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NZ Dental Hygiene REX study materials
NZ Dental Hygiene REX study resources

NZ Dental Hygiene REX practice questions

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Question 1Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

Under the Health and Disability Commissioner (Code of Health and Disability Services Consumers' Rights), which right allows a dental hygiene client to have a support person present during care?

  1. Right 4, the right to services of an appropriate standard
  2. Right 6, the right to be fully informed
  3. Right 1, the right to be treated with respect
  4. Right 8, the right to support Correct answer.

Explanation

Right 8 of the Code gives every consumer the right to have a support person present during the provision of services, unless this compromises the safety of others. This support person may be chosen by the consumer and is distinct from the informed consent and information rights in Rights 6 and 7.

Question 2Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A client arrives for a hygiene appointment and appears unable to understand the treatment plan despite it being explained in English. Which action best reflects the Code of Health and Disability Services Consumers' Rights?

  1. Provide an interpreter or other effective communication support so the client can give informed consent Correct answer.
  2. Ask a family member to sign the consent on the client's behalf
  3. Proceed with treatment because the client signed a general consent form at reception
  4. Postpone all hygiene care indefinitely until the client learns English

Explanation

Right 5 requires services to be provided in a manner that enables effective communication, and Right 7 requires informed consent. Arranging interpreter support respects both rights and allows the client to make an informed choice rather than relying on a signature or a third party.

Question 3Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

Which statement best describes the principle of cultural safety as applied in New Zealand dental hygiene practice?

  1. Learning about the ethnic background of every client before treatment
  2. Examining the power relationship in care and ensuring the client feels safe to be themselves Correct answer.
  3. Providing care that is culturally appropriate only when a client requests it
  4. Ensuring all clients receive identical treatment regardless of their culture

Explanation

Cultural safety, as defined in New Zealand health practice, requires the practitioner to reflect on their own power and biases and to create an environment where the client feels safe and respected. It is broader than learning facts about cultures or treating everyone identically.

Question 4Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A dental hygienist is employed at a clinic and a client asks her to perform a procedure she has not been trained or authorised to carry out. What is the most appropriate response?

  1. Perform the procedure because the client has consented
  2. Refer the client to an appropriate practitioner and explain the limits of her scope Correct answer.
  3. Perform the procedure under the supervision of a receptionist
  4. Ask the client to sign a waiver and proceed

Explanation

Practitioners must work within their defined scope of practice and competence. When a requested procedure falls outside that scope, the correct action is to explain the limit and refer the client to a suitably qualified practitioner.

Question 5Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

Under the Privacy Act 2020, which of the following is an information privacy principle relevant to dental hygiene records?

  1. Information may be collected without telling the client why
  2. Records must be destroyed after one year
  3. Clients have a right to access their own health information held by the practice Correct answer.
  4. Health information may be disclosed to employers on request without consent

Explanation

The Privacy Act 2020 gives individuals the right to access information held about them and to request correction. Collection and disclosure are constrained by the information privacy principles, so blanket disclosure or silent collection is not permitted.

Question 6Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A client with a mild intellectual disability attends for a scale and polish and can understand simple explanations. How should the dental hygienist approach consent?

  1. Provide information in an accessible way and seek the client's own consent Correct answer.
  2. Obtain consent from the accompanying caregiver in all cases
  3. Refuse treatment because consent is impossible
  4. Assume the client cannot consent and treat only with a court order

Explanation

Right 7 presumes every consumer is competent to make decisions unless there is a lawful finding otherwise. Practitioners should adapt communication to support the client's own informed consent rather than automatically relying on a caregiver.

Question 7Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A dental hygienist wants to take clinical photographs of a client's gingiva for teaching purposes. What is required before the photographs can be used?

  1. Nothing, as photographs are not health information
  2. Anonymising the images is never necessary if the client is an adult
  3. Specific informed consent for the use and any identifying disclosure Correct answer.
  4. Only verbal permission from the clinic manager

Explanation

Clinical photographs are personal health information, and using them for teaching or publication requires informed consent that covers the specific use and any identifying disclosure. General consent for treatment does not extend to educational use.

Question 8Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

Which document sets out the standards of competence a New Zealand dental hygienist must maintain for annual practising certification?

  1. The Oral Health Practitioners' Scope of Practice and standards issued by the Dental Council Correct answer.
  2. The Privacy Act 2020 only
  3. The clinic's internal dress code policy
  4. The Health and Safety at Work Act 2015 only

Explanation

The Dental Council sets scopes of practice and the standards of competence required for registration and annual practising certificates. Other statutes may also apply, but they do not define professional competence standards.

Question 9Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A client discloses during a hygiene appointment that they are being harmed at home. What is the most appropriate professional response?

  1. Record the disclosure, respond supportively, and follow practice policy and legal obligations for referral Correct answer.
  2. Confront the alleged abuser directly
  3. Ignore the disclosure because it is outside dental hygiene practice
  4. Tell other clients so they can help

Explanation

Practitioners have responsibilities to respond to disclosures of harm, document them accurately, and follow relevant policies and legal duties, including referral to appropriate services. Ignoring, gossiping, or confronting others is unprofessional and may be unsafe.

Question 10Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

Which of the following best describes the purpose of informed consent in dental hygiene care?

  1. To protect the practitioner from complaints
  2. To ensure the client authorises treatment after understanding the relevant information Correct answer.
  3. To transfer responsibility for outcomes to the client
  4. To satisfy reception paperwork requirements

Explanation

Informed consent is a client-centred process in which the client understands the nature, risks, benefits, and alternatives of care and freely authorises it. It is not primarily a protective tool for the practitioner or a paperwork formality.

Question 11Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A dental hygienist is asked by a client's insurance company to send the client's full clinical records. What should the hygienist do first?

  1. Confirm the client's authorisation or a lawful basis before disclosing Correct answer.
  2. Send only the parts that support the claim
  3. Refuse all requests from insurers permanently
  4. Send the records immediately because insurers are entitled to them

Explanation

Disclosure of health information to a third party such as an insurer requires the client's authorisation or another lawful basis under the privacy principles. Confirming that basis before sending records protects the client's privacy.

Question 12Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

Which behaviour is most consistent with the professional obligation to maintain patient confidentiality in a shared clinic space?

  1. Sharing clinical details only with those involved in the client's care Correct answer.
  2. Posting anonymised case details on social media without consent
  3. Leaving clinical notes open on a reception desk
  4. Discussing a client's treatment with a colleague in a public waiting area

Explanation

Confidentiality requires limiting disclosure of health information to those who need it for the client's care. Public discussion, open notes, and social media posting without consent all risk breaching privacy obligations.

Question 13Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A dental hygienist disagrees with a dentist's prescribed treatment plan that she considers clinically inappropriate. What is the most professional course of action?

  1. Refuse to treat the client and send them elsewhere without explanation
  2. Tell the client the dentist is incompetent
  3. Carry out the plan without comment to avoid conflict
  4. Raise the concern directly with the dentist and document the discussion Correct answer.

Explanation

Professional accountability requires raising concerns through appropriate channels and documenting them, which supports client safety and collegial resolution. Silent compliance, disparaging the colleague, or abandoning the client without explanation are all inappropriate.

Question 14Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

Which statement correctly describes the relationship between cultural safety and informed consent for Māori clients?

  1. Cultural safety means consent must always be given in te reo Māori
  2. Cultural safety removes the need for written consent
  3. Cultural safety requires practitioners to consider whānau involvement and communication preferences within consent processes Correct answer.
  4. Cultural safety applies only to clients who identify as Māori

Explanation

Cultural safety asks practitioners to recognise power dynamics and to adapt consent processes to the client's cultural context, which may include whānau involvement and preferred language. It does not mandate a single language or remove consent requirements.

Question 15Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A client asks to see the notes the hygienist has written about them. Under the Privacy Act 2020, what is the correct approach?

  1. Require the client to obtain a lawyer before any access
  2. Provide only a verbal summary and never the written record
  3. Provide access in accordance with the Act, subject to any lawful withholding grounds Correct answer.
  4. Refuse because clinical notes belong to the practice

Explanation

The Privacy Act 2020 gives individuals a right of access to personal information held about them, subject to limited withholding grounds. Practices should respond to access requests in accordance with the Act rather than refusing outright.

Question 16Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

Which of the following is an example of practising outside the scope of a dental hygienist?

  1. Applying fluoride varnish as part of preventive care
  2. Providing oral health education and scaling
  3. Taking a medical history and recording vital signs
  4. Diagnosing a systemic disease and prescribing medication for it Correct answer.

Explanation

Dental hygienists work within a defined scope focused on preventive and periodontal care, education, and related tasks. Diagnosing systemic disease and prescribing medication fall outside that scope and belong to other registered practitioners.

Question 17Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A dental hygienist is asked to treat a 15-year-old client. Who can lawfully provide consent for the treatment?

  1. Any adult who accompanies the young person
  2. The young person themselves if they are competent to consent, otherwise a guardian Correct answer.
  3. No one, because minors cannot receive hygiene care
  4. Only the client's school principal

Explanation

In New Zealand, a young person may consent to their own care if they are competent to do so, and otherwise a parent or guardian consents. Accompaniment by an unrelated adult or a school official does not create authority to consent.

Question 18Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A dental hygienist notices a colleague consistently failing to sterilise instruments between clients. What is the most appropriate first action?

  1. Raise the concern through the practice's internal processes so client safety is protected Correct answer.
  2. Report the colleague to the media
  3. Tell clients to avoid the colleague
  4. Ignore it because it is not her responsibility

Explanation

Infection control failures present an immediate risk to client safety and should be addressed promptly through internal reporting and escalation processes. Public disclosure or warning clients informally without following process is inappropriate.

Question 19Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

Which principle from the Code of Health and Disability Services Consumers' Rights requires services to be provided with reasonable care and skill?

  1. Right 9
  2. Right 10
  3. Right 4 Correct answer.
  4. Right 2

Explanation

Right 4 requires services to be provided with reasonable care and skill and to comply with legal, professional, and ethical standards. The other rights address different matters such as respect, rights of complainants, and the right to complain.

Question 20Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A client declines a recommended periodontal treatment after being fully informed. What is the most appropriate response?

  1. Tell the client they are being irresponsible
  2. Discharge the client immediately without further discussion
  3. Perform the treatment anyway because it is clinically indicated
  4. Respect the decision, document it, and discuss alternatives and possible consequences Correct answer.

Explanation

Respect for autonomy means a competent client may decline recommended care even when it is clinically indicated. The practitioner should document the decision and ensure the client understands alternatives and consequences.

Question 21Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

Which statement best reflects the Treaty of Waitangi's relevance to New Zealand health practice?

  1. It requires all practitioners to be fluent in te reo Māori
  2. It applies only to government departments
  3. It has no relevance to clinical practice
  4. It underpins partnership, participation, and protection obligations that inform culturally safe care Correct answer.

Explanation

The Treaty principles of partnership, participation, and protection are widely applied in New Zealand health policy and practice to support equitable, culturally safe care. They do not require fluency in te reo Māori or apply only to government.

Question 22Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A dental hygienist is considering a request to provide treatment in a client's home. Which factor is most important in deciding whether to proceed?

  1. Whether the client is a personal friend
  2. Whether the practitioner can maintain the required standards of infection control and safety Correct answer.
  3. Whether the client has a large house
  4. Whether the practitioner can charge a higher fee

Explanation

Wherever care is delivered, the practitioner must be able to meet the same standards of infection prevention, safety, and record-keeping as in a clinic. Convenience or fee considerations cannot justify compromising these standards.

Question 23Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A client requests that their clinical information not be shared with a family member who usually attends appointments. How should the hygienist respond?

  1. Ask the family member to consent instead
  2. Share the information anyway because the family member attends
  3. Refuse to treat the client until they change their mind
  4. Respect the client's instruction and limit disclosure accordingly Correct answer.

Explanation

The client controls disclosure of their own health information, and a competent client may direct that it not be shared with a particular person. Respecting that instruction is consistent with privacy obligations and client autonomy.

Question 24Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

Which action best demonstrates the professional obligation of practising within one's competence?

  1. Assuming all clients present the same way
  2. Relying on knowledge gained during initial training alone
  3. Undertaking continuing professional development and referring complex cases appropriately Correct answer.
  4. Attempting unfamiliar procedures to build confidence without supervision

Explanation

Maintaining competence requires ongoing professional development and honest recognition of when a case exceeds one's competence so it can be referred. Relying only on initial training or experimenting unsupervised is inconsistent with safe practice.

Question 25Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A dental hygienist is asked to sign a document confirming she witnessed informed consent when she did not. What is the most appropriate response?

  1. Sign it but note the issue in private notes later
  2. Ask another colleague to sign instead
  3. Sign it because the dentist asked
  4. Decline to sign and explain that she cannot confirm something she did not witness Correct answer.

Explanation

Professional integrity requires accuracy in clinical records and attestations. Signing to confirm an event that did not occur is dishonest and could compromise the validity of the consent record.

Question 26Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

Under the Health and Disability Commissioner (Code of Health and Disability Services Consumers' Rights) Regulations 1996, which right is most directly engaged when a dental hygienist explains the purpose, benefits, risks and alternatives of a recommended deep scaling before the client agrees to proceed?

  1. Right 1, the right to be treated with respect
  2. Right 10, the right to complain
  3. Right 4, the right to services of an appropriate standard
  4. Right 6, the right to be fully informed Correct answer.

Explanation

Right 6 of the Code gives consumers the right to the information a reasonable consumer would need to make an informed choice, including the expected benefits, risks and alternatives of treatment. Providing that information before obtaining agreement is the operational expression of Right 6 in clinical practice.

Question 27Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A dental hygienist in New Zealand is developing a care plan with a Māori client. Which approach best reflects the principle of cultural safety in this clinical interaction?

  1. Applying a standard treatment protocol uniformly so that all clients receive identical care
  2. Referring the client to a Māori health provider regardless of the client's own preference
  3. Documenting the client's ethnicity so the practice can report ethnicity statistics
  4. Inviting the client to define what matters to them, including whānau involvement, and adapting the plan accordingly Correct answer.

Explanation

Cultural safety requires the clinician to reflect on their own power and assumptions and to let the client determine what culturally appropriate care looks like for them, including whether whānau participate. It is defined by the recipient of care, not by a predetermined protocol or by the clinician's assumptions about ethnicity.

Question 28Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A client's adult daughter telephones the practice and asks the hygienist to confirm whether her mother attended her appointment and what treatment was provided. The hygienist knows the daughter usually brings the client to appointments. What is the most appropriate response under the Privacy Act 2020?

  1. Disclose the treatment details because the daughter is a usual support person
  2. Decline to confirm or discuss anything until the client's authorisation is verified Correct answer.
  3. Refer the daughter to the practice's public website for general information
  4. Confirm attendance only, since appointment attendance is not health information

Explanation

Health information may only be disclosed with the client's authorisation or where an exception applies, and being a family member or usual escort is not itself an exception. Attendance at a dental appointment is itself health information revealing that the person is a client, so even confirming it requires authority.

Question 29Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A dental hygienist holds an annual practising certificate and is asked by a dentist to administer a local anaesthetic infiltration before a periodontal debridement. Which statement correctly describes the position for a hygienist practising in New Zealand?

  1. Hygienists may administer local anaesthetic only under direct supervision of an oral health therapist
  2. Hygienists may never administer local anaesthetic because it falls outside dental hygiene scope
  3. Hygienists may administer local anaesthetic within their scope when they hold the required approved training and authorisation Correct answer.
  4. Hygienists may administer local anaesthetic only in a public hospital setting

Explanation

The dental hygiene scope of practice includes administration of local anaesthetic, provided the practitioner has completed the approved training and holds the necessary authorisation on their practising certificate. Scope is therefore conditional on qualification and authorisation rather than being permanently excluded or tied to a particular facility.

Question 30Professional practice, ethics and legislation (including scope of practice, informed consent, privacy and cultural safety)

A 16-year-old client attends for periodontal treatment and is assessed as competent to understand and weigh the information about the proposed care. Who should provide consent for the treatment?

  1. The client's parent or legal guardian, because the client is under 18
  2. The dentist, because treatment consent for minors sits with the treating practitioner
  3. The practice manager, because consent forms are administered at reception
  4. The client, because a young person assessed as competent can consent on their own behalf Correct answer.

Explanation

New Zealand law recognises that young people may consent to their own health care once they have sufficient understanding and maturity to make the decision, regardless of being under 18. Where the client is competent, consent should be sought from the client directly.

Question 31Infection prevention and control, and occupational health and safety

Under standard precautions, which item of personal protective equipment must a dental hygienist don before any procedure that is likely to generate splatter of blood or saliva?

  1. A lead apron
  2. Anti-fatigue footwear
  3. Sterile surgical gloves
  4. Protective eyewear with side shields Correct answer.

Explanation

Standard precautions require protection of the mucous membranes of the eyes whenever splatter or droplets of blood or saliva are anticipated, so protective eyewear with side shields is indicated. A lead apron is for radiation protection and sterile gloves are not required for routine non-surgical hygiene care. Supportive footwear does not substitute for eye protection.

Question 32Infection prevention and control, and occupational health and safety

A hygienist is about to remove a used scaler blade from its handle. Which action best reduces the risk of a sharps injury during this step?

  1. Recapping the blade with one hand before disposal
  2. Placing the whole instrument in the sharps container
  3. Breaking the blade off with gloved fingers
  4. Using a purpose-built blade-removal device or forceps Correct answer.

Explanation

Sharps injuries most often occur during handling and disposal, so mechanical removal with a dedicated device or forceps keeps hands away from the cutting edge. Recapping and finger manipulation increase the chance of a puncture. Whole instruments are not placed in sharps containers because they are not sharps waste.

Question 33Infection prevention and control, and occupational health and safety

What is the correct concentration of sodium hypochlorite commonly used for disinfection of blood-contaminated environmental surfaces in the dental setting?

  1. 0.05% available chlorine
  2. 5% available chlorine
  3. 0.5% available chlorine Correct answer.
  4. 10% available chlorine

Explanation

A 1:10 dilution of household bleach yields approximately 0.5% (5000 ppm) available chlorine, which is the standard intermediate-level disinfectant for blood spills and contaminated surfaces. Higher concentrations are corrosive and unnecessary, while 0.05% is too weak for blood-contaminated spills.

Question 34Infection prevention and control, and occupational health and safety

Which statement correctly describes the hand hygiene action required immediately before donning gloves for a patient procedure?

  1. Wash hands with soap and water only if visibly soiled, otherwise proceed
  2. Apply alcohol-based hand rub over the gloves after donning
  3. Perform hand hygiene with soap and water or alcohol-based rub before donning Correct answer.
  4. Rinse gloved hands with water to improve the fit

Explanation

Hand hygiene must be performed before donning gloves because gloves do not sterilise the hands and microflora can multiply beneath them. Either soap and water or an alcohol-based rub is acceptable when hands are not visibly soiled. Hand hygiene is not deferred until visible soiling occurs.

Question 35Infection prevention and control, and occupational health and safety

A hygienist sustains a percutaneous injury from a contaminated explorer. After washing the wound with soap and water, what is the most appropriate immediate next step?

  1. Wait to see whether symptoms develop before reporting
  2. Report the exposure promptly and seek source-patient and post-exposure assessment Correct answer.
  3. Squeeze the wound firmly to express blood and then dress it
  4. Apply a caustic antiseptic and continue the appointment

Explanation

After immediate wound care, the exposed worker must report the incident promptly so that the source patient's status can be assessed and post-exposure prophylaxis considered within the recommended window. Delaying to observe for symptoms forfeits the benefit of timely prophylaxis. Caustic agents and aggressive squeezing are not recommended.

Question 36Infection prevention and control, and occupational health and safety

Which of the following best defines a critical item in dental infection control?

  1. An item that contacts mucous membranes or non-intact skin
  2. An item that contacts only environmental surfaces
  3. An item that penetrates soft tissue or enters the vascular system Correct answer.
  4. An item that contacts intact skin only

Explanation

Spaulding classification places items that enter sterile tissue or the vascular system in the critical category, requiring sterilisation. Items contacting mucous membranes are semicritical and require high-level disinfection at minimum, while intact-skin contact defines non-critical items.

Question 37Infection prevention and control, and occupational health and safety

A hygienist is reprocessing a semicritical item such as a mouth mirror. Which level of reprocessing is the minimum acceptable standard?

  1. Cleaning followed by low-level disinfection
  2. Cleaning followed by high-level disinfection or sterilisation Correct answer.
  3. Rinsing in tap water and drying
  4. Wiping with a detergent wipe only

Explanation

Semicritical items contact mucous membranes and must receive at least high-level disinfection after thorough cleaning, with sterilisation preferred when the item can tolerate it. Low-level disinfection and simple rinsing are insufficient for items that contact mucous membranes.

Question 38Infection prevention and control, and occupational health and safety

Which practice is correct for maintaining the waterlines of dental unit equipment used during hygiene procedures?

  1. Disinfect lines with bleach at the end of every appointment
  2. Run high-volume lines with sterile water and monitor microbial counts Correct answer.
  3. Store the unit with water in the lines overnight
  4. Flush lines briefly at the start of each day only

Explanation

Dental unit waterlines can develop biofilm, so units should be operated with water meeting the recommended microbial limit, using flushing, independent water reservoirs, or filtration as appropriate, and quality should be monitored. Overnight stagnation promotes biofilm formation, and bleach is not an approved routine line disinfectant.

Question 39Infection prevention and control, and occupational health and safety

Which action is required before sterilising a hinged instrument such as extraction forceps?

  1. Oil the hinge to prevent corrosion during the cycle
  2. Open the hinge and clean the joint thoroughly Correct answer.
  3. Place it in a closed pouch without cleaning
  4. Close the hinge tightly and wrap it

Explanation

Instruments must be thoroughly cleaned, with hinged joints opened, so that steam can contact all surfaces and residual bioburden is removed before sterilisation. Oil residue and closed hinges prevent steam penetration and can trap organic material.

Question 40Infection prevention and control, and occupational health and safety

A steriliser load has completed its cycle. Which document provides the strongest evidence that the load was actually subjected to the specified sterilising conditions?

  1. The expiry date printed on the packaging
  2. A biological indicator result from that load Correct answer.
  3. The steriliser cycle log showing the time and temperature
  4. The external chemical indicator on the pouch

Explanation

Biological indicators containing resistant spores are the most reliable check that the sterilising conditions were actually achieved, because chemical indicators only respond to one or more physical parameters. External indicators and cycle logs show that processing occurred but do not confirm microbial kill.

Question 41Infection prevention and control, and occupational health and safety

Which of the following is the most appropriate action when a biological indicator from a steriliser load shows growth?

  1. Increase the temperature setting and continue routine use
  2. Repeat the cycle and release the load if the repeat passes
  3. Discard only the indicator pouch and release the rest of the load
  4. Quarantine the load, investigate the steriliser and recall affected items Correct answer.

Explanation

A positive biological indicator means the load may not have been sterilised, so the load must be quarantined, the steriliser taken out of service for investigation, and items already released recalled. Simply repeating the cycle does not address items already used from the failed load.

Question 42Infection prevention and control, and occupational health and safety

Which immunisation is specifically recommended for dental healthcare workers because of occupational exposure to blood and body fluids?

  1. Tetanus booster every six months
  2. Varicella vaccination for all adults
  3. Hepatitis B vaccination Correct answer.
  4. Influenza vaccination only

Explanation

Hepatitis B is transmitted through blood and body fluids and is a recognised occupational risk for dental workers, so vaccination with post-vaccination serological confirmation is recommended. Influenza vaccination is encouraged but is not specific to bloodborne exposure, and tetanus boosters are not required every six months.

Question 43Infection prevention and control, and occupational health and safety

A hygienist develops a weeping lesion on the hand. What is the most appropriate approach to clinical work?

  1. Cover the lesion with a waterproof dressing and continue with all duties
  2. Wear two pairs of gloves over the lesion and proceed
  3. Apply topical antiseptic and work without gloves on that hand
  4. Exclude the worker from patient contact until the lesion is assessed and resolved Correct answer.

Explanation

Weeping or exudative lesions on the hands cannot be reliably contained by gloves or dressings and represent a risk of transmitting organisms to patients, so the worker should be excluded from patient contact until assessed. Doubling gloves or applying antiseptic does not reliably prevent transmission.

Question 44Infection prevention and control, and occupational health and safety

Which statement about the use of gloves during dental hygiene care is correct?

  1. One pair of gloves may be worn for an entire clinic session if hands are clean
  2. Gloves should be washed with soap between patients to extend use
  3. Gloves should be changed between patients and when torn or heavily contaminated Correct answer.
  4. Gloves eliminate the need for hand hygiene after removal

Explanation

Examination gloves are single-use and must be changed between patients and whenever they are torn or visibly contaminated, because microleakage and contamination occur during use. Washing gloves is not acceptable, and hand hygiene remains required after glove removal.

Question 45Infection prevention and control, and occupational health and safety

Which of the following is the most appropriate management of a needlestick injury involving a hollow-bore needle from a patient with unknown bloodborne status?

  1. Take a course of antibiotics as prophylaxis against all bloodborne viruses
  2. Ignore the injury if the needle was visibly clean
  3. Apply a tight tourniquet above the site and observe for 24 hours
  4. Cleanse the site, report immediately and arrange source testing and prophylaxis assessment Correct answer.

Explanation

Management of a needlestick includes immediate local care, prompt reporting, testing of the source where consent permits, and assessment for hepatitis B and HIV post-exposure prophylaxis. Antibiotics do not prevent viral bloodborne infection, and a visibly clean needle does not exclude transmission risk.

Question 46Infection prevention and control, and occupational health and safety

What is the correct procedure for managing a blood spill on a hard clinic floor?

  1. Wipe with a dry paper towel and mop with water
  2. Spray disinfectant directly onto the pooled blood without removing it
  3. Cover the spill with a cloth and leave it to dry
  4. Absorb the spill, clean, then apply an intermediate-level disinfectant and allow contact time Correct answer.

Explanation

Spills are managed by absorbing visible material, cleaning the surface, and then applying an appropriate intermediate-level disinfectant for the manufacturer's contact time. Disinfectant applied over pooled blood is inactivated by organic matter, and leaving a covered spill allows contamination to persist.

Question 47Infection prevention and control, and occupational health and safety

Which of the following best describes the purpose of a post-exposure serological test in a healthcare worker who has sustained a sharps injury?

  1. To establish the worker's baseline immune or infection status for follow-up Correct answer.
  2. To assess the worker's fitness for duty the next day
  3. To determine the sterilisation status of the instrument
  4. To confirm that the worker's gloves were intact

Explanation

Baseline serology documents the worker's pre-existing immune or infection status so that any subsequent seroconversion can be attributed and managed correctly. It does not assess glove integrity, instrument sterility, or fitness for duty.

Question 48Infection prevention and control, and occupational health and safety

Which of the following is the most appropriate choice for hand hygiene when hands are visibly soiled with blood?

  1. Alcohol rub followed immediately by gloving
  2. Soap and water washing Correct answer.
  3. A disinfectant wipe
  4. Alcohol-based hand rub alone

Explanation

When hands are visibly soiled or contaminated with blood or body fluids, soap and water washing is required because alcohol rubs are less effective in the presence of organic material. Alcohol rub alone or a surface wipe is not adequate for visibly contaminated hands.

Question 49Infection prevention and control, and occupational health and safety

Which of the following is the most important engineering control for preventing sharps injuries in the dental clinic?

  1. Annual staff training on sharps handling
  2. Sharps containers placed close to the point of use and not overfilled Correct answer.
  3. A written sharps policy displayed on the wall
  4. A log of all instruments reprocessed

Explanation

Engineering controls physically remove or isolate the hazard, and placing puncture-resistant sharps containers near the point of use and replacing them before they are overfilled directly reduces injury risk. Policies, training and logs are administrative controls that support but do not substitute for the engineering control.

Question 50Infection prevention and control, and occupational health and safety

A hygienist is preparing to treat a patient and notices that the protective eyewear available is cracked. What is the most appropriate action?

  1. Use the cracked eyewear because it still provides some coverage
  2. Proceed without eyewear because the patient will be supine
  3. Replace the eyewear with intact protective eyewear before starting Correct answer.
  4. Wear the cracked eyewear only during scaling

Explanation

Damaged personal protective equipment cannot be relied upon to provide the intended barrier, so it must be replaced before care begins. Proceeding without eyewear or using compromised equipment leaves the mucous membranes unprotected during splatter-generating procedures.