in the ethics literature, all of which are somewhat similar in design and content. Most of these models use principle-based reasoning, an approach derived from the work of philosophers Beauchamp and Childress. An ethical dilemma is not a simple decision of right and wrong.

DIF: Recall REF: p. 56 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 12. Which of the following is true concerning the ethical decision-making model presented in the

chapter? a. It is a four-step approach diagrammed as a square grid. b. It is a four-step approach diagrammed as a circle. c. It is a six-step approach diagrammed as a square grid. d. It is a six-step approach diagrammed as a circle.

ANS: D

The model provided in the chapter is a six-step approach derived from the decision-making literature as interpreted by Atchison and Beemsterboer and used in the early 1990s with dental and dental hygiene students in a combined ethics course. The model has been diagrammed as a circle to emphasize the use of past information and experiences on current and future decision making.

DIF: Recall REF: p. 56 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 13. The process of ethical decision making is static, meaning that truth is immutable. Dental

hygienists are confronted with many questions to consider, and they must filter out their own values and beliefs to eliminate bias in the decision. 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

The process of ethical decision making is dynamic, evolving as additional information comes into play. Dental hygienists are confronted with myriad questions to consider, requiring them to factor in the code of ethics and their own values and beliefs before arriving at a decision.

The evaluation process involved in an ethical dilemma is not unlike that which occurs when the practitioner is faced with a clinical or scientific problem. Careful attention to and systematic analysis of the evidence, facts, and details will help the health care provider reach an appropriate decision. Applying the decision-making model gives the dental hygienist a tool to use throughout professional life.

DIF: Comprehension REF: p. 57 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 14. Which of the following is the first step in the ethical decision-making model presented in the

text? a. State the options. b. Identify the ethical dilemma or problem. c. Apply the ethical principles to the options. d. Collect information.

ANS: B

The correct order of the six-step ethical decision-making model presented in the text is: (1) identify the ethical dilemma or problem, (2) collect information, (3) state the options, (4) apply the ethical principles to the options, (5) make the decision, and (6) implement the decision.

DIF: Recall REF: p. 57 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 15. Which of the following is the most critical step in the ethical decision-making model? a. Apply the ethical principles to the options. b. State the options. c. Collect information. d. Identify the ethical dilemma or problem.

ANS: D

Identifying the ethical dilemma or problem is the most critical step in the process. Many situations are simply never perceived to be ethical problems or dilemmas. Once the problem has been recognized, the decision maker must clearly and succinctly state the ethical question, considering all pertinent aspects of the problem. If the ethical question does not place principles in conflict, it is a simple matter of right and wrong and no process of ethical decision making is required.

DIF: Recall REF: p. 57 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 16. Brainstorming to identify as many alternatives or options as possible is part of which of the

following steps of the ethical decision-making model? a. Collect information. b. State the options. c. Implement the decision. d. Apply the ethical principles to the options.

ANS: B

This is the third step and follows identifying the ethical dilemma or problem and collecting information about it. Often the best decision is not the first one that comes to mind. This step forces us to stop and view the situation from all angles to identify what other people might see as alternative answers to the problem.

DIF: Recall REF: p. 57 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 17. Which of the following steps of the ethical decision-making model is characterized by

developing a list of pros and cons? a. Apply the ethical principles to the options. b. Collect information. c. State the options. d. Identify the ethical dilemma or problem.

ANS: A

Focus on the ethical principles and ethical values and concepts. State how each alternative will affect the ethical principle or rule by developing a list of pros and cons. In the pro column, show alternatives that protect or hold inviolate each principle or value. In the con column, state how an alternative could violate the principle or value. This process will enable you to see which ethical principles are in conflict in this situation.

DIF: Recall REF: p. 57 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 18. The ethical decision-making process is futile if no action is taken, because no action

represents tacit approval of the situation. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

Many appropriate decisions are never implemented because this step is omitted. Remember that no action represents tacit approval of the situation.

DIF: Recall REF: p. 57 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 19. According to a 1990 survey of ethical issues in dental hygiene conducted by Gaston and

colleagues, each of the following is one of the most frequently encountered practice dilemmas EXCEPT one. Which one is the EXCEPTION? a. Observation of behavioTrE inScToB nfAliN ctKwSitEhLstLanEdRa. rdCiO nfM ection control procedures b. Nondiagnosis of dental disease c. Overdelegation of procedures to nonqualified personnel d. Failure to refer patients to a specialist ANS: C

They found that the three most frequently encountered practice dilemmas were observation of behavior in conflict with standard infection control procedures, failure to refer patients to a specialist, and nondiagnosis of dental disease. One of the conclusions drawn from this study was that serious ethical dilemmas are encountered by most dental hygienists, prompting the authors to advocate increased education of hygienists in the recognition and resolution of ethical problems.

DIF: Recall REF: p. 58 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 20. Dental hygienists usually are employed by a dentist or groups of dentists, which is

problematic, because an ethical conflict or dilemma can be intensified when a subordinate observes an unethical action performed by an individual in a position of power. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

This arrangement can place the hygienist in a difficult situation when inappropriate care or unethical practices are observed, especially when the dentist employer is involved in the action. In these situations, if the dental hygienist advocates the good of the patient, his or her continued employment may be in jeopardy—thus causing moral distress. Conversely, if the dental hygienist remains silent, professionalism is compromised and no one speaks for the interests of the patient.

DIF: Recall REF: p. 58 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent 21. Which of the following steps is being implemented by Joan Lakeside, in the hypothetical case

presented in the text, when she checks her oral pathology book and looks at photographs of squamous cell carcinoma? a. Identify the ethical problem. b. Make the decision. c. Implement the decision. d. Collect information.

ANS: D

Step 2 involves gathering all pertinent information. The decision maker must gather information to make an informed decision. The ethical problem identified in Step 1 is whether or not to call the patient regarding the lesion in his mouth. Step 3 is to list the possible options, and Step 4 is to apply ethical principles to the options.

DIF: Comprehension REF: p. 56 OBJ: 5 TOP: 7.0 Professional RespT onEsiS biT liB tyA| 7N.1KE hiL caL lP in. ciC plO esM , including informed consent StE ErR 22. Which of the following choices in the hypothetical case presented in the textbook applies the

principle of beneficence as well as autonomy? a. Go back to Dr. McVey with the textbook and restate her suspicions in an attempt to convince him to refer the patient for a diagnostic biopsy. b. Go to another dental practitioner and describe the situation, hoping the other practitioner will intervene. c. Call the patient directly and advise him to seek another opinion about his lesion. d. Do nothing and wait until the patient comes in for his next appointment.

ANS: C

Calling the patient directly applies the principles of autonomy and beneficence. Autonomy is involved because the patient came in for an examination and has a right to know that he may or may not have a disease. Beneficence—doing good for the patient—is applicable because doing nothing could cause the patient great harm if the lesion were found to be cancerous. The first option—talking to Dr. McVey and convincing him to call the patient back in for another examination—applies the principles of nonmaleficence and autonomy. Going to another practitioner would violate confidentiality. The last option—doing nothing and waiting for 6 or 7 months—many involve respecting the autonomy of the dentist.

DIF: Comprehension REF: p. 60 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent

23. Which of the following options was recommended for Joan Lakeside according to the

hypothetical case presented in the textbook? a. Showing her oral pathology textbook to Dr. McVey and attempt to convince him to refer the patient. b. Go to another practitioner herself to try and gather support for her position. c. Call the patient herself and recommend another opinion. d. Do nothing and wait for the patient’s next appointment.

ANS: A

Joan decided to approach Dr. McVey again and try to convince him to call the patient in for another appointment. If she is unsuccessful in convincing her employer, she will call the patient directly.

DIF: Recall REF: p. 60 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.1 Ethical Principles, including informed consent

Chapter 07: Society and the State Dental Practice Act Beemsterboer: Ethics and Law in Dental Hygiene, 3rd Edition MULTIPLE CHOICE 1. Which of the following forms of government has the authority and responsibility to protect

the health, safety, and welfare of the state’s citizens? a. The federal government b. State government c. County government d. City or township government ANS: B

The state government is responsible for protecting the health, safety, and welfare of the state’s citizens. The practice of health professionals, including dental hygienists, is governed under this authority.

DIF: Recall REF: p. 65 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 2. Each of the following is protected for citizens of a state EXCEPT one. Which one is the

EXCEPTION? a. Health b. Finances c. Safety d. Welfare ANS: B

State governments are given authority and responsibility to protect the health, safety, and welfare of the state’s citizens, not finances.

DIF: Recall REF: p. 65 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 3. Which of the following branches of state government is authorized to enact laws or statutes

that prescribe or prohibit activities within the state? a. Legislative branch b. Executive branch c. Judicial branch d. Municipal ANS: A

The legislative branch. The executive branch plays a major role in the implementation and enforcement of the prescriptions and prohibitions enacted into law. The judicial branch is the final arbiter regarding the rights and responsibilities of individuals subject to the laws of the state. In general, state governments are divided into three branches. Municipal is not one of those three.

DIF: Recall REF: p. 65 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

4. Which of the following is the function of the judicial branch of state government? a. Enact statutes that prescribe or prohibit activities within the state b. Implementation of prescriptions and prohibitions enacted into law c. Final arbiter regarding the rights and responsibilities of individuals subject to the

laws of the state d. Regulate trade across state lines ANS: C

The judicial branch of state government is the final arbiter of rights and responsibilities of individuals subject to the laws of the state. The legislative branch is authorized laws or statutes that prescribe or prohibit activities within the state. The executive branch is involved with implementation and enforcement of the prescriptions and prohibitions enacted into law.

The Federal Constitution gives the power to the Congress of the United States to regulate trade across state lines.

DIF: Recall REF: p. 65 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 5. The practice of dental hygiene is regulated through which of the following branches of state

government? a. Legislative, executive, and judicial b. Legislative and executive, but not judicial c. Legislative and judicial, but not executive d. Executive and judicial, but not legislative e. Legislative only ANS: A

The practice of dental hygiTenEeSiT s rBeA guNlaKteSdEtL hrL ouEgRh.eC acOhMof the three branches of state government. If left unregulated, the practice of dental hygiene could have the potential to harm patients. Government regulation is intended to minimize the public risk of untoward health care outcomes.

DIF: Recall REF: p. 65 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 6. Which of the following government regulations most specifically controls the practice of

dental hygiene? a. Title VII of the Civil Rights Act of 1964 b. Equal Pay Act of 1963 c. Age Discrimination in Employment Act of 1967 d. Americans with Disabilities Act of 1990 e. State Dental Practice Act ANS: E

The State Dental Practice Act is the government regulation that most specifically controls the practice of dental hygiene. Title VII of the Civil Rights Act of 1964 is a federal law that protects against discrimination on the basis of race, color, religion, sex, or national origin. The Equal Pay Act of 1963 is a federal law that protects men and women who perform substantially equal work in the same establishment from sex-based wage discrimination. The Age Discrimination in Employment Act of 1967 is a federal law that prohibits discrimination based on age against any employee or applicant for employment who is at least 40 years old.

The Americans with Disabilities Act of 1990 is a federal law that prohibits discrimination against qualified individuals with disabilities.

DIF: Recall REF: p. 65 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 7. Which of the following branches of government is responsible for enactment of the State

Dental Practice Act? a. The federal legislative branch in all cases b. The federal judicial branch in all cases c. The state legislative branch in all cases d. The state legislative branch in most cases e. The state judicial branch in all cases ANS: D

The legislative branch of state government generally is responsible for the enactment of the State Dental Practice Act. In a limited number of states, the state constitution reserves for the people the right to enact laws independent of the legislature. This is the case in the state of Washington.

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OBJ: 1 DIF: Recall REF: p. 66 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 8. Which of the following states enacted Initiative Measure No. 607 in 1994, which made it legal

for a denturist to practice in that state? a. Washington b. Rhode Island c. California d. New Jersey e. Missouri ANS: A

The Washington State Denturist Act was enacted by the people of the state of Washington in 1994. It stated that “a program of licensure for denturists should be established.” In 2013, denturism is permitted in six states according to the National Denturist Association website: http://nationaldenturist.com. The six states include: Arizona, Idaho, Maine, Montana, Oregon, and Washington. Additionally, there are four states with recent legislative action and nine more states seeking legislative action.

DIF: Recall REF: p. 66 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

9. Dental hygienists must be familiar with the laws that deal specifically with dental hygiene as

well as the general laws that protect the well-being of the state’s citizens because the statutes that regulate the health professions are not all encompassing. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

For example, most states have enacted laws that require health care professionals to report suspected child abuse. This law may be found in acts that focus on child protection rather than on the practice of dental hygiene. Issues that may be regulated by state laws but may not be specifically incorporated into the state dental practice act may be found in Box 7-1 in the text.

DIF: Comprehension REF: p. 66 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 10. Each of the following is an example of an issue that may be regulated by state laws but may

not be specifically incorporated into the State Dental Practice Act EXCEPT one. Which one is the EXCEPTION? a. False health care claims b. Consent to treatment and informed consent c. Continuing education requirements d. Biomedical wastes and hazards management e. Mandatory malpractice insurance ANS: C

The continuing education requirement is part of the State Dental Practice Act. The continuing education requirement differs from state to state and it is different for a dentist than a dental hygienist. Current continuing education requirements for a dental hygienist in each state may be found on the website of the American Dental Hygienists’ Association (ADHA). The ADHA website address for information regarding continuing education is: http://www.adha.org/resources-docs/7512_CE_Requirements_by_State.pdf.

DIF: Recall REF: p. 68 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 11. Which of the following is most likely found in state statutory law for the practice of dental

hygiene? a. Licensure examination requirements b. Abuse reporting requirements c. Business operation practices d. Public health reporting requirements e. Patient confidentiality ANS: A

State statutory law that regulates the practice of dental hygiene is likely to include provisions for licensure requirements, licensure examination requirements, licensure eligibility requirements, licensure by endorsement, approval of educational programs, examination and disciplinary authority, scope of practice, supervision requirements, and continuing education requirements.

DIF: Recall REF: p. 69 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 12. Which of the following branches of state government implements administrative procedures

and requirements for the practice of dental hygiene in that state? a. Legislative branch b. Executive branch c. Judicial branch ANS: B

State statutory laws provide a general outline of requirements, provisions, and limitations of the practice of dental hygiene and grant authority to the executive branch of government to implement administrative procedures and requirements. The executive branch includes the departments and agencies of state government (e.g., Department of Health, Department of Professional Regulation, Department of Consumer and Industry Services, or Secretary of State).

DIF: Recall REF: p. 67 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 13. The legislative branch of government is responsible for implementing the statutory law and

providing more specific guTidEaS ncTeBaA ndNrKegSuElaLtiL onER re. gaCrdOiM ng the practice of dental hygiene. The development of more specific requirements for implementing statutory law is accomplished through a process known as interrogatories. 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

It is the executive branch rather than the legislative branch of government that is responsible for implementing the statutory law. Interrogatories and depositions are part of the discovery of evidence to support or deny legal claims and allegations. Development of more specific requirements for implementing statutory law is through a process known as rule making, which is a public process that provides the opportunity for input from interested persons, including dental hygienists.

DIF: Comprehension REF: p. 67 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 14. Depending upon the state, the regulation of the practice of dental hygiene may be facilitated

by a. an appointed board or elected regulatory body. b. the administrators of the professional schools in the state. c. the governor of the state.

d. the mayor of the city where the state capitol is located.

ANS: A

The regulation of the practice of dental hygiene may be facilitated by an appointed board, as in Colorado, or it may be the purview of an elected regulatory body, as in North Carolina.

Dental hygiene representation on such regulatory bodies is common. In some states the regulatory body may be advised by a secondary body, which has greater dental hygiene representation, such as a council, as in Florida, or a Dental Hygienists Committee, as in New Mexico.

DIF: Recall REF: p. 67 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 15. Each of the following is a term that may be used to refer specifically to the body regulating

dental hygienists in a state EXCEPT one. Which one is the EXCEPTION? a. Dental Quality Assurance Commission b. Board of Dental Health Care c. Board of Dentistry d. Department of Health e. Board of Dental Examiners ANS: D

The body regulating dental hygiene may be referred to in terms such as Board of Dental Examiners, Board of Dentistry, State Dental Board, State Dental Commission, Dental Quality Assurance Commission, or Board of Dental Health Care. The Department of Health is a more encompassing term including other health professions, such as medicine and pharmacy, in addition to dental hygiene.

DIF: Recall REF: p. 67 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 16. The functions of the regulatory body for dental hygiene may include each of the following

EXCEPT one. Which one is the EXCEPTION? a. Inspection of a dental office for compliance with infection control procedures b. Examination of a candidate for licensure as a dental hygienist c. Renewal of a dental hygiene license d. Investigation of disciplinary charges against a dental hygienist e. Adoption of rules and regulations regarding the practice of dental hygiene ANS: A

Inspection for compliance with infection control procedures is the purview of the Occupational Safety and Health Administration (OSHA). The functions of the dental hygiene regulatory body may include the examination of dental hygiene candidates for licensure; issuance, renewal, and revocation of dental hygiene licenses; investigation of disciplinary charges; and adoption of rules and regulations regarding the practice of dental hygiene.

DIF: Comprehension REF: p. 67 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 17. The practice of dental hygiene is different in each state, because it is not nationally regulated. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

This requires the dental hygienist to be familiar with the laws regarding practice for the particular state where he or she practices. A dental hygienist should, on an annual basis, review the applicable state dental practice act.

DIF: Recall REF: p. 68 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 18. How often should a dental hygienist review the applicable State Dental Practice Act? a. When first graduating from an accredited dental hygiene program. b. When first applying for a license in the state where he or she intends to practice

dental hygiene. c. Once every 3 years. d. On a yearly basis. e. It is not necessary once a student has graduated from an accredited dental hygiene

program.

ANS: D

The professional obligation of a dental hygienist is to be intimately familiar with the laws and regulations of the state where he or she practices. A dental hygienist should, on an annual basis, review the applicable State Dental Practice Act. A good time to do this may be at the time of annual license renewal, birth date, or other annually recurring date of significance.

DIF: Recall REF: TpE . 6S8TBANKS OE BJ:LLE 2 R.COM TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 19. An individual must have a dental hygiene license issued by which of the following types of

governmental authority in order to practice dental hygiene? a. Federal government b. State government c. County government d. City or township government ANS: B

To practice dental hygiene legally, individuals must have a dental hygiene license in the state in which they practice.

DIF: Recall REF: p. 68 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 20. A condition of dental hygiene licensure generally is graduation from a dental hygiene program

accredited by which of the following organizations? a. The Commission on Dental Accreditation (CODA) of the American Dental Association b. The Food and Drug Administration c. The Federal Trade Commission d. The National Institutes of Health

ANS: A

In general, a condition of dental hygiene licensure is graduation from a dental hygiene program accredited by the Commission on Dental Accreditation (CODA) as well as successful completion of a national, regional, and/or state licensure examination.

DIF: Recall REF: p. 68 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 21. Which of the following states provides for licensure of a dental hygienist if he or she is a

“graduate of a school of dental hygiene which has been approved by the board, or in lieu thereof, shall have served as a dental assistant for a period of time established by board rule and shall have served at least 1 year as a dental hygienist trainee under a training permit issued by the board to a qualified dentist practicing in this state in accordance with the dental hygienist training program established by the board”? a. Maine b. Illinois c. Alabama d. Mississippi e. Washington ANS: C

The law provides for an exception to general conditions for dental hygiene licensure in Alabama. The instructor manual for the Alabama Dental Hygiene Program may be found at the following website: http://www.dentalboard.org/pdf/2014%20Instructor%20Manual%20%20revised.pdf.

DIF: Recall REF: p. 68 OBJ: 2 SeEgL TOP: 7.0 Professional RespT onEsiS biT liB tyA| 7N.2KR ulL atE orR y.

CoCmOpM liance 22. “Dental hygienists who have graduated from a CODA accredited dental hygiene program,

who are licensed in good standing in a state with similar or higher requirements for licensure, and who have practiced dental hygiene for a minimum prescribed period may have examination requirements waived on the basis of their credentials,” according to which of the following principles? a. Licensure by endorsement or reciprocity b. Garnishment c. Quid pro quo d. Informed consent ANS: A

Issuance of a dental hygiene license based on a review of credential is provided for in Colorado, North Dakota, and Connecticut statutes, as may be seen in the text, and is true for many other states.

DIF: Recall REF: p. 68 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 23. Some states provide for temporary or provisional licensure of dental hygienists who are

licensed in other jurisdictions, are relocating to that state, and do have the option of licensure by credential available to them. A temporary or provisional license is valid for a prescribed period or purpose or until the next scheduled licensure examination.

a. b. c. d.

Both statements are true.

Both statements are false.

The first statement is true, the second statement is false.

The first statement is false, the second statement is true.

ANS: D

Information about obtaining a provisional or temporary license to practice dental hygiene may be found in the text.

DIF: Recall REF: p. 69 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 24. Which of the following types of dental hygiene license may be granted on the basis of

examination or endorsement of credentials? Such a license permits unrestricted practice within the scope of the State Dental Practice Act. a. Full license b. Temporary license c. Volunteer license d. Faculty license ANS: A

A full license. A temporary dental hygiene license, granted on the basis of licensure in another jurisdiction, permits practice within the scope of the State Dental Practice Act for a limited period of time while the dental hygienist pursues full licensure status. A volunteer dental hygiene license, granted on the basis of licensure in another jurisdiction, permits practice within the scope of the State Dental Practice Act for the purpose of volunteer (e.g., unremunerated) public service. A faculty dental hygiene license, granted on the basis of prior .eCmObMer to practice within the scope of his licensure in another jurisdiT ctE ioSnT , pBeA rmNiK tsSaEfaLcL ulE tyRm or her educational responsibilities.

DIF: Recall REF: p. 71 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 25. Each of the following types of dental hygiene licenses is granted on the basis of licensure in

another jurisdiction EXCEPT one. Which one is the EXCEPTION? a. Faculty license b. Volunteer license c. Full license d. Temporary license ANS: C

A full dental hygiene license may be granted on the basis of examination or endorsement of credentials. A faculty, volunteer, or temporary license is granted on the basis of licensure in another jurisdiction.

DIF: Recall REF: p. 71 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 26. A dental hygienist generally is required to display a current copy of which of the following at

his or her place of practice? a. Dental hygiene board examination results b. State license to practice dental hygiene

c. Certificate or diploma from the school of graduation d. Dental hygiene course grades ANS: B

Dental hygienists generally are required to display a current copy of their license at their place(s) of practice. At one time state licenses often had the dental hygienist’s home address, especially if the dental hygienist was employed in more than one office, but addresses have been removed for reasons of personal security.

DIF: Recall REF: p. 70 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 27. Dental hygiene licenses expire and require renewal on a schedule prescribed by state law. It is

critical not to let current licensure expire, because when a dental hygienist experiences even a limited lapse of licensure, the state requires retaking written and clinical board examinations. 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

Dental hygiene license must be renewed on a schedule prescribed by state law. When a dental hygienist experiences a limited lapse of licensure, state law may provide for reinstatement without examination with proof of continued professional competence and payment of renewal and penalty fees.

DIF: Recall REF: p. 70 OBJ: 2 TOP: 7.0 Professional RespT onEsiS biT liB tyA| 7N.2KR ulL atoErR y.

CoCmOpM liance SeEgL 28. The practice of dental hygiene without a valid license is a a. criminal offense that may be categorized as a felony. b. criminal offense that may be categorized as a misdemeanor but not as a felony. c. civil offense that may be categorized as a felony. d. civil offense that may be categorized as a misdemeanor but not as a felony.

ANS: A

It is a criminal offense that may be categorized as a felony. For example, according to FLA. STAT. Ann. 466.026 (2015) “(1) Each of the following constitutes a felony of the third degree … (a) Practicing … dental hygiene unless the person has an appropriate, active license … (b) Using or attempting to use a license … which license has been suspended or revoked.” The penalty for noncompliance with licensure requirements may include a monetary fine and/or imprisonment.

DIF: Comprehension REF: p. 71 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 29. What is the penalty in California for practicing dental hygiene “without causing to be

displayed in a conspicuous place in his or her office his or her license under this article to practice dental hygiene”? a. A felony with imprisonment and a monetary fine b. A felony with imprisonment or a monetary fine c. A misdemeanor with imprisonment and a monetary fine

d. A misdemeanor with imprisonment or a monetary fine ANS: D

A person who practices without displaying his or her license is guilty of a misdemeanor and upon conviction, shall be punished by imprisonment in a county jail not less than 10 days nor more than 1 year, or by a fine of not less than one hundred dollars ($100) nor more than one thousand five hundred dollars ($1500), or by fine and imprisonment.

DIF: Recall REF: p. 71 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 30. Which of the following is considered a misdemeanor rather than a third-degree felony in the

state of Florida? a. Practicing dental hygiene without an appropriate, active license b. Using a dental hygiene license that has been suspended c. Using a dental hygiene license that has been revoked d. Implying to any patient or consumer that she or he is an actively licensed dental hygienist unless that person has an active dental hygienist’s license ANS: D

Using the name “dental hygienist” or the initials “R.D.H.” or otherwise holding herself or himself out as an actively licensed dental hygienist or implying to any patient or consumer that she or he is an actively licensed dental hygienist unless that person has an active dental hygienist’s license is considered a misdemeanor. Each of the other acts is a third-degree felony.

DIF: Recall REF: p. 71 OBJ: 2 TOP: 7.0 Professional RespT onEsiS biT liB tyA| 7N.2KR ulL atoErR y.

CoCmOpM liance SeEgL 31. Dental hygienists are obligated to comply with the accepted standards of professional practice

and conduct. These standards are specific to the practice of dental hygiene and are not intended to be more generally applicable to health care professionals. 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 standards may be specific to the practice of dental hygiene or more generally applicable to health care professionals. Some states have uniform standards of professional conduct for health care professionals including the delineation of conduct, acts and conditions that constitute unprofessional conduct. Dental hygienists are responsible for ensuring that they are competent to engage in practice and comply with the provisions of their licensure.

DIF: Recall REF: p. 72 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 32. Each of the following is grounds for suspension or revocation of a license to practice dental

hygiene EXCEPT one. Which one is the EXCEPTION? a. Unprofessional conduct b. Violation of the laws and regulations governing the practice of dental hygiene c. An accident requiring the dental hygienist to use a wheelchair

d. Clinical incompetence ANS: C

An accommodation must be made for a dental hygienist who requires the use of a wheelchair.

A dental hygiene license may be suspended or revoked on the basis of unprofessional conduct, violations of the laws and regulations governing the practice of dental hygiene, and clinical incompetence or the delivery of substandard care. Unprofessional conduct is a broad term that may encompass, but is not limited to, acts of fraud, misrepresentation, or deception; conviction of a felony; aiding and abetting, in the practice of dentistry or dental hygiene, any person not licensed to practice dentistry or dental hygiene; sexual conduct with a patient; and violation of state or federal laws.

DIF: Recall REF: p. 66 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 33. Each of the following is true of an applicant for dental hygiene licensure in Idaho EXCEPT

one. Which one is the EXCEPTION? a. All active dental hygienists must hold a current CPR card. b. All active dental hygienists shall acquire twenty-four (24) credits of verifiable continuing education in each biennial renewal period. c. A dental hygienist holding an active status license issued by the Board shall be allowed one (1) credit of continuing education for every (1) hour of verified volunteer dental hygiene practice performed during the biennial renewal period. d. Continuing education must be oral health/health-related education for the professional development of a dental hygienist.

ANS: C

A dental hygienist is allowT edEoSnTeB(1A)NcK reS diE tL ofLcE onRt. inC uiO ngMeducation for every two (2) hours of verified volunteer dental hygiene practice performed during the biennial renewal period up to a maximum of ten (10) credits.

DIF: Recall REF: p. 72 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 34. When is a dental hygienist required to provide documentation or certification of compliance

with continuing education requirements? a. When making an initial application for a license in a particular state following graduation from an accredited dental hygiene program in any state b. When relocating from one state to another while in practice c. When renewing a current license to practice as a dental hygienist d. Only when renewing a lapsed license to practice as a dental hygienist ANS: C

Renewal of the license also requires payment of a licensing fee. When a dental hygiene student graduates from a dental hygiene program, he or she typically applies for an initial license. The continuing education requirement takes effect when applying for relicensure. The purpose of the continuing education requirement is to keep the knowledge acquired in school current.

DIF: Recall REF: p. 73 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

35. Dental hygienists who are not actively practicing dental hygiene and do not want to maintain a

current license may be able to apply for which of the following types of licenses? a. Full license b. Temporary license c. Faculty license d. Inactive license e. Volunteer license ANS: D

Although not all states have provisions for an inactive status, when available, an inactive license may permit a dental hygienist to avoid the expense of maintaining an active license. It also permits the dental hygienist to maintain recognized professional status as a dental hygienist and to reactivate the license upon demonstration of professional competence.

DIF: Recall REF: p. 73 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 36. All licenses issued to dentists and dental hygienists are automatically forfeited if the licensee

ceases to practice his or her profession in the state of Arkansas for how long? a. 1 year b. 2 years c. 5 years d. 7 years ANS: B

A period of 2 years. It is very important to be familiar with the laws in the state where you practice.

DIF: Recall REF: p. 73 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 37. Which of the following is considered to be an expanded function rather than a basic function

for a dental hygienist? a. Application of pit and fissure sealant b. Exposing oral radiographs c. Administration of an injectable local anesthetic d. Application of topical fluoride ANS: C

Examples of functions that are routinely allowed to be performed by the dental hygienist include the removal of deposits, accretions, and stains from the supragingival and subgingival surfaces of teeth by scaling, root planing, and polishing; the application of pit and fissure sealants, fluoride, and other topical therapeutic and preventive solutions; dental hygiene examinations and the charting of oral conditions; and exposing, developing, and referring to oral radiographs. The practice of dental hygiene may include additional functions such as the administration of local anesthesia and performance of restorative procedures. This expanded scope may require approved instruction, formal endorsement, and/or heightened supervision.

DIF: Recall REF: p. 73 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

38. The scope of dental hygiene practice is defined on a national basis. The practice of dental

hygiene includes educational, assessment, preventive, clinical, and other therapeutic services. 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 scope of dental hygiene practice varies among the states. The specific functions that can be legally performed in each of the aspects of dental hygiene practice are defined by state law.

DIF: Comprehension REF: p. 73 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 39. Which of the following is true regarding administration of local anesthetics and nitrous oxide

for a dental hygienist in Oregon? a. Administration of local anesthetic agents is permitted under the indirect supervision of a dentist. b. Administration of nitrous oxide is permitted under the indirect supervision of a dentist. c. Use of local anesthetic reversal agents is not permitted for a dental hygienist. d. Injected local anesthetic agents may only be administered to a patient who is over the age of 18.

ANS: B

Upon completion of a course of instruction in a program accredited by the Commission on Dental Accreditation of the American Dental Association or other course of instruction approved by the Board, a dTeE ntS alThB ygAiN enKisSt E mL ayLaEdRm.inCisOteMr nitrous oxide under the indirect supervision of a licensed dentist in accordance with the Board’s rules regarding anesthesia.

Administration of local anesthetic agents and local anesthetic reversal agents requires the general supervision of a licensed dentist. Local anesthetic reversal agents shall not be used on children less than 6 years of age or weighing less than 33 pounds.

DIF: Recall REF: p. 73 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 40. Each of the following steps in the restoration of a carious lesion is permitted for a dental

hygienist in at least one state EXCEPT one. Which one is the EXCEPTION? a. Expose radiographs of the area requiring restoration. b. Administer topical and injected local anesthetic. c. Prepare the tooth with a rotary instrumentation such as burs in a handpiece. d. Restore the tooth with silver dental amalgam.

ANS: C

General preclusions of dental hygiene practice include diagnosis for dental procedures or treatments, the cutting or removal of hard or soft tissues, and the prescribing of drugs or medications. Exposing, developing, and referring to oral radiographs is an example of a function that is routinely allowed to be performed by the dental hygienist. Endorsements to administer injected local anesthetic and a Restorative Functions Endorsement (RFE) are mentioned in the text for dental hygienists in Oregon.

DIF: Comprehension REF: p. 74 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 41. Dental hygienists have the obligation to limit their practice to the scope of functions permitted

by law in the jurisdiction in which they are practicing. If asked by an employing dentist to perform services that are clearly outside the legal scope of practice, the dental hygienist should defer to his or her supervisor and perform those services. 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

If asked by an employing dentist or other licensed dental professional to perform services that are clearly outside the legal scope of practice, the dental hygienist is obligated to decline to comply with the request. If whether a procedure is within the legal scope of practice is unclear, the dental hygienist or employing dentist should seek clarification from the governing authority.

DIF: Recall REF: p. 74 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 42. Which of the following forms of supervision requires the dentist’s approval of the work prior

to dismissal of the patient? a. Direct supervision b. Indirect supervision c. General supervision ANS: A

Direct supervision generally requires prior diagnosis of the patient’s condition and authorization of the procedure by a dentist, the presence of a supervising dentist on the premises, and dentist approval of the work performed before patient dismissal.

DIF: Recall REF: p. 74 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 43. Which of the following forms of supervision require the dentist to be present in the dental

office during treatment by the dental hygienist? a. Direct supervision, indirect supervision, and general supervision b. Direct supervision and indirect supervision, but not general supervision c. Direct supervision and general supervision, but not indirect supervision d. Indirect supervision and general supervision, but not direct supervision e. Direct supervision, but not indirect supervision and general supervision ANS: B

Both direct and indirect supervision require the dentist to be on the premises. General supervision requires that the services being delivered be authorized by the dentist; however, the presence of the supervising dentist in the treatment facility is not required, but the dentist’s availability for consultation may be required.

DIF: Comprehension REF: p. 74 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

44. All of the following states permit the unsupervised practice of dental hygiene EXCEPT one.

Which one is the EXCEPTION? a. Colorado b. Connecticut c. Michigan d. New Mexico e. Maine ANS: C

The unsupervised practice of dental hygiene is permitted in some states, including Colorado, Connecticut, New Mexico, Minnesota, and Maine.

DIF: Recall REF: p. 74 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 45. Unsupervised dental hygiene may be performed by licensed dental hygienists without

supervision of a licensed dentist in Colorado, because some states, including Colorado, Connecticut, New Mexico, Minnesota, and Maine, permit the unsupervised practice of dental hygiene. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

In Colorado, what constituT teE sS prTacBtiAciNnK gS unEsL upLeE rvRis.eC dO deMntal hygiene, (1) Unless licensed to practice, dentistry, a person shall be deemed to be practicing unsupervised dental hygiene who, within the scope of a the person’s education, training, and experience: (a) Removes deposits, accretions, and stains by scaling with hand, ultrasonic, or other devices from all surfaces of the tooth and smooths and polishes natural and restored tooth surfaces, including root planing; (b) Removes granulation and degenerated tissue from the gingival wall of the periodontal pocket incidental to root planing; (c) Provides preventive measures including the application of fluoride, sealants, and other recognized topical agents for the prevention of oral disease; (d) Gathers and assembles information; (e) Administers a topical anesthetic to a patient in the course of providing dental care; (f) Performs dental hygiene assessment, dental hygiene diagnosis, and dental hygiene treatment planning for dental hygiene services as described in this section and identifies dental abnormalities for immediate referral to a dentist; or (g) Prescribes, administers, and dispenses fluoride, fluoride varnish, and antimicrobial solutions for mouth rinsing and other nonsystemic antimicrobial agents in collaboration with a licensed dentist.

DIF: Recall REF: pp. 74-75 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 46. Which of the following statements is true regarding the reporting of child and elder abuse? a. All states have enacted laws that mandate the reporting of child abuse. b. All states have enacted laws that mandate reporting elder abuse. c. Dental hygienists have a personal responsibility to report abuse. d. Child abuse is concentrated in particular socioeconomic strata of society and

knowledge of this fact helps predict when and where it will occur.

ANS: C

Dental hygienists should be familiar with their personal responsibility to report abuse as it has ethical and legal professional demands. According to the text “(m)ost states have enacted laws that mandate the reporting of child abuse” and (i)n addition, several states, including Colorado, have enacted legislation that mandates or encourages the reporting of abuse of vulnerable, dependent, and disabled adults. The prevalence of elder abuse is also alarming and while no one knows precisely how many older Americans are being abused, neglected, or exploited evidence of such issues is accumulating.

DIF: Comprehension REF: p. 76 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 47. Child abuse spans which of the following aspects of society? a. Socioeconomic, cultural, and ethnic b. Socioeconomic and cultural, but not ethnic c. Socioeconomic and ethnic, but not cultural d. Cultural and ethnic, but not socioeconomic e. Socioeconomic only ANS: A

Child abuse and neglect are widespread public health problems and this problem spans all socioeconomic, cultural, and ethic aspects of society.

DIF: Recall REF: p. 76 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 48. Which of the following is true regarding the maintenance of patient health care records? a. Patient health care records are the property of the patient. b. Health care records are generally recognized to be confidential and protected

against disclosure to unauthorized third parties. c. Health care records should be destroyed as soon as the person is no longer an active patient in the dental practice. d. There is no requirement regarding maintenance of a patient record.

ANS: B

In some instances, the patient may indicate which portions of the health care record may be disclosed and which portions are not to be disclosed. Patient health care records are the property of the dentist not the patient; however, the patient has the right of access to the information contained in those records. Most states require the maintenance of patient health records for a period following active treatment. Maintenance of a patient record may be mandated statutorily, particularly for identification in the event of a mass disaster.

DIF: Recall REF: p. 77 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 49. Dental hygienists in some states are mandated to maintain professional liability insurance or

other indemnity against liability for professional malpractice. When mandated, the law may prescribe the level of insurance that must be maintained per incident as well as in the aggregate. 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

In some cases dental hygienists who are employees are covered by the malpractice policy carried by the dentist. There have been recommendations that dental hygienists purchase their own malpractice insurance policies, particularly if they are not sure whether they are covered on the dentist’s policy or not, or if they are working in several offices and wish to have their own, independent liability coverage. Malpractice policies for dental hygienists may be purchased online for a very reasonable amount, usually less than 100 dollars per year.

DIF: Recall REF: p. 77 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 50. Some states have enacted legislation that mandates that dental professionals be currently

certified a. in cardiopulmonary resuscitation (CPR). b. in advanced cardiac life support (ACLS). c. as an emergency medical technician (EMT). d. as a pharmacy technician.

ANS: A

Maintaining current cardiopulmonary resuscitation (CPR) or Basic Life Support (BLS) certification is professionally prudent. In some states, the practitioner is required to show evidence of current certification at the time of application for licensure. It is important to take the course entitled “BLS for Healthcare Providers” from the American Heart Association or R.thCeOAMmerican Red Cross. Some dental “BLS/CPR for Healthcare T anEdSPTuB blA icNSKaS feE tyL ”L frE om programs offer training as an EMT to dental students.

DIF: Recall REF: p. 77 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 51. When a patient suggests that the dentist pay him $50 for every patient referred to the dental

office, the dentist says no because it would be (a/an) a. insufficient amount for the value of a new patient. b. excessive amount for the value of a new patient. c. kickback. d. violation of patient confidentiality.

ANS: C

State and local self-referral statutes have been enacted to avoid the conflict of interest that may be inherent in the referral of a patient by a health care provider to a provider of health care services in which the referring provider has an investment interest. Prohibitions on kickbacks, or remuneration of payment back as an incentive or inducement to refer or solicit patients, also have been enacted at the federal and state levels.

DIF: Comprehension REF: p. 77 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

52. General due process provisions include notice and an opportunity to be heard. Notice

generally includes a statement of the proposed action to be taken, the available evidence supporting the proposed action, and a. opportunity for a hearing. b. waiving of rights to a trial. c. discussion of Miranda rights. d. requirement to pay a fine.

ANS: A

The proposed action can be taken uncontested if the dental hygienist fails to respond within the time and in the manner specified in the notice. If a hearing is requested, the dental hygienist will be notified, at a minimum, of the time and place of the hearing and who will conduct the hearing.

DIF: Recall REF: p. 77 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

Chapter 08: Dental Hygienist–Patient Relationship Beemsterboer: Ethics and Law in Dental Hygiene, 3rd Edition MULTIPLE CHOICE 1. The dental hygienist–patient relationship is a critical factor in the delivery of quality dental

hygiene care. The dental hygienist–patient relationship is a two-party association that can only achieve its fullest potential with the committed participation of each of the parties. 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

Patients enter into this therapeutic relationship with certain expectations. Dental hygienists must understand these expectations through communication with their patients.

DIF: Recall REF: p. 79 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.3 Patient and Professional Communication 2. If a dental hygienist is unable to meet a patient’s expressed expectations, the patient must a. demand that the dental hygienist meet those expectations. b. understand but not accept the limitation. c. either accept the limitation and alter the expectations or seek care from a different

provider who is able to meet the expectations. d. cease to seek care.

ANS: C

If dental hygienists are unable to meet their patient’s expressed expectations, the patient must understand this limitation and either accept the limitation and alter his or her expectations or seek care from an alternative provider who is able to meet the expectations.

DIF: Recall REF: p. 79 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.3 Patient and Professional Communication 3. The dental hygienist has a professional obligation in the relationship with the patient to

comply with the laws that govern the practice of dental hygiene and to deliver oral health care services that meet the standards of the profession, because failure to fulfill this professional obligation can result in untoward consequences for the patient although the hygienist is spared. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: C

Failure to fulfill this professional obligation can result in untoward consequences for both the patient and dental hygienist.

DIF: Recall REF: p. 79 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.3 Patient and Professional Communication 4. Which of the following is a consequence for the patient of the failure of a dental hygienist to

fulfill a professional obligation to comply with the laws that govern the practice of dental hygiene and to deliver oral health care services that meet the standards of care of the profession? a. Substandard care b. Complaint review c. Sanctions d. Criminal penalties ANS: A

The consequences for the patient may be substandard and/or unauthorized care. Several consequences are possible for the dental hygienist such as complaint review, sanctions, or even criminal penalties.

DIF: Recall REF: p. 79 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.3 Patient and Professional Communication 5. Each of the following is grounds for a complaint to be filed with the administrative hearing

commission in Missouri EXCEPT one. Which one is the EXCEPTION? a. Use of an alcoholic beverage to an extent that such use impairs a person’s ability to perform the work of any professional licensed or regulated by the commission b. Failure or refusal to properly guard against contagious, infectious, or communicable diseases or the spread thereof c. Failure to maintain his or her office or offices, laboratory, equipment, and instruments in a safe anTdEsS anTitBarAyNcK onSdE itL ioL n ER.COM d. Discrimination based on the provision of free dental services ANS: D

According to Missouri Statute 332.323, “Notwithstanding any other provision of law to the contrary, any health care provider licensed pursuant to this chapter who provides any service for which the health care provider is licensed may provide such service free of charge. Such health care provider shall not be subject to an action for civil damages for discrimination based on the provision of such free dental services.” (L. 1998 S.B. 790) DIF: Recall REF: p. 79 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 6. A person who practices dental hygiene in Nevada without a license or who, having a license,

practices dental hygiene in a manner or place not permitted is guilty of a category D felony a. if it is the first offense. b. if it is the second offense. c. if it is the third offense. d. in no circumstances, because the offense is categorized as a misdemeanor.

ANS: C

This person is guilty of a category D felony if it is the third or subsequent offense. A misdemeanor is a less serious offense than a felony and involves jail time of less than 1 year.

Felonies are categorized according to how serious the offense is found to be, with a category D felony being the least serious and category A being the most serious. Felonies involve jail time of more than 1 year.

DIF: Recall REF: p. 80 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 7. Dental hygiene professionals must be familiar with the legal principles of the dental

hygienist–patient relationship to guide their actions, decisions, record keeping, and professional interactions. The legal principles are based on society’s general belief that citizens have a right to be protected and, if they come to harm at the hands of another, they have a right charge the offender with a criminal offense. 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

Citizens have a right to be compensated; however, the offense may involve civil rather than criminal litigation. Although civil offenses are most commonly litigated, both civil and criminal offenses can be committed in the practice of dental hygiene.

DIF: Comprehension REF: p. 80 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

EpSleTsBwAoN 8. Which of the following exT am ulK dSinEvL olL veER cr. imCiO naMl action as well as civil action? a. Supervised neglect of a periodontal condition involving increased probing depths b. Sexual assault of a patient during dental treatment c. Discussion of a 22-year-old patient’s treatment conditions with her mother without obtaining permission d. Discussion of an 88-year-old patient’s treatment conditions with her daughter

without obtaining permission ANS: B

A violation of criminal law is a violation of a societal rule outlined by statutory law. Sexual assault of a patient would involve criminal as well as civil action. A civil offense is a wrongful act against a person that violates his or her person, privacy, or property or contractual rights. A dental hygienist who fails to provide appropriate periodontal therapy, resulting in a condition of increased severity, may have committed a civil offense. An office manager who breaches confidentiality by discussing a patient’s medical condition with an unauthorized person without the patient’s consent may have committed a civil offense.

DIF: Comprehension REF: p. 81 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 9. Which of the following is a wrongful act against a person that violates his or her person

(body), privacy, or property or contractual rights? a. Civil offense b. Criminal offense

c. Deposition d. Defamation ANS: A

A civil offense is a noncriminal violation of an administrative matter. A deposition is part of the discovery of evidence during the investigation of claims and allegations. Defamation is spoken or written words that cause damage to the reputation of another person.

DIF: Recall REF: p. 81 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 10. Which of the following is the correct sequence for dealing with civil and criminal offenses? a. Filing, investigating, resolving b. Investigating, filing, resolving c. Filing, resolving, investigating d. Investigating, resolving, filing e. Resolving, filing, investigating ANS: A

The investigation of claims and allegations includes the discovery of evidence. The resolution of claims and allegations may require a court proceeding.

DIF: Recall REF: p. 81 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 11. Which of the following is correct name for the party bringing a claim in a civil proceeding and

in a criminal proceeding respectively? a. Complainant; prosecutT orESTBANKSELLER.COM b. Plaintiff; prosecutor c. Prosecutor; plaintiff d. Plaintiff; complainant e. Aggressor; defendant ANS: B

The party bringing the claim is referred to as the plaintiff in a civil proceeding and the prosecutor in a criminal proceeding. The party defending a claim is referred to as the defendant.

DIF: Recall REF: p. 81 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 12. Interrogatories and depositions may be utilized during which of the following stages of the

investigation of a legal claim? a. Informed consent b. The trial c. Discovery of evidence d. Intentional tort e. Unintentional tort ANS: C

The investigation of claims and allegations includes the discovery of evidence, which may be gathered through interrogatories and depositions.

DIF: Recall REF: p. 81 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 13. The resolution of legal claims and allegations may require a court proceeding known as a a. deposition. b. trial. c. grand jury. d. tort.

ANS: B

In a trial, the plaintiff or prosecutor is given the opportunity to present allegations, including evidence, and the defendant is given an opportunity to present a defense, including evidence, to a panel of judges or jury.

DIF: Recall REF: p. 81 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 14. Who decides questions of law in a trial? a. Judges b. Juries c. Prosecuting attorney d. Plaintiff e. Defendant ANS: A

Questions of law are decided by judges, whereas questions of fact are decided by juries.

DIF: Recall REF: p. 81 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 15. The establishment of guilt in a criminal case requires a high level of certainty known as a. beyond a reasonable doubt. b. preponderance of evidence. c. fiduciary relationship. d. binding arbitration.

ANS: A

In a criminal case, the establishment of guilt requires a high level of certainty known as beyond a reasonable doubt. In a civil case, the establishment of a claim may require a level of certainty that is greater than 50%, known as the preponderance of evidence. The nature of the claim or allegation influences the determination of which party bears the responsibility for meeting the required level of proof.

DIF: Recall REF: p. 81 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 16. Which of the following are the two major categories of civil law? a. Intentional tort and unintentional tort law b. Contract law and tort law c. Implied contract law and explicit contract law d. Assault and battery law

ANS: B

The two major categories of civil law are contract law and tort law. A contract is a legally binding agreement to keep a promise in exchange for something of value. A tort is a civil wrong that results from breach of a legal duty that exists by virtue of society’s expectations of performance, rather than a contractual or privately created performance obligation.

DIF: Recall REF: p. 81 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 17. When a patient agrees to cooperate in oral health care and arrange for appropriate payment in

exchange for the delivery of services, the courts view the relationship in terms of a contract called a a. null and void relationship. b. fiduciary relationship. c. barter or trade of goods relationship. d. quid pro quo relationship.

ANS: B

The courts view the relationship between a health care provider and a patient in terms of a contract. The dental provider agrees to deliver oral health care services to a patient and, in return, the patient agrees to cooperate in the care and arrange for appropriate payment. The exchange of promises that creates a binding contract may be express or implied.

DIF: Recall REF: p. 81 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 18. Which of the following is tThE eS beTstBeAxN am nR ex.pC reOssMrather than implied contract?

KpSleEoLfLaE a. The patient seats herself in the dental chair. b. The dentist presents a written treatment plan involving periodontal surgery for the

maxillary right quadrant to the patient. c. The patient arrives at the dental office at the scheduled time for an initial appointment to have an examination of discomfort in the mandibular left quadrant. d. The patient asks the dentist if the injection of local anesthetic will hurt and the dentist replies that she will anesthetize the patient very slowly and carefully to minimize discomfort.

ANS: B

An express contract is an agreement that is stated in explicit language, either orally or in writing. A written treatment plan that outlines the procedures to be performed and associated costs for the delivery of those procedures may be viewed as an express contract. An implied contract is recognized if, based on the circumstances surrounding a particular event, the assumption that a contract exists between the parties is reasonable. An implied contract can occur through inference by signs, inaction, or silence. The patient’s action of arriving at the dental office at a scheduled time and sitting in the dental chair and the dental provider’s actions of treating the patient may establish an implied contract.

DIF: Recall REF: p. 81 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

19. A contractual relationship is a relationship that binds each of the parties to fulfill his or her

committed responsibilities. A disruption of contract is the failure to meet one’s contractual obligation, and it may be remedied through the judicial system. 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

Failure to meet a contractual obligation is known as a breach of contract rather than a disruption of contract, which may be remedied through the judicial system.

DIF: Recall REF: p. 81 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 20. A civil wrong that results from breach of a legal duty that exists by virtue of society’s

expectations of performance is called a(n) a. assault. b. battery. c. tort. d. sanction.

ANS: C

A tort is a civil wrong that results from breach of a legal duty based upon society’s expectation of performance.

DIF: Recall REF: p. 81 OBJ: 3 TOP: 7.0 Professional RespT onEsiS biT liB tyA| 7N.2KR ulL atoErR y.

CoCmOpM liance SeEgL 21. Which of the following is true of tort law? a. A tort is a crime that involves criminal law. b. A tort is a civil wrong. c. A tort is a legally binding agreement in writing. d. A tort is a legally binding agreement that is not in writing.

ANS: B

A tort is a civil wrong that results from a breach of legal duty. The two major categories of civil law are contract law and tort law. A contract is a legally binding agreement to keep a promise in exchange for something of value.

DIF: Recall REF: p. 81 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 22. Each of the following is true of an intentional tort EXCEPT one. Which one is the

EXCEPTION? a. No intent to cause harm b. A deliberate and purposeful act c. Relates to persons and to property d. Misrepresentation ANS: A

An unintentional tort includes no intent to cause harm, although harm or injury does occur. An intentional tort is a deliberate and purposeful act that has substantial certainty of untoward consequences from the act. Intentional torts relate to persons and to property.

Misrepresentation is deliberate; thus it is an intentional tort.

DIF: Recall REF: p. 82 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 23. Which of the following is true of assault and battery? a. Both are categorized as intentional torts. b. Assault is categorized as an intentional tort; however, battery is an unintentional

tort. c. Battery is categorized as an intentional tort; however, assault is an unintentional

tort. d. Neither assault nor battery is categorized as an intentional tort.

ANS: A

Both are categorized as intentional torts to persons. An assault is an action that causes apprehension in a person. Battery is a harmful, nonconsensual, or offensive contact with a person.

DIF: Recall REF: p. 82 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 24. Which of the following is true of an intentional tort to a person? a. Physical contact must happen for assault to occur. b. Physical contact must happen for battery to occur. c. An injury must be invoT lvEeS dT foBr A baNttKerSyEtoLoLcEcuRr. . COM d. More than one of the above.

ANS: B

An assault is an action that causes apprehension in a person. No physical contact occurs in assault, but the action may involve words and conduct. The tort of battery is defined as harmful, nonconsensual, or invasive contact with a person. An injury does not have to occur, only a physical invasion of a person. Dental hygienists must use caution in patient management techniques to minimize the risk of being accused of assault or battery.

DIF: Recall REF: p. 82 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 25. Which of the following is an example of an unintentional tort rather than an intentional tort? a. Allowing a dental assistant to work as a dental hygienist b. Failure to inform a patient of the severity of his or her periodontal treatment needs c. Slander or libel resulting in defamation d. Slapping a child to punish him or her for difficult behavior ANS: B

Negligence is an unintentional tort that involves the failure to act as a reasonable, prudent person under similar circumstances. Malpractice is a form of negligence. Allowing a dental assistant to work as a dental hygienist is misrepresentation, an intentional tort. Slander, which is spoken words, or libel, which is written words, results in damage to the reputation of another person and is an intentional tort. Slapping a child is an intentional tort to a person.

DIF: Comprehension REF: p. 82 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 26. Trespassing on private property without authorization is a form of an a. intentional tort to a person. b. unintentional tort to a person. c. intentional tort to property. d. unintentional tort to property.

ANS: C

The physical invasion of intruding on land without authorization is a form of intentional tort.

Interference with possession of an individual’s property is another form of intentional tort.

DIF: Recall REF: p. 82 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 27. A dental hygienist has which of the following responsibilities to the patient in regard to

licensure? a. The dental hygienist must have a current national license issued by the U.S. government and the license must be displayed as required. b. The dental hygienist must have a current license for the state where he or she practices and have it displayed as required. c. The dental hygienist must have a current national license issued by the United States; however, the license need not be displayed as the patient can verify the license on the Internet. d. The dental hygienist must have a current license for the state where he or she practices; however, theTlE icS enTseBnAeNedKS noEt L beLdEiR sp. laCyO edMas the patient can verify the license on the Internet.

ANS: B

Dental hygienists must have a current license for the state in which they practice and have it displayed as required. An individual who fails to renew a license or who is denied a license cannot practice. Dental hygienists must perform only the legally allowed duties with appropriate supervision.

DIF: Recall REF: p. 83 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 28. A dental hygienist is held to the standard of care for a a. periodontist. b. general dentist. c. dental hygienist. d. physician.

ANS: C

A practitioner makes a judgment or decision based on his or her educational training and experience. A dental hygienist is held to the standard of a dental hygienist, not a dentist or a physician.

DIF: Recall REF: p. 83 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

29. The practice of dental hygiene is a wonderful opportunity for a dental hygienist to try out

experimental medications, because trying untested medications on patients can prove or disprove their effectiveness. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: E

A dental hygienist must use drugs, materials, and techniques recognized by the profession.

Patients trust that the dental hygienist will recommend or use therapeutic treatments recognized by professional groups, such as the American Dental Association (ADA) or the American Academy of Periodontology (AAP). There is a whole sequence of events that occurs during development of a new drug. Following preclinical trials, an investigational new drug application (INDA) must be submitted prior to any clinical trials. Clinical studies of drugs involve four phases. In Phase 1: Small and then increasing doses are administered to a limited number of healthy human volunteers, primarily to determine safety. Phase 2: Larger groups of people receive the drug and any adverse reactions are reported to the Food and Drug Administration. The primary purpose of phase 2 is to determine effectiveness. Phase 3: More clinical evaluation takes place involving a large number of patients who have the condition for which the drug was created to manage or treat. Safety and efficacy are evaluated, and the dose is determined. Phase 4: Postmarketing surveillance.

DIF: Recall REF: p. 83 OBJ: 4 TOP: 7.0 Professional RespT onEsiS biT liB tyA| 7N.2KR ulL ator y.

CoCmOpM liance SeEgL ER 30. Discontinuation of the provider–patient relationship requires appropriate notification to avoid a. termination of services. b. abandonment of the patient. c. a severance clause. d. a notice to quit.

ANS: B

An office cannot stop treatment if harm will occur. The notification to avoid charges of abandonment includes: informing the patient in writing of the discontinuation of services, continuing to provide emergency care for a sufficient period of time in order to allow the patient to locate a subsequent provider, and explaining how the patient may obtain a copy of his or her dental records.

DIF: Recall REF: p. 83 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 31. The purpose of the Health Insurance Portability and Accountability Act (HIPAA) is to a. support the digital imaging and communications in medicine (DICOM) standard

for exchange of information between health care providers. b. protect the patient’s right to privacy. c. help in the transmission of electronic dental claims forms through a clearinghouse. d. make certain that the electronic records of members of the armed forces follow

them if they are transferred to another location.

ANS: B

According to HIPAA a patient’s health information can be shared with unauthorized parties only with the patient’s permission. Office staff must be careful not to divulge information without a patient’s consent. Office staff must be cautious not to have casual or public conversations about a patient that would violate the patient’s privacy.

DIF: Recall REF: p. 83 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 32. Patient records may include a. written documentation, radiographs, and models. b. written documentation and radiographs, but not models. c. written documentation and models, but not radiographs. d. written documentation only.

ANS: A

Records may include written documentation, radiographs, and models. Written documentation may include collected data, diagnoses, treatment plans, and a description of the treatment provided.

DIF: Recall REF: p. 83 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 33. Patients have the right to obtain their original records. Records must be provided free of

charge. a. Both statements are true. b. Both statements are falT seE. STBANKSELLER.COM c. The first statement is true, the second statement is false. d. The first statement is false, the second statement is true.

ANS: B

The practitioner owns the original records. Patients have a right to a copy of the records. It is permitted to charge a reasonable copying fee for transfer of records. Fees to obtain records may be dictated by state regulations. State Medical Records Payment Rates may be found at the following website: https://www.nosscr.org/state-medical-records-payment-rates.

DIF: Recall REF: p. 83 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 34. Which of the following is a recommended method for a dental hygienist to remain current

with all aspects of patient care? a. Attend continuing education courses in person. b. Watch Webinars and Podcasts relating to the clinical practice of dental hygiene on the Internet. c. Read scientific literature pertaining to dental hygiene. d. All of the above.

ANS: D

Dental hygienists are required to remain current with all aspects of patient care. Attending continuing education courses, reading scientific literature, and using other educational sources to keep knowledge and skill levels up to date are important. In addition, an awareness of and adherence to a professional code of ethics are imperative.

DIF: Comprehension REF: p. 83 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 35. Each of the following is a responsibility of the patient when receiving oral health care

EXCEPT one. Which one is the EXCEPTION? a. Cooperate in care and keep appointments. b. Provide accurate answers about the dental or medical history and current health status. c. Pay a reasonable fee in a reasonable amount of time. d. Arrive for an appointment 15 minutes prior to the appointment time. e. Follow instructions, including home care instructions.

ANS: D

While early arrival certainly is courteous it is not one of the responsibilities of a patient in receiving oral health care. The rest of the possible answers all are responsibilities of the patient. A patient should pay a reasonable fee in a reasonable amount of time. A patient should cooperate in care and keeping appointments. A patient should provide accurate answers about the dental or medical history and current health status. A patient should follow instructions, including home care instructions.

DIF: Recall REF: p. 81 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.3 Patient and Professional Communication 36. Why is it important for a dental patient to provide accurate answers about the medical or

dental history and current health status? a. It is important to be honest in daily life. b. Honesty is the best policy in one’s personal life and professional life. c. The delivery of dental care may be affected by a number of diseases and conditions. d. Inaccurate answers constitute a breach of contract.

ANS: C

Dental care may be affected by a number of diseases and conditions. For example, physicians tell HIV positive patients to inform the dentist about their conditions because a positive status may affect the delivery of dental care.

DIF: Comprehension REF: p. 86 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.3 Patient and Professional Communication 37. Patients have a number of responsibilities when receiving oral care. One of the patient

responsibilities is to follow instructions, including home care instructions. 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

Patients are sometimes surprised to learn that they have any responsibilities in receiving health care, but they do. Many patients are noncompliant with treatment directions. Patients often do not take their medications as prescribed, possibly through a lack of understanding or lack of motivation. It may result from communication problems, inadequate patient education, or even the patient’s health belief system. Poor patient adherence to treatment recommendations can be an important factor in a therapeutic failure.

DIF: Recall REF: p. 83 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.3 Patient and Professional Communication 38. Each of the following is one of the three most common actions relating to health care

EXCEPT one. Which one is the EXCEPTION? a. Violation of patient confidentiality b. Breach of contract c. Professional malpractice d. Failure to obtain informed consent ANS: A

The three most common actions relating to health care are: (1) failure to obtain informed consent, (2) professional malpractice, and (3) breach of contract. At the core of each of these actions is the question of whether the dental hygienist violated a duty owed to the patient.

DIF: Recall REF: p. 84 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 39. Which of the following concepts is based on the premise that every citizen has the right to be

free from invasion of his or her body without permission? a. Informed consent b. Integrity of self c. The principle of self versus nonself d. Breach of contract ANS: A

An essential step in understanding and meeting the expectations of a patient involves obtaining the patient’s informed consent prior to the delivery of oral health care services. It can be summed up by the phrase “inform before you perform.” Informed consent balances the health care provider’s unique knowledge and skill with the patient’s decision-making role by placing an affirmative duty on the health care provider to disclose the nature of a procedure to be performed as well as the risks and benefits of the proposed and alternative treatment.

DIF: Recall REF: p. 84 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 40. The concept that every citizen has the basic right to be free from invasions of his or her body

without permission was first extended to health in which of the following legal opinions? a. Union Pacific Railway v. Botsford, 141 U.S. 250, 251 in 1891 b. Schloendorff v. Society of New York Hospital, 105 N.E. 92, 93 in 1914 c. Salgo v. Leland Stafford Jr. Univ Bd. Of Trustees, 317 P.2d 170 Cal. Ct. App. in 1957 d. Health Insurance Portability and Accountability Act [HIPAA] 42 U.S.C. in 2008 ANS: B

The court opined that “(E)very human being of adult years and sound mind has a right to determine what shall be done with his own body; and a surgeon who performs an operation without his patient’s consent commits an assault.”

DIF: Recall REF: p. 84 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 41. Which of the following concepts was first expressed in 1957 in Salgo v. Leland Stafford Jr.

Univ Bd. Of Trustees, 317 P.2d 170 Cal. Ct. App.? a. The concept that every citizen has the basic right to be free from invasions of his or her body without permission b. The extension of the concept regarding the basic right to be free from invasions of his or her body to the delivery of health care c. The concept of informed consent for the delivery of health care d. The concept of the privacy of patient information ANS: C

The concept of informed consent was first expressed in Salgo v. Leland Stafford Jr. Univ Bd. Of Trustees, when the court held that formal and documented consent was legally ineffective if the patient lacked an understanding of material information about the treatment being authorized. The concept that every citizen has the basic right to be free from invasions of his or her body with permission was first expressed in Union Pacific Railway v. Botsford, and the concept was extended to health care in Schloendorff v. Society of New York Hospital. Privacy of patient information was articulated in the Health Insurance Portability and Accountability Act [HIPAA] 42 U.S.C. in 2008. p. 84 OBJ: 6 DIF: Recall REF: TESTBANKSELLER.COM TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 42. The doctrine of informed consent has been codified through which of the following? a. Common law b. Case law c. State statutory enactments d. Codes of ethics ANS: C

Informed consent was first addressed in common law, which is the reported opinions of courts, and is also known as case law. The doctrine of informed consent also has been codified through state statutory enactments. In addition to a legal obligation to obtain informed consent, the American Dental Hygiene Association (ADHA) also recognizes an ethical obligation as specified in its Code of Ethics for Dental Hygienists.

DIF: Recall REF: p. 84 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 43. To successfully establish a cause of action for failure to obtain informed consent, a patient

must generally establish, in sequence, that (1) the duty was breached, (2) the breach of duty was the cause of the injury sustained by the patient, (3) the health care provider had a duty to disclose sufficient information about the proposed treatment to obtain the patient’s informed consent. a. 1, 2, 3

b. c. d. e.

1, 3, 2 2, 1, 3 2, 3, 1 3, 1, 2

ANS: E

A patient must generally establish that (1) the health care provider had a duty to disclose sufficient information about the proposed treatment to obtain the patient’s informed consent, (2) the duty was breached, and (3) the breach of duty was the cause of the injury sustained by the patient.

DIF: Comprehension REF: p. 85 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 44. Which of the following are the two different standards that have emerged as the general

measure of the duty to disclose information when a potential danger or risk is associated with a proposed treatment that may influence the decision whether to proceed with the treatment? a. Prevailing opinion standard and national databank standard b. Impartial group standard and American College of Dental Surgeons (ACDS) standard c. Professional community standard and materiality standard d. State government standard and federal government standard ANS: C

The professional community standard is based on the accepted practice of the professional community (see the North Carolina and Kentucky statutes in the textbook), whereas the materiality standard (see the Washington statute in the textbook) is based on the needs of the ToEuSs T .eCnO patient to make an autonom anBdAinNfK orSmEeL dL trE eaRtm t dMecision. The dental hygienist must be familiar with the informed consent statutes in the jurisdiction of practice as well as the judicial interpretation of the statutory language.

DIF: Recall REF: p. 85 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 45. The elements of informed consent require the dental hygienist to inform that patient of the

risks, consequences, and anticipated results of the proposed treatment and alternative feasible treatments. The consequences of accepting no treatment should be discussed as well. 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

The duty to disclose information generally requires the following: (1) The nature of the patient’s condition or diagnosis; (2) The nature and purpose of proposed treatment; (3) The risks, consequences, and anticipated results of the proposed treatment; (4) The alternative feasible treatment; (5) The risks, consequences, and anticipated results of the alternative feasible treatment; and (6) The probable or possible consequences of accepting no treatment.

The discussion of risks should include the nature and severity of the risk and the likelihood of its occurrence.

DIF: Recall REF: p. 86 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 46. To establish a causal link between the breach of duty and patient injury a. both injury causation and decision causation must exist. b. injury causation but not decision causation must exist. c. decision causation but not injury causation must exist. d. neither injury causation nor decision causation must exist.

ANS: A

Both injury causation and decision causation must exist. Injury causation requires that the patient suffer an adverse consequence and that the cause of the injury be an undisclosed risk.

Decision causation requires demonstrating that the patient would not have consented to treatment had the disclosure been adequate.

DIF: Recall REF: p. 86 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 47. Which of the following must be established to prove injury causation during a breach of duty

to obtain informed consent from a patient? a. That the patient suffered an adverse consequence b. That the patient suffered an adverse consequence and that the cause of the injury be an undisclosed risk c. That the patient did not consent to treatment d. That the patient would not have consented to treatment had the disclosure been adequate ANS: B

A breach of duty to obtain informed consent generally is not sufficient to establish a claim of lack of informed consent if the breach was not the cause of an injury to the patient. Injury causation requires that the patient was injured as a result of a risk that was not disclosed.

Decision causation requires proving that if the disclosure was adequate the patient would not have consented to treatment.

DIF: Recall REF: p. 86 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 48. Consent to health care services for a competent adult may be determined by a. the federal court system. b. the state and county court systems. c. the person him or herself. d. the parents of the adult if they are determined to be competent themselves.

ANS: C

Competent adults are solely responsible for the determination of the health care services to which they are willing to consent. The parents of an incompetent person may be authorized to consent on behalf of the patient.

DIF: Recall REF: p. 86 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

49. Which of the following is grounds for obtaining informed consent to the treatment of an adult

patient from a person other than the patient him or herself? a. Incompetency or incapacity b. Advanced age c. Incarceration in a federal prison d. Lack of residency status ANS: A

Informed consent to the treatment of an adult patient may be sought from an authorized person other than the patient only when the patient is incapable of consenting because of incompetency or incapacity. Guidance in determining who is an authorized person to care for an incompetent or incapacitated adult should be sought from statutory law.

DIF: Recall REF: p. 86 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 50. Who has the priority for providing informed consent for health care for a patient who is not

competent according to the statute in the state of Washington? a. The patient’s spouse or state registered domestic partner b. The appointed guardian of the patient c. Parents of the patient d. The individual to whom the patient has given a durable power of attorney ANS: B

According to the WASH. REV. STAT. 7.70.065 “(1) Persons authorized to consent of behalf of a patient who is not competent to consent … shall be a member of one of the following classes of persons in the following order of priority: (a) The appointed guardian of the patient, SEthLeLpEatRie.nC if any, (b) The individual, T if E anSyT, B toAwNhK om t hOaM s given a durable power of attorney that encompasses the authority to make health care decisions; (c) The patient’s spouse or state registered domestic partner; (d) Children of the patient who are at least 18 years of age; (e) Parents of the patient; and (f) Adult brothers and sisters of the patient.”

DIF: Recall REF: p. 86 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 51. Consent to treatment of persons younger than which age should be sought from the parents? a. 12 b. 16 c. 18 d. 21 ANS: C

Minor patients generally are unable to consent legally to health care; in most jurisdictions the age of majority is attained at the age of 18 years. Therefore, consent to treatment of persons younger than 18 years generally should be sought from the minor’s parents.

DIF: Recall REF: p. 87 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 52. Each of the following is an exception to the requirement of parental consent for the treatment

of minors EXCEPT one. Which one is the EXCEPTION? a. Treatment of a minor in an emergency

b. Treatment of a legally recognized emancipated minor c. Treatment of a statutorily authorized consenting minor d. Treatment of a minor who is a child of parents who are minors themselves ANS: D

Parents who are themselves minors typically are granted authority to consent to the health care needs of their children.

DIF: Recall REF: p. 87 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 53. Who has the priority for providing informed consent for health care for a patient who is under

the age of majority according to the statute in the state of Washington? a. Parents of the minor patient b. A competent adult representing himself or herself to be a relative responsible for the health care of such minor c. A person authorized by the court to consent to medical care for a child in out-of-home placement d. The appointed guardian, or legal custodian … of the minor patient, if any e. The individual, if any, to whom the minor’s parent has given a signed authorization to make health care decisions for the minor ANS: D

The order of priority is: (1) The appointed guardian, or legal custodian … of the minor patient, if any; (2) A person authorized by the court to consent to medical care for a child in out-of-home placement … if any, (3) Parents of the minor patient; (4) The individual, if any, to whom the minor’s parent has given a signed authorization to make health care decisions for the minor; and (5) A compT etE enStTadBuAltNrK epSreEsL enLtiE ngRh.iC mO seMlf or herself to be a relative responsible for the health care of such minor. Dental hygienists should be familiar with requirements of the jurisdiction within which they are practicing because the laws and regulations vary from state to state.

DIF: Recall REF: p. 87 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 54. Which of the following is true concerning documentation of informed consent? a. The dental hygienist must use dental terminology so the patient understands the

procedure as a professional would. b. The patient must have the opportunity to ask questions and receive adequate

answers. c. Informed consent must be written to be valid. d. Implied consent may be adequate for performance of a clinical examination with

minimal risk.

ANS: B

The patient must be able to ask questions and receive answers. The dental hygienist must use lay terminology to ensure patient comprehension. In general, informed consent does not have to be written to be valid. The patient’s implied consent, by his or her presence in the dental chair, may be adequate consent for a clinical examination.

DIF: Recall

REF: p. 87

OBJ: 6

TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 55. Informed consent must be written to be valid. Informed consent that is not written may be

difficult to prove. 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

In general, consent does not have to be written to be valid; however, consent that is not written may be difficult to prove. Written documentation of consent may take the form of an entry in the patient record, a consent document that acknowledges the required disclosures were made and understood, or a consent form that delineates the required disclosures and acknowledges understanding. Electronic consent software options are available providing detailed patient information packets that educate patients about planned procedures. The type of procedure to be performed and the nature and severity of risk, as well as the likelihood of its occurrence, can be used as guides for the selection of the form or consent.

DIF: Recall REF: p. 87 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 56. Which of the following is the term used to describe the failure of an oral health care provider

to exercise the degree of care, skill, and learning expected of a reasonably prudent oral health care provider, in the class to which he or she belongs with the state, acting in the same or similar circumstances? a. Malpractice b. Unnecessary roughness c. Willful neglect d. Wanton negligence ANS: A

Malpractice occurs when the standard of care is violated. Dental hygienists violate the standard of care when they injure a patient by not using the care, knowledge, skill, and ability possessed by other dental hygienists. The standard of care can be established legislatively, administratively, and through expert testimony.

DIF: Recall REF: p. 88 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 57. Which of the following is permitted in the state of Oregon provided that informed consent has

been obtained? a. Failure to exercise supervision required by the Dental Practice Act b. Rendering services that the licensee is not licensed to provide c. Use of the Hand Over Mouth (HOM) technique for behavior management d. Use of the Hand Over Mouth Airway Restriction (HOMAR) technique for behavior management ANS: C

Use of the HOM technique is not permitted without first obtaining informed consent for the use of the technique. Use of the HOMAR technique is not permitted. A patient cannot consent to treatment by persons who are not qualified according to supervision requirements nor to receiving services the practitioner is not licensed to provide.

DIF: Recall REF: p. 88 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 58. Which of the following stands for the proposition that employers act through their employees

or agents and are therefore responsible for the negligent acts of their employers or agents? a. Respondeat superior b. Prima facie c. Quid pro quo d. Perfectum ANS: A

Responsibility for injuries may be shared between the provider and the employer. The dentist may be a sole or joint defendant in cases of health care injury resulting from care delivered by a dental hygienist. Prima facie means “at first glance.” Quid pro quo means “something for something.” Perfectum means “binding unconditionally.”

DIF: Recall REF: p. 89 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 59. Statutes of limitations are generally how many years from the date of the incident in question? a. 1 year b. 2-4 years c. 4-6 years d. 6-7 years ANS: B

Statutes of limitations for health care injuries or malpractice actions vary from state to state; however, they usually are in the range of 2-4 years from the date of the alleged act, omission, neglect, or occurrence. The statute of limitations also provides for a period after discovery of an injury. The purpose of these time limitations is to protect against stale claims that will be difficult to judge because of limited documentation and undependable recollection of events.

DIF: Recall REF: p. 89 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 60. Which of the following is different about the statute of limitations for minors than for adults? a. It is 3 years from the date of the incident. b. It is 5 years from the date of the incident. c. It is tolled (suspended) until they reach the age of majority. d. There is no statute of limitations for minors.

ANS: C

It is tolled until a minor reaches the age of majority. According to Wikipedia, the age of majority for most of the United States is 18, but it is 16 in Kansas if the person is married, 19 in Alabama and Nebraska, and 21 in Puerto Rico and Mississippi.

DIF: Recall

REF: p. 89

OBJ: 7

TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 61. What is the purpose of the National Practitioner Data Bank? a. It is a national program that collects negative information on a health care

practitioner including malpractice awards and loss of a license. b. It is a social media website for health care professionals. c. It is a national job bank for professionals seeking employment opportunities. d. It is a national data bank of statistics regarding health care professionals.

ANS: A

There have been situations where a practitioner lost a license to practice in one state and moved to another state to practice without reporting the adverse action when he or she applied for a new license. The purpose of the National Practitioner Data Bank is to prevent a practitioner with a negative history from moving to another state without disclosing an adverse action on his or her record. Another facet of the desire to track a practitioner with a negative incident in his or her professional history is the requirement that each practitioner applies for and obtains a National Provider Identification (NPI) number.

DIF: Recall REF: p. 89 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 62. Which of the following is the most common claim for breach of contract associated with

health care injuries? a. That the health care provider promised that the injury suffered would not occur b. That the patient was not told of the risks of treatment c. That the patient was not informed that not seeking treatment was one of the treatment choices d. That the patient was guaranteed a positive outcome ANS: A

Statements indicating that a proposed procedure will take care of “someone’s troubles” and that there is “nothing much to the procedure” may represent promises that cannot be kept.

Health care providers are not expected to be guarantors of health care outcomes. The dental hygienist should be careful to avoid making statements that a patient may interpret as a guarantee of a successful outcome.

DIF: Recall REF: p. 90 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

Chapter 09: Dental Hygienist–Dentist–Employer Relationship Beemsterboer: Ethics and Law in Dental Hygiene, 3rd Edition MULTIPLE CHOICE 1. Which of the following scenarios is most likely? a. The dental hygienist is self-employed. b. The dental hygienist is employed by a dentist. c. The dental hygienist is employed by a dental service organization (DSO). d. The dental hygienist is employed by a government agency.

ANS: B

In most practice settings the dental hygienist will work as an employee for an employing dentist or dentists. As an employee, the dental hygienist must understand the legal parameters of the employer–employee relationship. The interests of employees are protected by numerous federal and state laws. Familiarity with these laws may help ensure a safe, productive, and professionally rewarding work environment for the dental hygienist.

DIF: Recall REF: p. 91 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 2. Intentional violations of employment laws should be brought to the attention of the employer,

but unintentional violations should not, because the employers did not knowingly intend to break the law. a. Both the statement and reason are correct and related. b. Both the statement and reason are correct but NOT related.

TESTBANKSELLER.COM 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: D

Although a dentist, as an employer, should be familiar with and comply with legal employment obligations, uninformed and unintentional violations can occur. Questions, potential oversights, and unintentional violations should be brought to the attention of the employer for resolution. However, when this does not result in satisfactory resolution and a dental hygienist suspects that his or her employment rights have been violated, an attorney or appropriate agency should be contacted for guidance and possible legal resolution.

DIF: Recall REF: p. 91 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 3. Word of mouth and networking with fellow professionals regarding obtaining employment is

most likely to occur a. through classified advertisements in local newspapers. b. by reading professional publications, such as newsletters and journals. c. by contacting a dental hygiene placement service. d. through an electronic posting of available positions on the Internet. e. at meetings, continuing education programs, and community service events.

ANS: E

This can be a valuable mechanism for finding well-suited employment opportunities.

Participating in organized dental hygiene through a local or state component society can provide many contacts and opportunities that are not found through the other methods of seeking employment. Formal job announcements generally indicate the application procedure and provide details regarding the preferred mode of contact and résumé submission.

DIF: Recall REF: p. 92 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.3 Patient and Professional Communication 4. The interview with a prospective employee must be limited to a question-and-answer period.

A so-called working interview is not permitted because the person is not yet an employee. 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

The interview may be limited to a question-and-answer period, or it may include a working interview, which provides an opportunity for the employer to assess the applicant’s professional competence. Working interviews are very popular with employers because they provide a chance not only to see how the dental hygienist performs clinically but also how he or she interacts with patients and co-workers. Some dental practices will have a staff member conduct question-and-answer interviews with the initial applicant pool and then select three top candidates for a working interview and second interview with the dentist. The thought is that both the employees and the dentist need to be comfortable with the new worker. p. 92 OBJ: 2 DIF: Recall REF: TESTBANKSELLER.COM TOP: 7.0 Professional Responsibility | 7.3 Patient and Professional Communication 5. Each of the following should be found in a professional résumé EXCEPT one. Which one is

the EXCEPTION? a. Educational background b. Marital status c. Employment history d. Professional experiences ANS: B

The résumé should not contain information about marital status. It probably also should not contain the year of graduation from high school as the applicant’s age can usually be determined from this information. The résumé should be concise, accurate, and professional.

It should highlight the educational background, employment history, and professional experiences of the candidate, such as association membership, presentations, and honors.

DIF: Recall REF: p. 92 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 6. Which of the following is a question that may legally be asked during the interview process? a. How many children do you have and how old are they? b. What is your native language? c. What languages can you speak? d. Do you practice a religion?

ANS: C

Languages that can fluently be spoken and written are one of the permitted questions that can be asked during an interview. Applicants should be cautious not to offer information voluntarily that cannot be solicited legally by the employer. A discussion of children could raise concerns about child care arrangements and the impact of sick children on the employee’s attendance record. Questions about national origin, ancestry, and descent are not permitted, so a question about native language is inappropriate.

DIF: Recall REF: p. 92 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 7. Each of the following interview questions is not permitted EXCEPT one. Which one is the

EXCEPTION? a. How old are you? (to someone who appears to be in his or her 40s) b. Are you Hispanic or from the Middle East? c. Have you ever been arrested? d. Have you ever been convicted of a crime? e. How long have you been married?

ANS: D

Being arrested is different from being convicted of a crime. Asking a person of his or her national origin, ancestry, and descent is not permitted. Marital and family status questions are not permitted. This is a federal law according to Title VII of the Civil Rights Act of 1964.

Questions are classified as impermissible when the information sought could be used in a discriminatory manner and is irrelevant in terms of assessing an applicant’s qualification for a position. It is best for a prospective employer to have a prepared list of questions and to ask each candidate the same quTeE stS ioT nsBiA nNaKcoSnEsiLstLenEtRm.aC nnOeM r.

DIF: Recall REF: p. 92 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 8. A dental hygienist can be employed within two general categories of an employment

relationship, known as a. give and take. b. voluntary and involuntary. c. guided and nonguided. d. at will and term.

ANS: D

The at-will category is best described as employment with an indefinite duration. The category term is best described as employment with a definite duration.

DIF: Recall REF: p. 93 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 9. Which of the following is true of term employment and not at-will employment? a. Employment of indefinite duration b. Employment with a definite duration c. Termination at the will of the employer for no reason d. Termination at the will of the employee for no reason

ANS: B

Term employment is employment with a definite duration. For example, a dental office may need to hire a dental hygienist to cover for another dental hygienist who is pregnant. The substitute dental hygienist may sign an employment contract for a specified period of time. An employment contract generally has language that specifies the conditions under which the employment relationship can be terminated before the completion of the duration.

DIF: Recall REF: p. 93 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 10. At-will employment means that a. termination of employment can legally occur without notice. b. termination of employment requires 2 weeks’ notice. c. termination of employment requires 4 weeks’ notice. d. the employment has a definite duration.

ANS: A

The employment relationship can be terminated at the will of either the employer or employee for any or no reason. A dentist can inform a dental hygienist at the end of a workday that his or her employment in the office is terminated, effective immediately. Termination decisions customarily are accompanied by notice (e.g., 2 weeks before the end of the employment relationship) or severance pay. However, the termination of an at-will employment relationship can legally occur without notice, severance pay, or a statement of cause as long as it is not for a discriminatory reason.

DIF: Recall REF: p. 93 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 11. An employment contract is associated with at-will rather than term employment, because term

employment is employment with a definite duration. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: D

An employment contract is associated with term rather than at-will employment. An employment contract general has language that specifies the conditions under which the employment relationship can be terminated before the completion of the duration of employment. The legal term for these conditions is just cause.

DIF: Recall REF: p. 93 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 12. The employment relationship specified by a term cannot be terminated without breaching the

contract unless which of the following is present? a. An amicable relationship b. An acrimonious relationship c. Just cause d. A problematic situation

ANS: C

The employment relationship cannot be terminated without breaching the contract unless just cause exists, which is a specified and nondiscriminatory reason for termination.

DIF: Recall REF: p. 93 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 13. Many federal and state employment laws are designed to protect the interests of a. both employees and employers. b. employees but not employers. c. employers but not employees. d. neither employees nor employers.

ANS: A

They are designed to protect the interests of both employees and employers. Although the employer may have an obligation to inform employees of various state and federal laws, dental hygienists should be independently familiar with and know how to access additional information about their rights as employees.

DIF: Recall REF: p. 93 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 14. Which of the following is a federal law that protects against discrimination on the basis of

race, color, religion, sex, or national origin? a. Equal Pay Act of 1963 b. Americans with Disabilities Act of 1990 c. Uniformed Services Employment and Reemployment Rights Act of 1994 d. Title VII of the Civil RT igEhS tsTABcA t oNfK1S 96E4LLER.COM e. Age Discrimination in Employment Act of 1967 ANS: D

Discrimination is prohibited in any employment action including, but not limited to, hiring and firing, compensation and salary raises, promotions, fringe benefits, and retirement plans.

DIF: Recall REF: p. 93 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 15. Title VII of the Civil Rights Act of 1964 applies to employers with how many employees? a. Just 1. Any employer must comply with this Act. b. Five or more employees. c. Fifteen or more employees. d. Fifty or more employees. e. One hundred or more employees.

ANS: C

This act applies to employers with 15 or more employees as does the Americans with Disabilities Act of 1990. Interestingly, the Age Discrimination in Employment Act of 1967 applies to employers with 20 or more employees.

DIF: Recall REF: p. 93 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

16. Which of the following is true of the Pregnancy Discrimination Act? a. An employer can refuse to hire a qualified applicant on the basis of pregnancy. b. An employer can treat pregnancy-related conditions differently by requesting that

only pregnant employees undergo medical evaluations regarding the ability to work. c. An employer can treat the pregnant employee like any other temporarily disabled employee in terms of available options if a temporary inability to work occurs, such as leave or leave without pay. d. An employer can have a policy that prohibits an employee from returning to work for a predetermined time after childbirth. e. An employer can limit pregnancy benefits to married employees.

ANS: C

If a temporary inability to work occurs, the pregnant employee must be treated like any other temporarily disabled employee in terms of available options, such as leave or leave without pay. An employer cannot refuse to hire a qualified applicant on the basis of pregnancy. An employer cannot treat pregnancy-related conditions differently by requesting that only pregnant employees undergo medical evaluations regarding the ability to work. If an employer requires that all employees with a medical condition undergo medical evaluation to establish ability to work, then a pregnant employee can be required to comply with the same procedure.

An employer cannot have a policy that prohibits an employee from returning to work for a predetermined time after childbirth. Pregnancy benefits cannot be limited to married employees.

DIF: Recall REF: p. 93 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 17.1 The Pregnancy Discrimination Act was an amendment to which of the following federal laws 7 prohibiting discrimination? . a. Uniformed Services Employment and Reemployment Rights Act of 1994 b. Title VII of the Civil Rights Act of 1964 c. Americans with Disabilities Act of 1990 d. Age Discrimination in Employment Act of 1967 e. Equal Pay Act of 1963 ANS: B

The Pregnancy Discrimination Act was an amendment to Title VII or the Civil Rights Act of 1964. This amendment prohibits employment discrimination on the basis of pregnancy, childbirth, or related medical conditions.

DIF: Recall REF: p. 93 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 18. The Age Discrimination in Employment Act of 1967 prohibits discrimination based on age

against any employee or applicant for employment who is at least a. 20 years old. b. 40 years old. c. 60 years old. d. 65 years old.

ANS: B

At least 40 years old. The act applies to employers with 20 or more employees, including state and local government. Examples of age discrimination include a job advertisement that indicates age preferences and denial or cessation of benefits for older employees.

DIF: Recall REF: p. 94 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 19. The Americans with Disabilities Act of 1990 does not protect people with which of the

following impairments? a. Multiple sclerosis b. Human immunodeficiency virus (HIV) infection c. Addiction to illegal drugs d. Asthma e. Osteoporosis ANS: C

The inability to perform a single, particular job does not constitute a substantial limitation in the major life activity of working. Examples of impairments that can limit major life activities include: multiple sclerosis, asthma, diabetes, osteoporosis, bipolar disorder, dyslexia, and human immunodeficiency (HIV) infection. Although a history of drug addiction is recognized as an impairment, individuals currently using illegal drugs are not protected by this act.

DIF: Recall REF: p. 94 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 20. Disabled individuals can qualify for protection under the Americans with Disabilities Act if

they can perform the job with or without reasonable accommodation. Employers are required to provide reasonable accoT mEmSoT daBtiA oN nK toSaEqL uaLliEfiR ed.dCiO saM bled employee or job applicant. 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

Reasonable accommodation can include making existing facilities accessible, modifying schedules, or modifying equipment. Reasonable accommodations do not include modifications that would cause undue hardship to the employer.

DIF: Recall REF: p. 94 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 21. Each of the following is an example of a reasonable accommodation that an employer would

be required to provide to a qualified disabled employee or job applicant EXCEPT one. Which one is the EXCEPTION? a. Changes that allow an employee with a disability to enjoy equal benefits and privileges of employment b. Changes to the job application process c. Changes to the work environment or the way a job is usually performed d. Changes that allow for full-time pay for part-time work ANS: D

Three categories of reasonable accommodation exist: (1) changes to the job application process, (2) changes to the work environment or the way a job is usually performed, and (3) changes that allow an employee with a disability to enjoy equal benefits and privileges of employment.

DIF: Recall REF: p. 94 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 22. An employer cannot ask an applicant about the existence, nature, or severity of a disability

before making a job offer to a potential employee. Accordingly, the employer cannot and should not inform an applicant of the essential functions of the position and inquire whether the applicant is able with or without accommodation, to perform those job functions. 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 employer can and should inform the applicant of the essential functions of the position and inquire whether the applicant is able, with or without accommodation, to perform those job functions.

DIF: Recall REF: p. 94 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 23. States may enact laws that a. extend the provisions of federal laws against employment discrimination and

extend the scope of proTteEcS tioTnBs.ANKSELLER.COM b. extend the provisions of federal laws against employment discrimination and restrict the scope of protections. c. restrict the provisions of federal laws against employment discrimination and extend the scope of protections. d. restrict the provisions of federal laws against employment discrimination and restrict the scope of protections.

ANS: A

Such state laws may extend the reach of the nondiscrimination provisions (e.g., redefining “employer” to require fewer employees to be bound by the employment discrimination laws).

Other state laws may extend the scope of protections (e.g., redefining the term “disability” to include a broader scope of conditions or extending the protected categories). The “law against discrimination” in the state of Washington prohibits employment discrimination against any person because of “the presence of any sensory, mental, or physical disability” and extends the protected categories to include “sexual orientation.”

DIF: Recall REF: p. 95 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 24. Which of the following federal agencies enforces federal laws against discrimination in the

employment setting? a. The Federal Trade Commission (FTC) b. The Equal Employment Opportunity Commission (EEOC)

c. The Food and Drug Administration (FDA) d. The Drug Enforcement Administration (DEA) ANS: B

The EEOC is organized into 15 districts and has several field offices to assist individuals who believe they are subjects of a violation of a federal law. Individuals who believe they have experienced a violation of their employment rights may file a charge of discrimination with the EEOC. DIF: Recall REF: p. 95 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 25. According to the Family Medical Leave Act (FMLA) of 1993, an employer must grant an

eligible employee up to how many weeks of unpaid leave during a 12-month period for a qualifying reason? a. 4 weeks b. 8 weeks c. 12 weeks d. 16 weeks e. 20 weeks ANS: C

The FMLA applies to public and private employers with 50 or more employees. To be eligible, an employee must have worked for the employer for 12 months and have worked at least 1250 hours over the previous 12 months. Under the FMLA an employer must grant an eligible employee up to 12 weeks of unpaid leave during a 12-month period.

DIF: Recall REF: TpE . 9S5TBANKS OE BJ:LLE 4 R.COM TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 26. Each of the following is a reason why an employer must grant an eligible employee unpaid

leave under the Family Medical Leave Act (FMLA) EXCEPT one. Which one is the EXCEPTION? a. Birth and care of a newborn child within 1 year of birth b. Provision of care for a cousin with a serious health condition c. A serious health condition that makes an employee unable to perform the function of his or her position d. Any qualifying exigency arising out of the fact that a family member is a covered military member on “covered active duty” ANS: B

It must be an immediate family member to qualify, which is defined as a spouse, child, or parent. In some circumstances the FMLA permits leaves to be taken intermittently, such as taking leave in blocks of time or reducing a normal daily or weekly schedule. When possible, employees should give their employer 30 days’ notice before beginning an FMLA leave.

DIF: Recall REF: p. 95 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

27. An employer is not required to maintain the insurance benefits provided as a part of the

employment relationship during an approved Family Medical Leave Act (FMLA) leave. Upon return to employment, an employee is required to be restored to his or her original position or to an equivalent position with equal pay, benefits, and other terms and conditions of employment. 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

During an approved FMLA leave, an employer must maintain the insurance benefits provided as a part of the employment relationship. More details on FMLA can be obtained at the U.S. Department of Labor website.

DIF: Recall REF: p. 96 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 28. Which of the following is true of the Occupational Safety and Health Act (OSHA) of 1970? a. It is a federal law intended to ensure working conditions for employees are free

from recognized hazards to safety and health. b. States may not modify the requirements imposed by OSHA. c. The law places responsibility solely on employers to comply with established

standards and training requirements intended to minimize the number of personal injuries and illnesses that arise out of employment. d. The law places responsibility solely on employees to comply with established standards and training T reE quSirTeB mA enNtsKiS ntEeL ndLeE dR to.m niM mize the number of personal CiO injuries and illnesses that arise out of employment.

ANS: A

The law places responsibility on both employers and employees. In general, employers are obligated to provide a place of employment free from recognized hazards that may cause serious physical harm to their employees. For example, OSHA standards require that dentist employers provide personal protective equipment in the dental office to minimize the hazards associated with contact with blood-borne pathogens. Employees, in turn, are obligated to comply with OSHA standards applicable to their scope of employment. State laws also may be enacted that equal or exceed the requirements imposed by OSHA. DIF: Recall REF: pp. 96-97 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 29. Which of the following provisions provides relief for employees who are injured while acting

in the course of their employment? a. State workers’ compensation programs b. The Occupational Safety and Health Administration (OSHA) c. The Environmental Protection Agency (EPA) d. The Equal Employment Opportunity Commission (EEOC) ANS: A

Dental hygienists who are injured at work should notify their employer dentist of the injury and seek assistance in complying with the requirements of the state workers’ compensation program. The home pages of all of the state government workers’ compensation websites can be found at: www.usa.gov/agencies.

DIF: Recall REF: p. 97 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 30. Sexual harassment violates which of the following federal regulations? a. Americans with Disabilities Act of 1990 b. Equal Pay Act of 1963 c. Age Discrimination in Employment Act of 1967 d. Title VII of the Civil Rights Act of 1964 e. Uniformed Services Employment and Reemployment Rights Act of 1994 ANS: D

Sexual harassment is a form of discrimination. Federal regulations define sexual harassment as unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature when submission to such conduct is made either explicitly or implicitly a term or condition of an individual’s employment; submission to or rejection of such conduct by an individual is used as a basis for employment decisions affecting such individual; or such conduct has the purpose or effect of unreasonably interfering with an individual’s work performance or creating an intimidating, hostile, or offensive work environment.

DIF: Recall REF: p. 97 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 31. Quid pro quo means a. captain of the ship. b. something for something. c. at first glance. d. the meaning is obvious.

ANS: B

Quid pro quo means “something for something.” Quid pro quo harassment occurs when (1) an individual’s submission to or rejection of sexual advances or conduct of a sexual nature is used as the basis for employment decisions affecting the individual, or (2) the individual’s submission to such conduct is made a term or condition of employment.

DIF: Recall REF: p. 97 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance 32. A hostile environment occurs when any type of unwelcome sexual behavior creates an

offensive or hostile environment. The harassment must result in tangible or economic job consequences, such as the loss of pay or promotion opportunities. 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 harassment does not need to result in tangible or economic job consequences to be a hostile environment. The harassment must be proven to have been unwelcome to prove a hostile environment. The harassment must be sufficiently severe or pervasive as to create an abusive working environment. An important criterion is that the employer had actual knowledge or constructive knowledge of the hostile environment but took no remedial or prompt action. Constructive knowledge is a legal term that means that employer, under the circumstances, should have known about the hostile work environment. An environment is hostile if a reasonable person would find the environment hostile or abusive and the victim subjectively perceives the environment to be abusive.

DIF: Recall REF: p. 98 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.2 Regulatory Compliance

Chapter 10: Risk Management Beemsterboer: Ethics and Law in Dental Hygiene, 3rd Edition MULTIPLE CHOICE 1. Which of the following is a term used to describe a philosophy of risk identification and

system of injury prevention? a. Risk management b. Fiduciary relationship c. Virtue d. Deontology ANS: A

The term risk management also is applied to other areas of private and public business but is most frequently used in health care. Management, as part of the term, means that once risk is identified, it is measured for the seriousness of the potential outcome and the likelihood of its occurrence. A strategy is then created to handle the risk in such a way as to minimize it or, in some cases, to eliminate it altogether. A fiduciary relationship is part of contract law.

Character or virtue and the goodness of a person in living a good life are acquired by a person through learning and reflection and repetition. Deontology is nonconsequentialist ethics.

DIF: Recall REF: p. 101 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.4 General 2. A general dental practice may not provide complex oral surgery procedures for patients,

because the clinicians haveTdEeS teT rm neNdKthSaEt L exLteEnR si. veCrOisM k factors are associated with those BiA procedures. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

The liability associated with complex oral surgery procedures may be too significant, thus making the risk greater than the benefit to the dental practice. In these cases the risk management strategy is the removal of such a procedure from the scope of care delivery.

DIF: Recall REF: p. 102 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.4 General 3. Eliminating a high-risk procedure from the scope of practice is not always possible or

desirable. In such cases a risk management strategy should be implemented to control the risk. 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

The development of well-targeted procedures for minimizing adverse outcomes requires an awareness of the most frequently occurring negative incidents. Strategies for identifying risk include incident reporting and a quality improvement program.

DIF: Recall REF: p. 102 OBJ: 1 TOP: 7.0 Professional Responsibility | 7.4 General 4. Each of the following is true for a system of incident reporting EXCEPT one. Which one is

the EXCEPTION? a. Complete a report for all accidents or unusual incidents. b. Reporting should include patient care problems, patient management issues, and patient complaints. c. The report should focus on facts rather than subjective assessments and provide details of the event. d. The reports should be retained in the patient record.

ANS: D

These reports should not be retained in the patient record but rather filed in a risk management portfolio. An incident reporting system permits the systemic tracking of adverse events. A clear understanding of the risk exposure of a practice provides an opportunity for targeted problem solving.

DIF: Recall REF: p. 102 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.4 General 5. Which of the following is a characteristic of a quality improvement program rather than

incident reporting system? a. A systemic tracking ofTaE dvSeT rsB eA evNeK ntS s ELLER.COM b. An ongoing evaluation system that focuses on patterns of behavior c. A system that requires members of the dental team to complete a report for all accidents or unusual incidents d. A report that focuses on facts rather than subjective assessments ANS: B

The purpose of a quality improvement program is to assess the patient care delivery system systematically and continuously through the collection and analysis of reliable information. It focuses on patterns of behavior rather than on isolated instances of behavior. It is a mechanism for assessing the quality of care and implementing and evaluating changes in the patient care delivery system to maintain or improve the quality of care.

DIF: Recall REF: p. 102 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.4 General 6. A quality improvement program should include three dimensions of health care delivery,

which are a. background, delivery, and outcome. b. skills, application, and evaluation. c. structure, process, and outcome. d. methodology, process, and recapitulation. e. structure, application, and evaluation.

ANS: C

The structure dimension considers physical plant factors, such as facilities and equipment.

The process dimension considers patient care issues, such as diagnosis, sequence of care, and technical skill. The outcomes dimension considers the result of care, such as improvements in oral health or overall health.

DIF: Recall REF: p. 103 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.4 General 7. Which of the following is a component of the process dimension of quality improvement? a. Facilities b. Technical skill c. Oral health improvement d. Organization e. General health improvement ANS: B

The structure dimension of quality improvement includes: facilities, equipment, organization, administration, personnel, and dental records. The process dimension of quality improvement includes: diagnoses, sequence of care, appropriateness of care, technical skill, and timeliness of care. The outcomes dimension of quality improvement includes: oral health improvement and general health improvement.

DIF: Recall REF: p. 102 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.4 General 8. Which of the following is the correct sequence for the assessment of quality in a quality

improvement process? a. Design a study, collectTdE atS a,TrB epAoN rt KreSsuElL tsL , rE esRp. onCdOtM o results, and analyze data. b. Design a study, collect data, report results, analyze data, and respond to results. c. Design a study, collect data, analyze data, report results, and respond to results. d. Design a study, collect data, analyze data, respond to results, and report results. e. None of the above is the correct sequence.

ANS: C

The first step in a quality improvement process is the assessment of quality in one or more of the dimensions of health care delivery. Quality assessment must be performed systematically and include designing a study, collecting data, analyzing data, reporting results, and responding to results.

DIF: Recall REF: p. 102 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.4 General 9. Which of the following correctly represents the sequence of continuous quality improvement? a. Assessment, implementation, evaluation, and planning b. Assessment, planning, implementation, and evaluation c. Planning, assessment, evaluation, and implementation d. Planning, evaluation, implementation, and assessment ANS: B

The correct sequence for quality improvement is assessment, planning, implementation, and evaluation.

DIF: Recall REF: p. 102 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.4 General 10. Which of the following is an analysis of the process dimension of quality improvement? a. A study to evaluate the quality of dental hygiene scaling and root planing b. c. d. e.

instruments A study to ensure compliance with the practice’s health history policy A study to evaluate the posttreatment effects of dental hygiene care A study to evaluate compliance with OSHA requirements A study to ensure compliance of personnel with required vaccinations

ANS: B

A protocol designed to ensure compliance with the practice’s health history policy is an example of a quality improvement program that focuses on the process dimension of care. A random sample of the records of patients who received periodontal maintenance therapy in a given period could be audited for compliance. An audit form should be designed to include the criteria that represent policy compliance. The results of the assessment can be used to acknowledge and reinforce policy compliance or to design in-service education that will support future compliance. Evaluation of the quality of dental hygiene instruments, evaluation of compliance with OSHA requirements, and compliance with required vaccinations are examples of an analysis of the structure dimension of quality improvement. Evaluation of the posttreatment effects of dental hygiene care is an example of the outcome dimension of quality improvement.

DIF: Recall REF: p. 103 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.4 General

NeKnS 11. Which of the following is tThE eS reT coBmAm deEdLmLeE thRo. dC toOeM ncourage completion of patient satisfaction surveys? a. Refuse to schedule another appointment unless the satisfaction survey has been completed. b. Mail multiple copies until the patient complies by completing the survey. c. Call the patient to request that the survey be completed by a particular date. d. Compensate the patient with an incentive, such as oral health care products.

ANS: D

Patient satisfaction surveys are a valuable assessment tool for quality improvement. Patient satisfaction surveys should be designed so that they gather the desired information and are easily completed. Survey participation can be encouraged by compensating patients with incentives, such as oral health care products, as a way of acknowledging the value of their time.

DIF: Recall REF: p. 103 OBJ: 2 TOP: 7.0 Professional Responsibility | 7.4 General 12. Documentation in the dental record as part of the provision of oral health care services is

important to protect a. both the patient and the oral health care provider. b. the patient but not the oral health care provider. c. the oral health care provider but not the patient. d. neither the patient nor the oral health care provider.

ANS: A

The dental record can protect both. It is a comprehensive, ongoing file of assessment findings, treatment services rendered, dental outcomes, notations, and contacts with the patient. If any type of legal action is initiated, the dental record, which contains the details of patient care, is the vital document that can (or cannot) protect the oral health care provider.

DIF: Recall REF: p. 103 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 13. All patient contacts should be recorded in the dental record, including cancellations and oral

and written communications including any requests for information. The fundamental requirement for effective and meaningful dental records is the implementation of a systematic process of accurate and complete documentation. 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

All patient contacts should be recorded. The premise of record keeping is that another person should be able to look at the dental record and be able to see exactly what happened.

DIF: Recall REF: p. 103 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 14. If the practitioner smells alcohol on a patient’s breath and suspects that the patient is drunk,

the a. patient should be described in objective terms according to the conditions

observed. b. patient should be asked directly if he or she is drunk. c. clinician should state the obvious in the patient chart and say that the patient was

drunk. d. clinician should not make any mention of it in the patient’s chart.

ANS: A

Comments about the patient encounter can be recorded in the dental record, but they must be related to the care of the patient and be stated in objective, professional, and nonjudgmental terms. A patient suspected of being under the influence of excessive alcohol consumption should be described according to the conditions observed as opposed to a conclusive statement that the patient was drunk.

DIF: Recall REF: p. 104 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 15. Which of the following is the proper correction to make if an error is made during an entry in

a written chart? a. Use a whitening product to cover the erroneous entry and write over it. b. Completely ink over the incorrect entry so it is impossible for another person to read it and the person becomes confused about the entry. c. Draw a single line through the entry, followed by a note that an error was made. d. Throw away the page with an erroneous entry and restart with a clean sheet.

ANS: C

A single line should be drawn through the entry, followed by a note that an error was made.

The correct information should then be recorded and the entry signed and dated. When a correction is distanced from the error by intermediate entries, a notation should be made regarding the location of the error and its correction.

DIF: Recall REF: p. 104 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 16. Which of the following statements is true regarding documentation in the dental record? a. The process of documentation should be completed by the business office manager

for consistency. b. Documentation should be completed at the end of the day to avoid issues of contamination of records with saliva or blood. c. Abbreviations and professional jargon should be used to save time and space in the record form. d. A simple note such as “prophy” is not appropriate because it does not convey what procedures were performed.

ANS: D

It does not convey what procedures were performed or how the patient responded to treatment and patient education. The process of documentation should not be relegated to another staff person and should be completed in a timely manner after the patient visit. Delaying the entry may cause incomplete and inaccurate documentation. Abbreviations and professional jargon should be avoided unless a clear definition of terms is used within the dental practice that is readily documented.

DIF: Recall REF: p. 104 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 17. Good risk management practice may call for keeping a dental record beyond the mandated

retention date because dental records are the best defense in any legal action. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

State dental practice acts may dictate the information that must be included in a dental record and the length of time the record must be kept by the dental practice. Many legal advisors, however, recommend keeping the record indefinitely because the three most important things in legal defense are records, records, and records.

DIF: Recall REF: p. 104 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 18. Dental record entries that are written should be made in a. Number 2 pencil for ease of correction. b. red ink to highlight the importance of the information. c. blue or black permanent ballpoint ink.

TESTBANKSELLER.COM d. blue of black erasable ballpoint ink to simplify correction.

ANS: C

Entries should be clear, concise, legible, and permanent (e.g., black or blue permanent ballpoint ink) for a written record.

DIF: Recall REF: p. 104 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 19. Commonly understood acronyms should be used in the dental record so that all members of

the dental office staff are familiar with the meaning of the term. Unusual or creative shorthand is encouraged as this may help ensure patient confidentiality. 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

Unusual or creative shorthand should not be used in dental documentation.

DIF: Recall REF: p. 105 OBJ: 3 TOP: 7.0 Professional Responsibility | 7.4 General 20. Each of the following statements is true for electronic record keeping EXCEPT one. Which

one is the EXCEPTION? a. Electronic record keeping is a common and very acceptable method of maintaining patient information and should follow the general documentation guidelines. b. Various types of electrT onEicSsToB ftA wN arK eS arE eL onLE thR e. mC arOkM et and are not difficult to learn. c. Steps must be in place to ensure that the record cannot be tampered with and that a valid signature is associated with each entry. d. The guidelines for paper records are different from the guidelines for electronic records and do not apply to the electronic record.

ANS: D

The same guidelines for paper records apply to the electronic record. Dental hygienists working in virtually all clinical settings will find electronic record keeping. Manufacturers date stamp entries in a manner that the initial entry may be corrected but not changed or deleted. This protects both the practitioner and patient.

DIF: Recall REF: p. 105 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.4 General 21. Dental office documentation includes which of the following in addition to written entries? a. Radiographs, models, and photographs. b. Radiographs and models but not photographs. c. Radiographs and photographs but not models. d. Radiographs but neither models nor photographs. e. Dental office documentation does not include any of these in addition to written

entries.

ANS: A

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Risk management in record keeping is not limited to written entries. Documentation, broadly defined, includes radiographs, models, and photographs. The dental practice should maintain the quality of additional information gathered. Appropriate identification information, such as the patient’s name, the current date, and the patient’s chart number, should be marked on items such as models, radiographs, and photographs.

DIF: Recall REF: p. 105 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.4 General 22. Patients have a legal right to their original dental records. The dental office has the legal right

to refuse to transfer those records if the patient has not paid his or her bill. 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

Patients have a legal right to a copy of their dental records; however, the original records are the property of the dentist. Holding records hostage because a fee has not been received is not permitted.

DIF: Recall REF: p. 105 OBJ: 4 TOP: 7.0 Professional Responsibility | 7.4 General 23. Which of the following is considered to be the key to a successful, safe, and satisfying dental

hygiene practice? a. Excellent remuneration b. Communication c. A good practice location d. Extended hours for patients who are working ANS: B

The relationship that is established and that develops between the patient and the dental hygienist relies on verbal and nonverbal communication. Effective communication ensures that the needs of the patient and dental hygienist are clearly conveyed. Communication is also essential between the dentist employer, colleagues in the dental office, and other health care providers.

DIF: Recall REF: p. 105 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.4 General 24. The dental hygienist uses various levels of communication skills on a daily basis. The ultimate

success of verbal communication depends on the way the material is presented, the attitude of the speaker, the tone and volume of voice, and the degree to which the dental hygienist and patient/colleague are able and ready to listen effectively. 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

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The dental hygienist is constantly adapting, changing, and adjusting to the needs of patients and colleagues in the dental environment. E-mail and other forms of electronic communication between patients and health care providers are commonplace. Any electronic communication should comply with good practices for verbal and nonverbal communication.

DIF: Recall REF: p. 105 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.4 General 25. The attitude and tone with which the spoken words are presented can have an impact on the

effectiveness of the communication, because judgmental or negative attitudes and tone can influence the patient’s response to the information or distract the patient from the educational message the dental hygienist is trying to convey. a. Both the statement and reason are correct and related. b. Both the statement and 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.

ANS: A

Some experts have said that more of the message is conveyed by attitude and tone of voice than the words themselves. Nonverbal communication is as critical as the spoken word in a patient–provider interchange. Facial expressions and gestures often communicate a great deal, and the dental hygienist must be sensitive to the messages sent through this method.

DIF: Recall REF: p. 106 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.4 General

.eCnO 26. Each of the following listeT niE ngST strBaA teN giK esSiE sL reL coEmRm deMd by Purtilo and Haddad EXCEPT one. Which one is the EXCEPTION? a. Concentrate on central themes rather than isolated statements; listen in paragraphs. b. Listen with an open mind rather than focus on emotionally charged words. c. Summarize in your own mind what you have heard before speaking again. d. Clarify positions and statements before proceeding. e. Allow vague or incomplete ideas to go unchallenged.

ANS: E

Purtilo and Haddad recommended all of the strategies mentioned, except they recommended not to allow vague or incomplete ideas to go unchallenged.

DIF: Recall REF: p. 106 OBJ: 5 TOP: 7.0 Professional Responsibility | 7.4 General 27. Who is responsible for managing the professional competency and maintaining the

appropriate credentials associated with being a licensed professional? a. The dental hygienist b. The employer c. The state dental association d. The dental hygiene program where the practitioner graduated e. The American Dental Hygiene Association (ADHA) ANS: A

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The individual dental hygienist is responsible for managing his or her own professional competency and maintaining the appropriate credentials. Each dental hygienist must be familiar with the scope of practice allowed by the State Dental Practice Act. Familiarity with the requirements for continuing education also is important.

DIF: Recall REF: p. 107 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.4 General 28. Most State Dental Practice Acts require that any licensed dental health care provider inform

which one of the following of any address or name changes within a certain period? a. The monitoring agency, usually the State Dental Board b. The American Dental Hygienists’ Association (ADHA) c. The local component society of the American Dental Hygienists’ Association (ADHA) d. The dental hygiene program of graduation ANS: A

Often the requirement for the monitoring agency is for notification within 30 days, so it is important to be aware of the laws in the state where the dental hygienist is practicing.

DIF: Recall REF: p. 107 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.4 General 29. Dental hygienists should carry adequate professional liability insurance and be familiar with

the policy and its coverage, terms, and requirements. Claims-made coverage is limited to protection for allegations that arise from treatment rendered and reported while the policy is in force. a. Both statements are truT e.ESTBANKSELLER.COM 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

Occurrence coverage is not limited to protection for allegations that arise from treatment rendered and reported while the policy is in force. Policy terms to consider include the liability limits and deductibles that will apply. The types of insurance available can be different from state to state and insurance policies must be carefully inspected so that the dental hygienist is fully aware of coverage and limitations.

DIF: Recall REF: p. 107 OBJ: 6 TOP: 7.0 Professional Responsibility | 7.4 General 30. The same ethical and legal standards and practices applied in the dental clinical settings

should be adhered to when utilizing social media. Confidentiality of patient information must be maintained and any breach of privacy could result in civil and criminal penalties. 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

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The various types of electronic communications that are used in today’s world have benefits and risks in both personal and professional settings. The gift of trust that patients extend to their oral health care professionals needs to be treated with the utmost care.

DIF: Recall REF: p. 108 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.4 General 31. Each of the following is recommended in the textbook for utilizing social media EXCEPT

one. Which one is the EXCEPTION? a. Carefully view anything and everything posted online for its communication value and tone. b. Strive to maintain personal and professional integrity in posting. c. Do not post any patient information. d. Be encouraged to “Friend” or “Like” patients on social networking to enhance communication. e. Know the rules and policies on social media of employers and related institutions.

ANS: D

The text states “Do not friend or like patients on any social networking site. Keeping those boundaries is respectful and prudent.”

DIF: Recall REF: p. 108 OBJ: 7 TOP: 7.0 Professional Responsibility | 7.4 General

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