8 Legal and Ethical Issues
Multiple choice questions
1. From time to time a patient may require certain medications and the practice will issue a prescription. A prescription sheet will be valid and can be issued by the pharmacy if it has been signed by which one of the following persons?
(a) Dental hygienist
(b) Practice manager
(c) Qualified dental nurse
(d) Receptionist
(e) Vocational trainer
2. When patients attend the dental surgery for treatment, they must be given certain information by the dental team before they can decide if they wish to proceed with the treatment or not. This is termed valid consent. Which one of the following is not necessary for consent to be valid?
(a) Agreed in writing
(b) Detail all costs
(c) Give full information
(d) Given voluntarily
(e) Specific to the treatment
3. One of the responsibilities of the dental surgery is to undergo a 3-yearly assessment of radiation safety on the premises. This can be done using a specialist processing test kit which is sent off for analysis, or by undergoing an inspection on the premises. Which one of the following organisations is most likely to undertake this inspection?
(a) Health and Safety Executive
(b) Health Protection Agency
(c) Primary Care Trust
(d) Radiation Protection Adviser
(e) Radiation Protection Supervisor
4. A 27-year-old private patient attends the surgery with severe dental pain and requests the extraction of the lower left third molar tooth. Four months later, the left side of his tongue is still numb and he decides to make a formal complaint against the dentist. Which one of the following organisations should the patient contact?
(a) Care Quality Commission
(b) Department of Health
(c) General Dental Council
(d) Primary Care Trust
(e) Strategic Health Authority
5. Radiation monitoring badges are devices designed to protect staff from over-exposure to ionising radiation. Their use is not compulsory in the dental workplace, unless staff are exposed to an excess of which one of the following over a weekly period?
(a) 100 intra-oral exposures
(b) 15 extra-oral exposures
(c) 150 intra-oral exposures
(d) 30 extra-oral exposures
(e) 50 intra-oral exposures
6. One of your old high school friends attends the surgery for extraction of the upper left second molar tooth. You know her to be an intravenous drug user, but notice that she has not declared this on her medical history form. Which one of the following actions should you take?
(a) Ask your dentist to double glove
(b) Ask your dentist to prescribe antibiotics
(c) Tell her to go to another dentist
(d) Tell your dentist that she may harbour blood-borne viruses
(e) Treat her as any other patient
7. While working on reception at your dental surgery, the husband of a patient telephones and asks you for information about the treatment procedure his wife had carried out yesterday. You explain to the husband that you are unable to disclose this information as it is a breach of confidentiality. Which one of the following is the legislation that relates to patient confidentiality?
(a) Access to Health Records
(b) Caldicott Regulations
(c) Dentists Act 1984
(d) Department of Health guidance
(e) General Dental Council Standards guidance
8. In certain circumstances, it is acceptable for the dental surgery to release personal details to a third party without the patient’s written permission. To which one of the following persons can details be given?
(a) Bailiff
(b) Employer
(c) Headmaster
(d) Husband or wife
(e) Tax inspector
9. When using radiography techniques in the dental surgery, it is important that the dental team have a Quality Assurance system in place. The use of this system has to achieve all except which one of the following options?
(a) Ease of use
(b) Identify processing faults
(c) Identify solutions to problems
(d) Keep costs to a minimum
(e) Limit exposure
10. An associate dentist is completing an NHS claim form for a patient who is exempt from charges and you have noticed that he regularly claims for treatment that has not been carried out. You have reported this matter to your principal dentist. Which one of the following gives you protection from possible retaliation in this matter?
(a) Caldicott Regulations
(b) Data Protection Act (1998)
(c) Freedom of Information Act
(d) General Dental Council
(e) Public Interest Disclosure Act (1998)
11. Patient records are legal documents that provide a wealth of information about patient attendance, treatment, personal details, and attitudes to oral healthcare. When a child patient leaves the dental surgery, it would be ideal for the records to be kept forever. However, legally they only need to be kept until the patient is what age?
(a) 16 years old
(b) 18 years old
(c) 21 years old
(d) 25 years old
(e) 30 years old
12. The dentist has taken a diagnostic periapical radiograph of an upper right central incisor during root canal treatment. After processing, the image appears elongated and the apex of the root is not visible on the film. Which one of the following would correctly score the quality assurance rating of this radiograph?
(a) Score 0
(b) Score 1
(c) Score 2
(d) Score 3
(e) Score 4
13. Recently, money has been found to be missing from the cash box at your dental surgery and this has put everyone under suspicion. Yesterday lunchtime you observed the locum dentist taking money from the box and placing it in his wallet, and you have now reported this to your employer. Which one of the following gives you protection from possible retaliation in this matter?
(a) Caldicott Regulations
(b) Data Protection Act (1998)
(c) Freedom of Information Act
(d) General Dental Council
(e) Public Interest Disclosure Act (1998)
14. From time to time, patients may feel that they have received a less than adequate service from their dental surgery and make a complaint. In order to handle the complaint correctly, the dental team must carry out which one of the following?
(a) Accept liability
(b) Acknowledge receipt within the week
(c) Apologise unreservedly
(d) Provide details of the staff member involved
(e) Report back to the patient within 10 days
15. To ensure the safety of all staff and patient escorts, a designated controlled area is set up at each X-ray machine. This is an area which must admit no one except the patient during the exposure time. Which one of the following is the point from which this distance is measured?
(a) Dental chair
(b) Machine control panel
(c) Machine head
(d) Surgery door
(e) X-ray film packet
16. You have recently started a new job as a trainee dental nurse in a local surgery. As part of your induction training, the dentist provides you with information about the responsibilities and standards that the dental team have to comply with. Which one of the following documents is the information that you were provided with?
(a) Access to Health Records
(b) Caldicott Regulations
(c) Dentists Act 1984
(d) Department of Health guidance
(e) General Dental Council Standards guidance
17. Whilst working on the reception desk you overhear the receptionist talking to a patient on the telephone. The receptionist becomes frustrated and puts the telephone down, then tells you that she could not understand the patient as he didn’t speak English very well. Which one of the following types of discrimination has the receptionist shown?
(a) Age discrimination
(b) Ethnic discrimination
(c) Religious discrimination
(d) Sex discrimination
(e) Socioeconomic discrimination
18. Under the IR(ME)R regulations, every effort must be made to follow the principle of ALARP (ALARA) when exposing patients to ionising radiation. Which one of the following will not achieve ALARP (ALARA)?
(a) Expose patient only
(b) Fresh processing solutions
(c) Maintain equipment
(d) Quality assurance programme
(e) Use of D speed films
19. The dentist has taken a left bitewing radiograph to determine if an interproximal cavity is present on the lower left first molar tooth. After processing, it is clear that coning has occurred during exposure of the film, and the lower left second and third molar teeth are missing from the image. Which one of the following would correctly score the quality assurance rating of this radiograph?
(a) Score 0
(b) Score 1
(c) Score 2
(d) Score 3
(e) Score 4
20. An important part of the day-to-day duties of all dental team members is to record the personal and clinical details of all patients, and their treatment sessions. These records should always be contemporaneous. Which one of the following indicates the correct meaning of this term?
(a) Accurate
(b) Date ordered
(c) Legible
(d) Signed off
(e) Using correct terminology
21. Throughout their dental career, all dental personnel are required to act in the best interests of the patient. Unfortunately, a small minority of dental team members fail to follow this requirement at all times. Before statutory registration of DCPs began, only the dentist would have been held responsible for these failures. Which one of the following terms best describes this fact?
(a) Breach of confidentiality
(b) Indemnity
(c) Omission
(d) Valid consent
(e) Vicarious liability
22. The aim of a quality assurance programme of radiographs is to ensure that any faults of exposure or processing are identified, solved and kept to a minimum at all times. Which one of the following is the most likely ratio of acceptable ratings for processed films?
(a) Score 1, 10% maximum
(b) Score 1, 10% minimum
(c) Score 1, 70% maximum
(d) Score 3, 10% maximum
(e) Score 3, 70% minimum