DGBS 721 1 Fall 2008 Dr. Hinz

DGBS 721 Final Exam Form A

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Take a deep breath. DGBS 721 2 Fall 2008 Dr. Hinz 1. Which of the following is the correct order of the steps of systematic desensitization? A. autogenic training, desensitization in the , and construction of the hierarchy B. relaxation training, construction of anxiety hierarchy, real life encounter with feared situation, and desensitization in imagination C. relaxation training, desensitization in imagination, and construction of hierarchy D. relaxation training, construction of anxiety hierarchy, desensitization in imagination, and real life encounter with feared situation

2. Smiley Dental Group is having difficulty with no-shows. The appointment manager begins to ask all patients, “Will you please call us right away if you are unable to make your appointment?” and then waits for the patient to answer. Almost all say yes. After implementing this question the no show rate drops by half. Which principle of influence is the manager using to reduce the no show rate? A. Commitment B. Reciprocation C. Scarcity D. Social proof E. Authority

3. In question #2 above, the manager used the ______tactic for compliance noted in the Milgrom text. A. proximity B. opportunity C. expectation D. autocratic

4. A mandated reporter ______. A. is required by law to report suspected abuse or neglect of a child B. is protected from liability when making a report C. must thoroughly investigate the abuse before calling DCFS D. A and B E. B and C

5. In guided imagery, you want to: ______. A. describe a scene with as little detail as possible so the patient does most of the imaginative work B. give a patient a scene to imagine rather than use one with which the patient is familiar C. describe a scene appealing to as many senses as possible D. describe a very detailed scene so the patient is bored and relaxes naturally

6. Hannah Montana (a very popular TV character for kids and pre-teens) does a video that promotes dentistry. She is shown getting her teeth checked, following the dentist’s directions, having a good time at the dentist's office and getting a gift at the end. You show this video to your child patients. According to social theory, what is likely to happen? A. Your patients will be more likely to cooperate with you during treatment. B. The video will only have a positive effect if you show it to them during treatment as a distraction. C. Your patients will cooperate if they think Hannah Montana is similar to them in some way. D. A and B E. A and C

7. A dentist proposes a treatment for periodontal disease to a patient. He states that this treatment is new and has generated a lot of recent and therefore is in limited supply, so he will only prescribe it for a few specially selected patients. What principle of influence is the dentist using to get the patient to use the perio treatment? A. Authority B. Commitment C. Reciprocation D. Social proof E. Scarcity DGBS 721 3 Fall 2008 Dr. Hinz 8. You propose a top-of-the-line treatment plan to your patient. He refuses, citing the cost and time it would take to do all that work. You then present a less extensive plan that also meets his needs, which he accepts. Which principle of influence are you using to influence him to accept good treatment? A. Liking B. Authority C. Contrast D. Social proof E. Reciprocation

9. When discussing an extraction with a distrustful patient who asks if the surgery will be painful, a good response is: A. "Yes" B. "No" C. "Don't worry about pain. We'll take good care of you so you won't feel anything at all." D. "You will feel various sensations like pressure and vibration, but you should not feel anything sharp." E. "Since you're concerned about the pain, we can give you nitrous, the ‘laughing gas,’ in order to help you relax and tolerate the pain better."

10. In , the longer the reinforcement is delayed after the desired behavior the stronger the response conditioning. A. True B. False

11. After greeting your patient and confirming the work that needs to be done that day, you say, "Well, let’s get started," and put on your mask, like you always do. The patient begins to sweat and tense his muscles. He knows in his mind that the next step will be to "get a shot." His response is an example of both: A. General anxiety and UR to the mask B. General anxiety and CR to mask C. Fear of needles and CR to the mask D. Fear of needles and UR to the mask

12. 7-year old Katie comes to you with several molar caries and lots of plaque. When you ask her mother about brushing the child's teeth, mom replies, "Oh, she brushes every day." How should you respond? A. Say to mom, “You really ought to take more responsibility to keep her mouth clean and healthy. It's your job as her parent.” B. Say to mom, “Often, young children only brush the parts of their teeth they can see. It would be best if you would supervise her, so that she doesn't get these cavities and plaque buildup in the back of her mouth.” C. Since Katie is already brushing, you should teach her how to do it properly and also teach her how to floss. D. Say to the mom, “A child this age shouldn’t have so many problems. You’ll need to do better if you don’t want Katie to lose her teeth.”

13. To report a case of child abuse the dentist has to A. have proof of the abuse B. have photographs of abuse C. have a suspicion of abuse D. have a confession of abuse

14. Avoidance conditioning occurs when the patient is rewarded for not showing up for appointments by not experiencing the stress of dental treatment. A. True B. False

DGBS 721 4 Fall 2008 Dr. Hinz

15. According to Cognitive Change theory: A. Changing one's beliefs about an event changes the emotional reaction to it. B. Unpleasant emotions are caused by stressful events. C. To be healthy, one must learn to completely control emotions. D. Fear is a completely normal and healthy reaction to perceived threat, there is no to try to change it.

16. A group of students decides to influence their professor’s behavior using operant conditioning. When the professor stands in one place for more than 3 minutes, the students act bored and tired. When the professor moves away from the lectern, the students smile and look attentive. Over several weeks the student increase the amount of time the professor must be away from the lectern before they look attentive. Eventually, the professor spends almost the entire hour moving about the room. This is an example of ______. A. Partial reinforcement schedule B. Shaping C. Social learning D. burst

17. A patient has had a bad experience in the dental office and is fearful. After many weekly visits, which are uneventful, his fear decreases and then disappears. He stops going to the dentist for 2 years and then makes an appointment. At this appointment he becomes very anxious in the dental chair. This is an example of: A. extinction burst B. law of diminishing returns C. response ageing D. spontaneous recovery E. law of partial extinction

18. In #17 above, the level of anxiety experienced upon the visit 2 years later is less than experienced initially. This is referred to as: A. extinction burst B. law of diminishing returns C. response ageing D. spontaneous recovery E. law of partial extinction

19. A new patient says, “I came to the dental school because I can’t afford a regular dentist. It seems nice here, but I feel weird being treated by a student, no offense. What do you do if a patient has something terrible happen, like a heart attack or like when that little girl in Chicago died during her appointment? I just keep thinking something will go wrong and you won’t be able to fix it. No offense, but I’m really nervous.” Which term best describes the patient’s type of fear? A. Apprehension B. General anxiety C. Fear of specific stimuli D. Fear of catastrophe

20. Children age ______tend to focus on visual information and will generally only understand that brushing teeth is good because of the tangible benefits they can achieve at the moment. A. 2-7 B. 7-12 C. 12 and over

DGBS 721 5 Fall 2008 Dr. Hinz 21. Mr. Wayne says to you, “I have a needle phobia.” He has not missed any appointments and reports that he has not avoided medical or dental care because of his phobia. When offered nitrous, he declines. He says, “Just warn me when you’re about to give me a shot and don’t let me see it.” He closes his eyes tightly and flinches when you give him the injection. Which category best describes Mr. Wayne? A. Distrust of dental professional B. Fear of specific stimuli C. Generalized anxiety D. Fear of catastrophe

22. Smiley Dental Group has a system where patients under 18 who come in with clean teeth and no cavities get a ticket that they can trade in for a small prize. They can save up their tickets for a larger prize. The ticket is ______. A. primary reinforcement B. secondary reinforcement C. partial reinforcement D. negative reinforcement E. unconditioned stimulus

23. Your patient decides to try to quit smoking, but not to tell anyone she is quitting. You would like her to tell at least one other person about her attempt to quit. Which rule of influence are you suggesting to help her quit smoking? A. Reciprocation B. Liking C. Contrast D. Demand E. Commitment

24. (1) Meditation is a focused attention relaxation technique. (2) This technique would be particularly useful for someone who has high somatic anxiety and low cognitive anxiety. A. The first statement is true and the second statement is false. B. The first statement is false and the second statement is true. C. Both statements are true. D. Both statements are false.

25. Define the carry-over effect. A. Relaxing the mind will result in relaxation of the body. B. Relaxing the body will result in relaxation of the mind. C. Practicing a relaxation procedure regularly will help you become less physically reactive to stressors throughout the day. D. Stress causes physical or mental upset in more than one organ of the body. E. Stress and anxiety in one area of one’s life, affects other areas in a negative way.

26. Abstract thinking occurs in Piaget's ______period of cognitive development. A. pre-operational B. concrete operational C. formal operational D. sensory operational

27. “Trust me.” For which of the following categories of patient fears is this statement not recommended? A. Generalized anxiety B. Fear of specific stimuli C. Fear of catastrophe D. Distrust of dental professional

DGBS 721 6 Fall 2008 Dr. Hinz 28. Usually, it is recommended that the dentist give the patient lots of information to reduce patient fears or anxiety. For which of the following categories of patient fears is this not recommended? A. Generalized anxiety B. Fear of specific stimuli C. Fear of catastrophe D. Distrust of dental professional

29. (Bonus) How many cats does Dr. Hinz have? A. 0 B. 1 C. 2 D. 3

30. You show a video in your practice waiting room that depicts various stages of progression of periodontal disease. You base your video on the Health Belief Model. Which of the following is not based on the Health Belief Model? A. Statistics stating how common perio disease is. B. Easy-to-follow instructions for treating and preventing perio disease. C. Some questions that ask the patient to reflect on their own risk of perio disease. (ie, Do you have…) D. An authority on perio disease explaining the stages of the disease. E. Pictures of gums and teeth of a patient without good oral hygiene and the same patient after implementing good oral hygiene practices.

31. Mr. Wilco is trying to up a habit of flossing regularly in order to avoid losing more teeth. He decides to put the floss by the kitchen sink so he’ll see it when he cleans up after dinner and remember to floss right then. Which of the following learning concepts explains why this tactic is likely to help him increase flossing? A. Avoidance conditioning B. Spontaneous recovery C. Conditioned stimulus, conditioned response D. Reciprocal inhibition E. Cognitive reappraisal

32. Which of the following will help you maximize the usefulness of using a written fear assessment questionnaire in your practice? A. Start with an interview and then use the written questionnaire on those patients who state they are fearful or anxious. B. Follow up on any indications that your patient is fearful or anxious. C. Include one routinely in the forms all new patients fill out before their first appointment. D. A and B E. B and C

33. According to Dr. Rawson’s lecture, which of the following behavior management techniques is least likely to be acceptable to a child’s parent? A. Nitrous oxide B. Voice control C. Oral sedation D. Active restraint

34. (1) Positive reinforcement results in increased likelihood of the behavior occurring again. (2) Negative reinforcement results in decreased likelihood of the behavior occurring again. A. The first statement is true and the second statement is false. B. The first statement is false and the second statement is true. C. Both statements are true. D. Both statements are false.

DGBS 721 7 Fall 2008 Dr. Hinz 35. (1) It is normal for a child to develop several fears throughout childhood and overcome them. (2) It is normal for a pre-teen to have fears related to school performance and appearance. A. The first statement is true and the second statement is false. B. The first statement is false and the second statement is true. C. Both statements are true. D. Both statements are false.

36. A parent brings their child in for a dental check up before enrolling in Kindergarten as required by law. You diagnose severe decay that will likely cause further harm if left untreated. The parent was aware that there were problems, but did not bring the child to see a dentist sooner due to financial hardship. The parent also it was not urgent because the teeth were “baby teeth.” Under what circumstance is this considered abuse? A. It is only abuse if the parent does not get the child the recommended treatment. B. It is abuse automatically because the parent was aware of the problems. C. It is abuse automatically because of the severity of the problems. D. It is only abuse if the parent willfully caused the poor condition of the teeth. E. It is only abuse if the parent was aware of the severity of the problems.

37. According to the Model of Fear Acquisition presented by Milgrom et al., dental fears are acquired in situations where the patient experienced which of the following? A. 1 and 2 only 1. Indirect experiences of dentistry as negative. B. 2 and 3 only 2. Direct or personal painful dental experiences. C. 1, 2, and 4 3. Perceived little control in the situation. D. 1, 2, and 3 4. Perceived control if they wish it. E. All of the above

38. Mr. Hagar comes in to your office in extreme pain. He is a first time patient in your office. He reports that it has been years since he has seen a dentist and that he has had many negative dental experiences that have left him with significant fears of dentists and dental treatments. “My wife forced me to come in today.” Upon examination you determine that he has an abscess that should be treated with a root canal. The Milgrom text recommends that you do which of the following? A. Go ahead and treat him that day because he is unlikely to return. B. Give him pain medication and antibiotic to reduce the acute pain and distress. Schedule him for treatment when the pain has subsided. C. Assess his history of dental treatment, asking about fears and what you can do to help him feel more comfortable with treatment. D. A and C E. B and C

39. DELETED (1) Your Milgrom text recommends that you conduct an assessment of fears with all patients after the initial examination so that you can comment on their dental needs throughout the assessment. (2) The text also suggests that face to face interviewing is much better than a written questionnaire because questionnaires can seem cold and impersonal. A. The first statement is true and the second statement is false. B. The first statement is false and the second statement is true. C. Both statements are true. D. Both statements are false.

40. Which of the following is true of both distraction and guided imagery? A. Both help the patient learn to ignore any painful sensations they experience during treatment. B. Both help to refocus the patient’s attention away from the stressful or painful aspects of the dental appointment. C. Both give the patient behavioral control over the dental experience. D. All forms of relaxation skills are just complicated distraction techniques. DGBS 721 8 Fall 2008 Dr. Hinz

41. DELETED The chapter on child management by Allen, noted research on parental presence in the operatory. Which of the following is recommended? A. Parents should be instructed to discuss non-dental topics with children during injection. B. Parents should be instructed to reassure the child about procedures and tell them it will help them feel better later. C. Parents should not be allowed in the operatory during potentially painful procedures so that they don’t get anxious or upset in front of the child and convey their anxiety to the child. D. Parents should be present in the operatory since in most cases parental presence is beneficial to the child.

42. Children respond well to relaxation procedures such as imagery and deep breathing. A. True B. False

43. Missy Eltow has braces and is not keeping up with her oral hygiene. You decide to implement a behavior modification program with her. She gets prizes for showing up to her appointment with clean teeth. It worked and her oral hygiene improved significantly. Since this program worked so well with Missy, you decide to implement behavior modification procedures with all of your patients who have braces. Which of the following terms explains your decision to continue using this technique? A. shaping B. positive reinforcement C. punishment D. extinction E. stimulus discrimination

44. You recommend to your anxious patient Mr. Samiam to list what he wants to tell himself at various times throughout the appointment to counteract his negative about dentistry. He writes messages to himself on cards for just before he arrives, when he is in the chair getting an injection, in case he starts to panic and when the appointment is over. What is this technique? A. Stress inoculation B. Cognitive restructuring ½ point for B. C. Systematic desensitization D. Progressive relaxation

Use this scenario to answer questions 45 and 46. You have a child pt who is extremely fidgety and squirms around in the chair, disrupting treatment. You give him an DVD player so he can watch a movie. Every time he squirms around you turn off the player. When he sits still he can watch the movie. The amount of time he continuously sits still increases until he is able to sit still throughout the entire appointment.

45. Turning off the radio when the child squirms is positive reinforcement. A. True B. False

46. According to Piaget’s stages of cognitive development, this technique will only work with children under age 7. A. True B. False

DGBS 721 9 Fall 2008 Dr. Hinz

47. You have a patient who needs lots of work but also has a dental phobia. Which of the following techniques is recommended to treat the patient’s phobia? A. Stress inoculation B. Systematic desensitization C. Flooding or implosion therapy D. E. Progressive muscular relaxation

48. Mrs. Violet has a fear of many aspects of the dental environment. She especially notes the smell of the office as triggering her feelings of fear. According to principles, what are the smells? A. CR B. CS C. US D. Primary reinforcers E. Negative reinforcement



Good luck on the rest of your finals!

I hope you have a safe, refreshing and enjoyable holiday break!