# RDH Law and Ethics practice questions: Obligation to the patient

Five original RDH Law and Ethics practice questions on obligation to the patient, each answered on this page with a rationale and a source.

Last updated: 2026-07-25.

## Question 1

A hygienist completed the board-approved local anesthesia course nine years ago and has not given an injection since. Her new employer wants her giving blocks starting Monday, with the dentist present. What is the correct action?

- A. Proceed, because the board-approved course certificate does not expire and she remains qualified.
- B. Decline until she re-establishes competence through training and supervision.
- C. Proceed, but only on patients who have received that same block uneventfully before.
- D. Ask the dentist to sign a statement accepting responsibility for any resulting injury.

**Answer B:** Decline until she re-establishes competence through training and supervision.

the legal scope is the outer wall and personal competence is the inner one — a hygienist performs only procedures she has the appropriate education, training, and current skill for, and incompetence or negligence is a disciplinary ground.

**Common trap:** the board-approved course establishes eligibility for the § 1909 duties; it does not certify current skill after nine years away.

Source: [Cal. Bus. & Prof. Code § 1949 — revocation, suspension, reprimand, or probation for unprofessional conduct, incompetence, gross negligence, repeated…](https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1949.&lawCode=BPC)

## Question 2

A hygienist has used the same instrumentation and home-care protocol for 15 years and declines to review newer evidence, saying her results have been fine. What is the professional problem?

- A. There is none, as long as she completes her required continuing-education units.
- B. It is a marketing problem for the practice rather than a professional one for her.
- C. It matters only if a patient complains to the board about the result of her care.
- D. Staying current is part of competence — stale knowledge undercuts it.

**Answer D:** Staying current is part of competence — stale knowledge undercuts it.

the ethics codes make continued professional growth part of competence, and California converts it into a renewal condition measured over the preceding two-year period with defined mandatory coursework.

**Common trap:** minimum unit compliance is the floor for renewal, not proof that current practice reflects current evidence.

Source: [American Dental Hygienists' Association, Code of Ethics (revised October 2024) — fundamental principles (universality, complementarity, ethics,…](https://www.adha.org/wp-content/uploads/2025/03/ADHA-Code-of-Ethics_FY24_10_18.pdf)

## Question 3

A patient who reads at a low literacy level is handed a two-page home-care handout and nods when asked whether he understands. He returns with no change in his oral hygiene. What is the appropriate next step?

- A. Give him the same handout again and ask him to read it carefully at home this time.
- B. Document non-compliance in the chart and shorten his recall interval to three months.
- C. Adapt the instruction: demonstrate, use plain language, and have him show it back.
- D. Ask a family member to take over responsibility for his daily home care instead.

**Answer C:** Adapt the instruction: demonstrate, use plain language, and have him show it back.

cultural sensitivity and effective communication are working skills — adapt the method to the patient's language, literacy, values, and circumstances, and confirm understanding rather than confirm delivery.

**Common trap:** repeating the same failed method and charting "non-compliant" moves the blame without meeting the duty.

Source: [California Dental Hygienists' Association, Code of Ethics, within the CDHA Policy Manual (amended June 2022) — the licensee's direct accountability…](https://cdha.org/Portals/CDHA/Resources/CDHA%20Policy%20Manual%20Amended%20June%202022_FINAL.pdf)

## Question 4

A Bakersfield general practice is running an hour behind. After preparing tooth #30 for a composite, the supervising dentist tells the RDH, "You've watched me do a hundred of these — go ahead and place and carve the final restoration while I start the next patient. I'm right here in the building if you need me." What should the hygienist do?

- A. Place the restoration, because the dentist is physically present in the treatment facility and direct supervision covers the procedure.
- B. Place the restoration only if she has completed a board-approved course of instruction in restorative procedures.
- C. Decline, because placing, condensing, and carving permanent restorations is excluded from the practice of dental hygiene.
- D. Place the restoration and chart that the dentist directed it, which shifts responsibility for the act to the dentist.

**Answer C:** Decline, because placing, condensing, and carving permanent restorations is excluded from the practice of dental hygiene.

BPC § 1908 lists placing, condensing, carving, or removing permanent restorations among the acts expressly excluded from the practice of dental hygiene, alongside diagnosis and comprehensive treatment planning, surgery or cutting on hard and soft tissue, prescribing, and sedation beyond nitrous oxide-oxygen and § 1909 local anesthesia. Supervision level cannot authorize an act that is outside the profession, and a hygienist who performs one is exposed to discipline for incompetence or negligence under BPC § 1949. The CDHA Code makes the point personally: the licensee is ethically and legally responsible and directly accountable for her own professional conduct.

**Common trap:** Option A treats "direct supervision" as a permission slip, but supervision only governs how an in-scope duty is performed, never whether an excluded act becomes lawful. Option B borrows the logic of the § 1909 and § 1910.5 course pathways, which expand duties inside dental hygiene and cannot reach an excluded act. Option D is the most common real-world error — an employer's instruction never transfers accountability, and the license on the line is the hygienist's own.

Source: [Cal. Bus. & Prof. Code § 1908 — Practices Included in and Excluded from Dental Hygiene: assessment, care-plan development and implementation,…](https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1908.&lawCode=BPC)

## Question 5

A California RDH first licensed in 2016 faces her fifth biennial renewal, with the license expiring August 31, 2026 — so the first-renewal CE exemption is long behind her and the full requirement applies. During the preceding two-year period she completed exactly 25 units: 2 units of California-specific infection control, 2 units on the California Dental Practice Act, a BLS course with a live in-person skills session (4 units), and 17 units of online self-study courses. She also has 6 unused units left over from her previous renewal cycle. What is her renewal status?

- A. Compliant — she completed all 25 units, including every one of the mandatory courses.
- B. Not compliant — self-study (correspondence) courses may not exceed 50% of the units.
- C. Not compliant — an RDH must complete 35 units in each two-year renewal period, not 25.
- D. Compliant — she may apply the 6 leftover units from her prior cycle to cure the shortfall.

**Answer B:** Not compliant — self-study (correspondence) courses may not exceed 50% of the units.

The DHBC continuing-education regulations require 25 units per two-year renewal period for an RDH and cap correspondence (self-study) courses at 50% of the total, so no more than roughly 12.5 of her 25 units may be self-study; 17 units puts her over the cap. BPC § 1936.1 separately requires the units to be completed "during the preceding two-year period," which is why the leftover units cannot be carried forward, and it authorizes the board to randomly audit at least 5% of licensees each year.

**Common trap:** The first question to ask on any CE item is which renewal period it describes: 16 CCR § 1017(c) requires no CE units for the first renewal period, so a first-time renewer is compliant at zero — which is why this stem places the licensee at her fifth renewal. With that closed off, option C is the RDHAP number (35 units), not the RDH number; candidates who studied a mixed hygiene/dentist prep book also arrive with the dentist product's 50-unit figure, which has never applied to hygienists. Option D reflects the widespread belief that CE rolls over — it does not. Option A is tempting because every mandatory course is present and the total hits 25; the format cap is the silent failure.

Source: [16 CCR §§ 1016–1017 — continuing-education courses, providers, and units: RDH 25 units per two-year renewal (RDHAP 35); mandatory 2 units California…](https://www.dhbc.ca.gov/lawsregs/new_dhbc_2025_laws_and_regulations_book.pdf)

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Official reference: [DHBC/PSI RDH Laws and Ethics Written Examination Candidate Information Bulletin](https://www.dhbc.ca.gov/formspubs/candidate_handbook.pdf). Original exam-style questions written for study, never recalled exam content. Independent educational preparation, not legal advice, and not affiliated with or endorsed by the Dental Hygiene Board of California or PSI. Confirm current requirements with the Dental Hygiene Board of California.