Ethics

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Ethics

Note: Read chapter of Ethics in Dental Decks and DHA code of ethics.

➢ There are five principles in the ADA Principles of


1. Patient autonomy (“self-governance”). The dentist has a duty to respect the patient’s rights
to self-determination and confidentiality.
2. Nonmaleficence (“do no harm”). The dentist has a duty to refrain from harming the patient.
3. Beneficence (“do good”). The dentist has a duty to promote the patient’s welfare.
4. Justice (“fairness”). The dentist has a duty to treat people fairly.
5. Veracity (“truthfulness”). The dentist has a duty to communicate truthfully.

• Fidelity (being loyal): do as you say, respect confidently, honour your -commitments.

• Professionalism (being skilful and knowledgeable): be committed to involvement in


professional endeavours that enhance knowledge skill judgment and intellectual
development of the benefit of society.

• Tolerance (being open-minded): "Respect the rights of individuals regardless of personal,


ethnic, religious or cultural background in all dealings with patients, providers, peers and
employers"

• Integrity (being honest): "Incorporate core values as the basis for ethical decision making
and the foundation for honourable character.
• Competence (improve the skill): "Strive to achieve the highest level of knowledge, skill
and ability within your capacity"
ETHICS IN HEALTH CARE
1- Beneficence
2- Autonomy
3- Veracity
4- Justice
5- Nonmaleficence
6- Confidentiality

1- Beneficence = DO GOOD

ž It is the patient right to have highest quality dental care.


ž It is the dentist duty to act for the benefit of patient and public.

2- Autonomy = Self-governance
ž Auto = self nomy = control
ž Every human being of adult and sound mind has rights to determine what shall be done
with his own body
ž What is the patient right?
To choose his treatment without any pressure and to accept or refuse the treatment

3- Veracity = Truthfulness

ž It is telling the truth, honesty, and integrity.


ž Example: Do Not recommend unnecessary procedures
ž The dentist has a duty to communicate truthfully, and it is grounded in respect for
persons and the concept of autonomy. In order for a person to make fully rational choices, he
or she must have the information relevant to his or her decision

4- Justice = Equality and Fairness

ž The dentist duty to treat all patients fairly and equally regardless of personal or social
characters
ž It is unethical to refuse the treatment of patient infected with blood borne organism
ž Example:
• Treat poor and rich people with the same quality and price
• Do Not refuse the treatment of patient infected with blood borne organism

5- Nonmaleficence = DO NO HARM

ž It is the patient right to be not exposed to unnecessary harm


ž It is the dentist duty to protect patients from harm
ž Example:
• Sterilization of instruments and disinfection of a unit
• Do not Extract third molar without experience this may harm the patient

6- Confidentiality = PRIVACY

ž It is the patient right to have personal, medical information kept private and as secret
ž It is the dentist duty to keep patient information confidential
ž Note: dentist should safeguard confidentiality the patient records
• The dentist owns all patient records and radiographs and never allowed to leave the
practice without the dentist’s permission
ž When we don’t maintain confidentiality?
• With patient consent
ž Without patient consent: when?
• Required by law
• Protect patient from harm (child abuse)
• Protect others in infectious diseases (AIDS)

1. Definition of autonomy (patient right)


AUTONOMY (self-governance): The dentist has a duty to respect the patient's rights to self-
determination and confidentiality.
2. Definition of veracity
VERACITY (truthfulness") ... Under this principle, the dentist’s primary obligations include
respecting the position of trust inherent in the dentist-patient relationship, communicating
truthfully and without deception, and maintaining intellectual integrity

3. Dental ethics comprises of:


A. Behaviour with colleagues.
B. Professionalism.
C. Behaviour with patient.
D. All the above.
Answer: D.

4. Dentist decides to do surgical extraction of mandibular third molars even though he


does not have the experience. By doing that he contradicts which law of ethics?
A. Beneficence.
B. Non-maleficence.
C. Autonomy
D. Justice.
Answer: B.

5. Dentist refuse to treat AIDS patient which ethical concept?


Answer: Justice.
6. Doctor transfers patient to other doctor without reason, but the patient has been
informed that he is going to be referred, what does he ignore?
A. Autonomy.
B. Confidentially.
C. Justice.
D. Veracity.
Answer: D.

7. Doctor transfers patient to other doctor (he needs that referral, I mean it is for a
reason), and the patient has not been informed that he is going to be referred, what
does he ignore?
A. Autonomy.
B. Confidentially.
C. Justice.
D. Veracity.
Answer: A.

8. Doctor transfers patient to other Dr. without any benefit (just wanted to refer for
extra fees), what he ignores?
A. Autonomy
B. Confidentially
C. Justice.
D. Veracity.
Answer: D.

9. Dentist refer patient to specialist without discuss anything with him (or something like
that), what’s the dentist ignoring ethically?
A. Autonomy
B. Confidentially
C. Professionalism.
D. Veracity.
Answer: A.
Autonomy, if the dentist ignoring the patient.
Professionalism, if ignoring the referral specialist.

10. A group of researchers would like to study the relationship between oral health status
in childhood and adult systemic health conditions. They have found a 40-year-old
database that contains information on the oral health of children along with their
names. They plan on linking this information with current administrative health care
data to conduct this research. What ethical concern(s) would the researchers have to
consider?
A. Selection bias.
B. Privacy and confidentiality.
C. Beneficence.
D. Justice.
Answer: B.

11. “Self-Governance” is referred to which principle in the code?


A. Veracity.
B. Justice.
C. Autonomy.
D. Beneficence.
Answer: C.

12. Hippocratic oath main component?


Answer: Confidentiality.
It is an oath stating the obligations and proper conduct of doctors, formerly taken by those
beginning medical practice.

13. Doctor has no disease get injured and bleeds in the patient mouth what he should do?
A. Don’t inform the patient but write it in the record.
B. Reassure the patient to do nothing as the doctor is free of disease.
C. inform the patient to post exposure follow up and refer accordingly.
Answer: C.
14. How to tell patient about bad news?
A. Stop frequently to make sure they understood.
B. Try to minimize the severity of the situation.
Answer: A.
15. if you are in educational hospital, if a trainee wants to examine a patient, should you
take a permission or not?
Answer: yes.
16. The legally set age for authorization of health care treatment
A. is 16 years of age.
B. indicates ‘mature minor’ status.
C. presumes capacity.
D. applies universally.
Answer: C.

Competent refers to every adult person, 18 years and above as presumed to be capable of and
competent to give an informed consent, unless there is an evidence to verify incompetence

17. Informed consent includes all of the following EXCEPT


A. disclosure of all probable complications.
B. allowing for questions posed by the patient.
C. alternative treatment options, including no treatment.
D. informed consent form signed and witnessed.
Answer: B.

18. Which of the following American Dental Association Principles of Ethics states that a
dentist has a duty to respect the patient’s right to self-determination and
confidentiality?
A. Patient autonomy
B. Nonmaleficence
C. Beneficence
D. Justice
E. Veracity
Answer: A.
19. Which ethical principle is violated when a dentist practices while impaired?
A. Autonomy.
B. Beneficence.
C. Justice.
D. Nonmaleficence.
E. Veracity.
Answer: D.

20. An adult female patient presents to the dental office with fractured teeth, a lacerated
lip and a black eye. She is with her 6-year-old son, who is crying and upset. The dentist’s
receptionist discretely reports that the child was asking his mother “Why was Daddy
hurting you?” Upon questioning, the patient confides that her husband was the source
of her injuries and indicates that she would not be pursuing any action. She is referred
to a specialist due to the complexity of her dental injuries, but she requests that the
source of her injuries not be disclosed. What is the dentist’s obligation?
A. Respect the patient’s request regarding confidentiality.
B. Report her injuries to an adult protection agency.
C. Forward all information, including the source of the injuries, to the specialist.
D. Report the situation to a relevant child protection agency.
Answer: A.

Dentists have a concurrent ethical obligation to respect an adult patient’s right to self-
determination and confidentiality and to promote the welfare of all patients.
Care should be exercised to respect the wishes of an adult patient who asks that a suspected case of
abuse and/or neglect not be reported, where such a report is not mandated by law. With the
patient’s permission, other possible solutions may be sought.

B is not correct as adult reporting without permission is not allowed.


C since the patient refuses to disclose the cause of injury, we can’t breach this confidentiality, the
specialist duty is to find out the cause if that will affect on the treatment plan.
D Only if the child is involved or the mother asked for that.

21. Old patient came with his son, the patient has cancer, his son asked you to not tell the
father, what you will do?
A. consult lawyer.
B. inform patient that this is cancer.
C. inform patient that this is infection and treat as cancer.
D. refer patient to another dentist.
Answer: A.
22. Ethics principle:
A. competence, autonomy, professionalism.
B. competence, autonomy, accessibility
C. competence, professionalism, accessibility
Answer: A.
.

23. Ethics code arrangement:


Answer: Ethics-Law-professionalism.

24. A new definition to ethics, Deontology.


Deontology is a theory that suggests actions are good or bad according to a clear set of rules. Its
name comes from the Greek word deon, meaning duty. Actions that obey these rules are ethical,
while actions that do not, are not. This ethical theory is most closely associated with German
philosopher, Immanuel Kant
Medical ethics is a sensible branch of moral philosophy and deals with conflicts in obligations/duties
and their potential outcome.
Two strands of thought exist in ethics regarding decision-making: deontological and utilitarian. In
brief, deontology is patient-centred, whereas utilitarianism is society-centred.

25. Search about......moral (something like that):


A. deontological ethics or deontology .
B. principalism
Answer: A.

26. Which of the following is morally right?


a) You can seek help from another dentist when needed.
b) You can get your patient’s phone number for the record for social activities
c) Book appointments for family and friend for them to get fast treatment
Answer: A.

27. Medical ethics aim to:


A. The dentist should study to know patient psychology.
B. Not to compromise or undermine ability to treat patient in community as professional.
C. Ability to make decision.
D. All of above.
Answer: D.

28. Patient admires female dentist and wants to keep in touch with her. what to do?
A. yes, and do business with him
B. refuse any type of communication
Answer: B

29. Female patient came with pain and need a female dentist but was absent what to do?
A. refer her to another hospital that female dentist there immediately
B. advise her that your case emergency pain and female dentist not present today
Answer: B
Conduct clinical examination of patients from opposite gender in the presence of a chaperone.

30. The only situation that is accepted for the dentist to consider verbal consent.
Answer: Verbal consent is considered when there is no risk associated with the procedure ex,
taking a pulp test during examination.

31. Doctor’s uncle called him and asked him about an admitted patient in the hospital as
that patient’s relatives are calling him personally and need to know if he is good or not.
What should the doctor do?
A. Apologize to his uncle and refuse.
B. Tell him lets his relatives calls me and I will inform him
C. Tell the patient first
Answer: A.
With appropriate consent, being responsive in providing information to the relative.

32. Meaning of advance directive?


Answer: A written document (form) that tells what a person wants or doesn't want if he/she in the
future can't make his/her wishes known about medical treatment.

33. You must take the consent of all patient unless:


A. Emergency case for the patient
B. Another gender
C. Training hospital for student
Answer: A.

34. Medical representative asked doctor to use a new drug with his patient, and he will give
him ticket to travel to in a vacation in some place. If the doctor accepts this deal what
this is called?
A. Benefices
B. Malpractice
C. Medical bias
D. Conflict of interest
Answer: D (but if there is an option of veracity, I will choose it).
A conflict of interest is defined as a relationship or interest that could lead to bias or perceived bias
in the design or delivery of the work. It is important to take account of how actions and
relationships may be perceived, whether or not a conflict of interest actually exists.

35. Why not tell patient about his disease (something like that)?
A. Emotional
B. Patient do better without knowing.
Answer: none of them is correct, but may be A.
Sometimes it is better to break the bad news to the patient two or three days after until the patient
recovers from the attack (heart attack). We are expecting the patient on the same day will be
exhausted and may be react in a different way. If we postpone it two or three days, the patient will
be in a different space to understand and accept the idea of being ill. So, the emotional part of
breaking the bad news to the patient and patient interest is very important.

36. What are the near misses?


WHO defines a near miss as “an error that has the potential to cause an adverse event (patient
harm) but fails to do so because of luck or it is intercepted.

37. The following violations provide grounds for a criminal action in battery EXCEPT:
A. intentional touching.
B. defamation causing harm.
C. treatment without consent.
D. harmful contact.
Answer: B.

38. Child 8 years old come with his brother 14 years seeking for orthodontics treatment,
what is the correct management:
A. Take photographs
B. Take impression
C. Ask their parents to come
Answer: C.

39. You are doing a questionnaire (something like that) with depression patient. You first
explain it to the patient and then tell them the reason for doing it, then started to ask
them what you are doing.
A. extradite (extradition means sending someone back to the country or state where they've
been accused of a crime)
B. expert.
C. conflict of interest.
Answer: B.

40. Something about being accurate and comprehensive.


A. Veracity
B. Maleficence
Answer: A.

41. A supervisor asks some trainer to write consult for patient, this consent should:
A. Supervisor sign
B. Look at it and then sign
C. She must read it to him
D. Doesn’t matter what supervision want
Answer: B.

42. Patient with severe mental attitude manage:


A. Relative hold him
B. Dental crew hold him
C. Oral Sedation
D. Nitrous Oxide
Answer: C.

43. Mistake during dental work:


A. Tell senior and patient.
B. Tell senior and don’t tell patient.
C. Don’t tell the senior and patient.
Answer: A.

44. A surgeon with a busy operation list was told by his assistant that the next operation is
to remove the patient's right kidney. After the operation, it was found that it was the
left kidney that should have been removed. Which term best describes this event?
A. Sentinel event
B. Adverse event
C. Unintentional error
D. Medical negligence
Answer: D.
We can describe what happened is an error because of negligence leads to adverse event.

45. The statute of limitations states that the period during which an action in negligence
against a dentist can be initiated starts when the:
A. patient first meets the dentist.
B. treatment is rendered.
C. treatment is paid for.
D. patient first becomes aware of the problem.
E. patient seeks a second opinion about the problem.
Answer: D.

46. A study was conducted to determine if there was a difference in the prevalence of
diabetes mellitus among health care workers in Riyadh. The results showed that 30 out
of 100 doctors were diabetic as compared to 50 out of 200 nurses. Which is the most
appropriate statistical test?
A. t-test
B. ANOVA
C. Chi-square
D. Correlation
Answer: C.
47. An article reports that subjects receiving chlorhexidine varnish had significantly lower
(p<0.05) Streptococcus Mutans levels than did those receiving fluoride varnish. What
type of reporting error is of the most concern when interpreting these results?
A. Type II (ß) error.
B. Type I (ß) error.
C. Type II (α) error.
D. Type I (α) error.
Answer: D.

48. Reliability of the measurements reflects that property of the measurements which:
A. Measures what is intended to be measured.
B. Produces repeatedly the same results under a variety of conditions.
C. Detects reasonably small shifts in either direction, in group condition.
D. All of the above.
Answer: D.

49. A survey was conducted and all information was shared to the investigators, surveyor,
and sponsors. Where is the breach in trust there?
a) Investigator.
b) Sponsors.
c) Surveyors.
Answer: B.

50. A study on students in 5th grade compared with students of 5th grade before 10 years,
what is the name of study?
A. Case control study.
B. Cohort study.
C. Cross-sectional study
Answer: B.
51. Ethics of the study doesn’t include the followings EXCEPT:
A. Privacy of all subjects.
B. Informed consent may be required or not.
C. Object if the subject refuse to take part of the study.
Answer: A.

52. Which of the following statements regarding Informed Consent is FALSE? It is:
A. always necessary.
B. given only by the person receiving the treatment.
C. able to be withdrawn.
D. procedure specific.
Answer: B.

53. How to measure the quality of care health provider in hospital?


A. Quality inspection.
B. Quality assurance.
C. Quality evaluation.
D. Quality assessment.
Answer: D.
Quality assurance is sets of process to measure the quality of service.
Quality control is a set of process to ensure service meet the customer expectation.

54. Population affected by cholera in the past, three towns were contacted to take
participation in a study and samples were taken from each town to evaluate cholera
carriers and compared. What is the type of the study?
A. Cross sectional study
B. Concurrent cohort study
C. Non concurrent cohort study.
Answer: C.
Cohort studies can either be prospective (concurrent) or retrospective (non-concurrent)

55. The most effective method for protecting dental personnel who expose radiographs is
to have them:
A. stand behind a barrier during exposure.
B. stand 2 metres away from the x-ray generator during the exposure.
C. wear a lead apron during exposure.
D. wear a dosimeter during exposure.
Answer: A.

56. The first step in diagnostic workup, is obtaining the:


A. Medical history.
B. Present complaint.
C. Biographical data.
D. Restorative history.
E. Traumatic history.
Answer: B.

57. In domestic violence cases, the highest risk for victim fatality is associated with:
A. an actual or pending separation.
B. severe depression of the abuser.
C. prior threats to kill the victim.
D. a new partner in the victim’s life.
E. a history of abuse of the abuser as a child.
Answer: A.

58. A 40-year-old schizophrenic patient needs replacement of multiple anterior teeth.


Dentist discussed the procedure with the patient who understood the procedure. A
written consent should be signed by:
A. patient only
B. patient does not need consent
C. patient’s1st relative only
D. both patient and 1st relative
Answer: D.

59. Which of the following would be the main reason to consider research participants
vulnerable?
A. Poorer than other participants
B. Unable to protect their interests
C. Persons with emotional distress
D. Mentally disabled or handicapped
Answer: B and D is correct but B is more general term.
The vulnerable populations refers to but not limited to children, minors, pregnant women, foetuses,
human in vitro fertilization, prisoners, employees, military persons and students in hierarchical
organizations, terminally ill, comatose, physically and intellectually challenged individuals,
institutionalized, elderly individuals, visual or hearing impaired, ethnic minorities, refugees,
international research, economically and educationally disabled and healthy volunteers.

60. The reason patient choke from food and water.


A. true vocal cord
B. false vocal fold
C. nasopharynx
D. oropharynx
Answer: D

61. Patient lost conscious and stopped breathing while you were doing scaling. What is the
first thing to do?
A. Look for object obstructing air way
B. Take the patient shirt off
C. Start ventilating patient lungs
D. Determine the cause
Answer: A.

62. CPR:
A. Is best performed in the dental chair.
B. Should be performed on all patients experiencing chest pain.
C. Is more efficient when using a full mask, delivering 100% oxygen than with the mouth to
mouth technique.
D. Is beyond the medico legal responsibility of the practicing dentist.
Answer: C.

63. During CPR, if a patient is not breathing but has a pulse, how often should a breath be
given? Every:
A. 3-4 seconds.
B. 5-6 seconds.
C. 7-8 seconds.
D. 9-10 seconds.
Answer: B.
If the patient has a pulse but is not breathing, provide one breath every 5-6 seconds (10-
12 breaths/minute) and check for a pulse every 2 minutes.
If the victim loses their pulse, you will need to begin chest compressions 30 compression then 2
breath.

64. The compression / relaxation cycle of external cardiac compression should be repeated:
A. 2 times / second.
B. 60 times / minute.
C. 76 times / second.
D. 100 times / minute.
Answer: D.
At approximately 100/min, every 30 compressions then two breaths allowing about one second for
each inspiration.

65. The management of syncope following local anaesthetic administration does NOT
include:
A. elevating the legs.
B. placing in a supine position.
C. administering oxygen.
D. ensuring the airway is open.
E. administering epinephrine.
Answer: E.

66. A patient suddenly becomes pale and sweaty after an injection of 4ml of lidocaine 2%
with epinephrine l:l00,000. The radial pulse is slow and steady. The respiration is slow.
The blood pressure is 80/60. What is the most probable diagnosis?
A. A toxic reaction to lidocaine.
B. A toxic reaction to epinephrine.
C. An allergic reaction to the local anaesthetia.
D. Incipient syncope.
E. An impending adrenal insufficiency.
Answer: D.

67. A 50-year-old obese patient was diagnosed with type 2 diabetes last year and has
recently started taking an oral hypoglycaemic drug. He frequently skips meals in order
to reduce his weight. During his 8:30 a.m. appointment, his speech becomes slurred and
he is less alert than usual. Which of the following is the most appropriate management?
A. Have him drink 175ml of diet cola.
B. Give him 15g of glucose as tablets or in a solution.
C. Have him eat a chocolate bar.
D. Dismiss the patient and advise him to eat.
Answer: B.

68. Success of treatment depend on


A. doesn’t depend on patient attitude
B. depend on patient attitude -demand and financial
C. Failures only related to technical faults.
Answer: B.
69. Dentist refuses to treat AIDS patient, which ethical concept?
Answer: Justice.

70. Patient with wrong dental treatment refers to you what you should do?
A. Told patient that the previous doctor makes mistakes
B. Don’t told patient and start treating him
C. Write report to the HCO
D. Told patient that you have to return to the previous doctor to fix his work.
Answer: C (justice).

71. Patient teaches good work to his student principle?


A. Veracity
B. Justice
C. beneficence
Answer: C.

72. Autonomy is not contraindicated in:


A. older
B. partial retarded (like mild case of Down syndrome)
C. children
Answer: C.

73. The Least Important Thing to Be Written in The Consent:


A. The Diagnosis
B. The Risk Percentage
C. The Expected Cost
Answer: C.

74. A special need patient refuses and not understanding the treatment protocol and doctor
wants the consent
A. take consent from relative
B. refuse to treat the patient.
C. take patient consent
Answer: A.

75. Down's syndrome patient came to do FPD, he couldn't fully understand the dentist, so
dentist should:
A. start treatment
B. take patient finger print in consent & start treatment
C. take the relatives permission.
Answer: C

76. Some dental plans allow the dentist to charge the patient any difference between what
the plan agrees to pay and the dentist’s UCR (usual, customary, reasonable) fees. This
arrangement is called _____.
A. Payment differential
B. Balance billing
C. Prospective reimbursement
D. Managed care
E. None of the above
Answer: B.
Balance billing occurs when providers bill a patient for the difference between the amount they
charge and the amount that the patient's insurance pays.
Prospective reimbursement is a mechanism in which the dentist is compensated before treatment is
provided (i.e., in capitation systems).
Managed care is an arrangement in which a third party mediates between providers and patients
negotiating reimbursement for certain services and overseeing the treatments delivered.

77. Dentist manager punished one of the team due to fault. This will:
A. improve work.
B. the team will be afraid to make mistakes.
Answer: A.

78. A dentist must be prudent in deciding how far to follow a patient’s informed choice for
suboptimal treatment because:
A. the law protects a patient’s right to make poor decisions.
B. a patient’s informed choice must always be honoured.
C. the principle of do-no-harm overrides the patient’s personal choice.
Answer: C.

79. Patient has multiple amalgam restoration and wants to replace all of them with white
restoration. The dentist told her not all need to be changed and he will do some now
and some later but she insists to replace them all, what to do?
a) Refer to another dentist
b) Replaced some amalgam restoration
c) Replaced all amalgam restoration
d) Tell her you can treat her only if she accepts your treatment options
Answer: C.
• Respect for your patient’s right to refuse or choose their treatment in accordance with UAE
laws. So even if the treatment is not logic, we need to follow according to UAE law since it
is applicable.
• Respect your patient’s choice and right to refuse or choose their treatment, and obtain
informed consent to give treatment.
• If your patient or family refuses treatment or therapy that you believe is necessary for
their well-being or else would put them at significant risk or harm, you must take
reasonable efforts to persuade them to be treated.
• You must respect your patient’s wish for a second opinion, and/or decision to consult with
other health professionals.
• You must make reasonable records of the information provided to your patient.

80. Patient with sever intrinsic discoloration asking for full crown, dentist decided veneer
and try to tell the patient that the full crown is not right in his situation but the patient
insists, so the dentist should:
A. Do what the patient want.
B. refer him to another dentist to do it
C. politely reject and dismiss him.
Answer: A.
A is correct, the patient refuses the proposed procedure/treatment, the treating dentist shall document
the patient refusal and information regarding the consequences of refusal.
B referring the patient to another dentist for the second opinion, if the other dentist has the same
opinion so the patient can come back to us and do it for him after documentation.

81. Female patient wanted to correct her sever protruded anterior teeth. The protrusion
needs to be corrected by orthodontic treatment, but the patient insisted to do crowns.
What will happen if dentist agree to do this (pulp exposure might happen).
A. Dentist refuses
B. Dentist does with consultation
C. Send her to another doctor
Answer: B.

82. Patient needs multiple crowns and she is complaining of pain in second molar but she
asks you to do first molar and you explain to her that it will not solve the problem but
she insisted, what to do?
a) Refer to another dentist
b) Do the second molar that causes pain
c) Do the first molar
Answer: C.
Since you explained to her, it is her own choice.

83. A dentist who has been diagnosed as a chronic Hepatitis B carrier can perform
exposure prone procedures:
a) using Standard precautions.
b) in the absence of HBe Ag.
c) following a review by an Expert Panel.
Answer: C.
• You must consult a suitably qualified health professional, on ways that you can change
your practice to continue to be safe and effective, or stop practicing if it is necessary,
depending on their advice.
• If you are suffering from any communicable disease, you must take necessary precautions
and limit your practice in order to prevent infecting others. You are also to seek medical
advice and follow it.
• You must inform the HRD of any significant changes in your mental or physical health,
and resulting changes in your practice.

84. Difference between private and community dental clinic:


A. Evaluation
B. Patient assessment
C. Expected outcome
D. Evaluation of services
Answer: D.

85. Which of the following principles in the dental ethics covers patient protection from
falls?
A. Autonomy.
B. nonmaleficence.
C. Beneficial.
D. Veracity.
Answer: B.

86. Return the patient to the first dentist.


A. ethical.
B. Professionalism.
Answer: B.

87. Ethical scenario when the patient was referred from dentist A to B and then B did a
treatment plan and sent him back to A then the patient-decided to do the treatment
with B then A refused?
a) Paternalism
b) Professionalism
c) Confidentially
Answer: B.
Paternalism is the interference with the liberty or autonomy of another person, with the intent of
promoting good or preventing harm to that person. Examples of paternalism in everyday life are
laws which require seat belts, wearing helmets while riding a motorcycle, and banning certain drugs.

88. You have autism patient with mental retardation came with nurse and you want to take
consent before starting the treatment, from whom will take it?
A. Patient.
B. Parents.
C. Nurse.
D. No need.
Answer: B.

89. Action of feeling you have authority on the patient and you know what’s the better for
him and not take his opinion in treatment.
Answer: paternalism and breaching autonomy.
Paternalism is the policy or practice on the part of people in authority of restricting the freedom
and responsibilities of those subordinate to or otherwise dependent on them in their supposed
interest.

90. Question about a doctor who decide a medical option without even asking the patient
or refer to him?
A. Medical decision.
B. Paternalism.
C. Best interest.
Answer: B.

91. A good treatment plan in planning the bridge is:


A. To inform the patient about present condition, extent of proposed treatment time, and cost.
B. Not to tell anything to the patient.
C. Patients detailed past dental history.
D. Patient must know about drawbacks of treatment.
E. The patient should be only told the minimum possible things mainly about time and cost.
Answer: A, C, D. But A is more general option.

92. Dentist must:


A. Treat Patient medically.
B. Prescribe medication to patient with medical problem.
C. Do clinical examination, take medical history and evaluate the medical state.
Answer: C.

93. After patient came to your clinic and gave an extended history and complain, what’s
your next step in treatment?
A. Clinical examination
B. Start the treatment
C. Radiographic examination
Answer: A.

94. In a study, it should:


A. Protect you against role of the statistician.
B. Protect you against legal risks.
C. Protect against physical risks.
Answer: B.

95. Examination or taking a history of patient by the dentist:


A. To know the patients’ health.
B. To know what medications to give.
C. To know general health data.
D. All of the above.
Answer: D.

96. In clinical research:


A. Blind or double blind.
B. Needs control.
C. Includes intervention.
D. Offers no benefits to subject at risk.
Answer: C (all are true, except D).
If the question is all are true except, I will go for option D. All options other than D, are correct.

Clinical research helps to find new and better ways to detect, diagnose, treat, and prevent disease.
Types of clinical research include clinical trials, which test new treatments for a disease, and natural
history studies, which collect health information to understand how a disease develops and progresses
over time.
Clinical trial either be a blinded or double blinded.
A well-defined control group, which will enhance the validity of a study.

97. 10 years old child, who is unable to differentiate the colours, and can’t tell his name, or
address. He is acting like:
A. 3 years old.
B. 4 years old.
C. 10 years old.
Answer: A.

98. Patient un-cooperation can result in fault of operation, technical faults only are related
to patient factor:
A. TRUE.
B. FALSE.
Answer: B.

99. In a clinical research trial, we primarily need to:


A. Get written the subject in the patient's own native language .
B. Verbally the subject briefly.
C. Tell patients that they are part of study.
Answer: A

100. An 80-year-old woman presents to the Dental Clinic for her dental treatment.
She needs to have an extensive treatment because her mouth is in poor condition. She
appears confused and does not seem to be able to understand the treatment that the
dentist wants to provide. Which of the following is the most appropriate treatment?
Answer: Contact the next of kin to discuss treatment

101. A 12-year-old girl presents to the Dental Clinic to have corrective treatment for
her malocclusion. The suggested treatment by the dentist is in her best interest. Her
parents agree with the treatment but the girl does not want to have the treatment and
feels the dentist and the parents are forcing her to have the treatment. Which of the
following is the most appropriate treatment?
Answer: Treatment on which parents agree.

102. Which of the following pitfalls in the patient-dentist relationship is represented


when a dentist chooses a treatment plan on behalf of the patient?
Answer: Paternalism.

103. A patient asked his dentist to insert an implant in an empty space in his mouth.
The dentist is a new graduate with no training in implants. Which of the following is
the ethical action?
Answer: Refer the patient to a specialist even if there is a risk that the patient may prefer to stay
with the new dentist.
104. 7 years old boy presented with his mother for tooth restoration, the mother has
requested composite filling but the dentist insisted to convince her that amalgam is
better, which principle of ethics the dentist has violated?
a) Autonomy.
b) non-maleficence.
c) Privacy.
d) Veracity
Answer: A or D.
If the dentist opinion depends on the clinical situation and for the best interest of the
patient, so A will be the right option.
If the dentist opinion has no strong basic so the right option is D.

Amalgam is a material suitable for larger restorations of posterior permanent teeth


in children, young adults and adults.
Amalgam is now generally avoided for filling children’s teeth. Growing children tend to be
more sensitive to the effects of exposure to any chemical substance in their environment.
Several of the new tooth-coloured materials are suitable for use where cavities are small, as
they often are in children. Also, it is sometimes possible to treat a child’s tooth with a
preventive resin filling that stops existing decay and prevents further decay, rather than
inserting an amalgam filling.

105. Long case about newly graduated dentist and his friend come to check his teeth
and he found that the patient has a missing tooth that is best to be restored by implant
but he is not experienced enough to do it as he did only one case when he was in college,
what should he do?
a) refer him to a specialist.
b) ask a more experienced senior to supervise him while he is doing implant.
c) do fixes partial denture instead.
Answer: A.

106. 17 years old girl wants to put a diamond on the tooth and parent are not
approving. What should the dentist do?
a) refuse treatment.
b) ask for parent to come.
c) do it anyway.
d) ask for parents written consent.
Answer: B.

107. A young kid came with his teacher after trauma causing avulsion of tooth.
Dentist called the parent but they didn’t answer, how will the dentist get the consent to
proceed with the treatment?
a) from the teacher
b) don’t do treatment
c) dentist do the procedure with no consent for the patient sake and best interest
Answer: C.

108. The effect of parent present in the clinic.


a) impair communication with the child.
b) impair communication with the other parent.
c) impair communication with dental assistant.
Answer: A.

109. Unexperienced dentist did a surgery procedure of impacted 3rd molar


extraction during which he injured the IAN what does this action called?
a) Malpractice.
b) Negligence.
Answer: A.
The most distinctive difference between the two is intent. In simple terms,
medical negligence is a mistake that resulted in causing a patient unintended harm.
Medical malpractice, on the other hand, is when a medical professional knowingly didn't
follow through with the proper standard of care.

110. Sodium hypochlorite accident case, what is the first thing to do in management?
Answer: Tell the patient and then irrigate with saline.

111. You broke a file inside the canal, and in the first visit you can’t retrieve it. In the
second visit, you use by pass the file and remove it completely from the canal. What you
have to do with the patient?
a) Directly tell the patient about it.
b) You tell the patient in the second visit after you remove the file.
c) Don’t say anything about the problem.
Answer: A.

112. Famous player visited a dentist, then the dentist used that player picture without
ask him. What is the type of ethics violation?
Answer: Confidentiality.
Explain how the clinical team will maintain the confidentiality of data, especially with
respect to the information about the patient including photography and videography.

113. Definition of principlism ?


Answer: Principlism is a system of ethics based on the four moral principles of autonomy,
beneficence, nonmaleficence, and justice.

114. Which of the following is necessary for informed consent ?


a) can be verbal
b) must be written
c) can be implied by patient actions
d) does not include benefits of treatment
Answer: B.

115. Which of the following conditions would be acceptable for a doctor to disclose
information from a patient's record ?
a) to a reporter about a celebrity .
b) in consultation with a colleague.
c) to a concerned friend or relative.
d) when it is the public right to know .
Answer: D.
Ensure that there is no disclosure of any patient information without consent,
except where it is required or permitted by law, required by law or by public interest
considerations or if it is required to protect your patient or others from harm.

A good partnership between a practitioner and the person they are caring for requires high
standards of personal conduct. This involves protecting the privacy and right to
confidentiality of patients or clients, unless release of information is
Good practice involves sharing information appropriately about patients or clients for their
healthcare while remaining consistent with privacy legislation and professional guidelines
about confidentiality.

116. Why do we write the chief complain ?


a) Normal routine step.
b) to compare it with another patient complains.
c) Patient feels he is being listened.
d) to assure the patient that his need has been recognized
Answer: D.

117. Patient came late in dental clinic 30 minutes; the assistant asked the doctor let
him enter but the doctor he says sorry, which time the doctor refused to treat the
patient?
a) HIV.
b) another gender.
c) Full appointment schedule.
Answer: C.

118. When can a dentist ethically withhold treatment?


Answer: In case of full schedule

119. A dentist can refuse to treat a patient on the basis of:


a) religious beliefs.
b) infectious disease.
c) physical handicap.
d) recognition of lack of skill or knowledge.
Answer: D.

120. Why dentist write down patient complain on the file?


a) the dentist will not forget it
b) for records.
c) to make the patient feels that he is important or concerned.
Answer: B.

121. Paediatric patient came with abuse trauma, what to do:


a) report – treatment- record
b) treatment-record- report
c) report- record- treatment
d) treatment - report - record
Answer: B.
Steps:
1. Examination.
2. Discus with a colleague.
3. Provide an urgent dental care.
4. Ask for consent to share the information for referral.
5. Records.
6. Referral to child protection services and writing a full report about the clinical findings and
investigations found.
7. Follow-up with 48hours.
8. Write a report if required to a court.

122. Dentist with wild hair cut:


a) professional
b) unprofessional
c) unethical
d) personal choice
Answer: B.
You must ensure that your behaviour, whether in your personal or professional capacity, does not
damage the public confidence in you or your profession, or bring disrepute to your profession or
organization.

123. DFOTI :
a) Qualitative
b) Quantitative
c) Both
Answer: A.
DFOTI digital imaging fibre optic transillumination is qualitative measure to detect caries.

124. If I know a news about my patient should I tell the:


a) Patient
b) Patient parent or relative
c) I don’t tell anyone
Answer: A.

125. It is ethical to replace amalgam restorations:


a) on request from an informed patient.
b) to relieve symptoms of multiple sclerosis.
c) to reduce the risk of developing Alzheimer’s disease.
d) to eliminate toxins from the patient.
Answer: A.

126. It is ethical to replace amalgam restorations:


1. on request from an informed patient.
2. to relieve symptoms of multiple sclerosis.
3. in highly aesthetic areas of the mouth.
4. to eliminate toxins from the patient.
A. All of the above.
B. (4) only
C. (2) and (4)
D. (1) (2) (3)
E. (1) and (3)
Answer: E.
127. A patient with Alzheimer’s dementia presents with his personal care worker.
His daughter, who is his legal guardian, is unavailable. What is required to obtain
informed consent for an elective invasive procedure?
a) The patient’s presence implies consent.
b) Obtain written consent from the patient.
c) Obtain written consent from the personal care worker.
d) Obtain consent from the patient’s daughter.
Answer: D.

128. Dentist was on airplane and had a fight with someone, he injured him. The
ethical committee will report as:
a) Personal of conduct
b) professional of conduct
c) negligence
d) violence
Answer: A.
You must ensure that your behaviour, whether in your personal or professional capacity, does not
damage the public confidence in you or your profession, or bring disrepute to your profession or
organization.

129. Health measures should be given equally to everyone. This principle is called:
a) Justice.
b) Autonomy.
Answer: A.

130. Permission must be taken:


a) While examining the opposite gender.
b) While examining the private parts.
c) Always except in an emergency condition when the patient is unable to respond.
Answer: C.

131. A researcher planned to conduct a survey on the effect of electronic use on


health. He was taking information from patients during their visit to the clinic in the
presence of the nurse and was making notes of all this information. Later the Ethical
Committee rejected the study. What could be the reason?
a) Informed consent was not taken.
b) The place isn’t proper for such discussion.
Answer: B.
It is supposed that implied consent was taken since the patient answered the questions without
hesitation and with the presence of the nurse.

132. CA/SA principle drugs should be quoted, how to avoid confusion?


Answer: Highlighted name of the drug
CA/SA is the National Centre on Addiction and Substance Abuse.

133. Most common reason for error in prescribing medicine:


a) look alike, sound alike
b) manual prescription writing
c) communication gap
d) Nurse mistake
Answer: B.

134. Arrange in an order from maximum to minimum the errors which are
encountered related to drugs by the physician.
a) Wrong dose.
b) Drug to wrong patient.
c) Wrong drug.
d) Forgot to give medication.
Answer: D, A, C, B.

135. A budget was given by government to establish children dental hospital. Which
is the best place to establish it?
a) Area where maximum population is there.
b) Area with maximum children.
c) Area where people are interested in health care.
Answer: C.

136. The purpose of calibrating examiners in a randomized controlled clinical trial


is to ensure
a) consistent measurement of clinical outcomes.
b) similarity of experimental and control groups.
c) high ethical standards in conducting the trial.
d) measurement of all relevant clinical outcomes.
Answer: A.

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