# RDH Law and Ethics practice questions: Professional role

Five original RDH Law and Ethics practice questions on professional role, each answered on this page with a rationale and a source.

Last updated: 2026-07-25.

## Question 1

A hygienist sells oral-health supplements through her own online store and begins recommending them during appointments, without mentioning that she profits from every sale. What does the professional standard require?

- A. Nothing, because product recommendations fall outside the hygiene ethics codes.
- B. Avoid the conflict where possible and declare it when it exists.
- C. No disclosure is needed so long as the supplements she sells are harmless.
- D. The arrangement is acceptable once the practice owner approves it in writing.

**Answer B:** Avoid the conflict where possible and declare it when it exists.

both hygiene codes state the standard in the same words — avoid conflicts of interest and declare them when they occur — and the patient's autonomy right to full disclosure means an undisclosed financial interest taints the recommendation. The patient's actual need, not personal gain, has to drive every recommendation.

**Common trap:** conflicts are not only cash kickbacks; a side business, a bonus, or a relationship can bend judgment just as effectively, and recommending what pays rather than what the patient needs approaches clearly excessive treatment.

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 2

A whitening manufacturer offers a California dental office a $25 payment to the treating hygienist for every take-home whitening kit dispensed to a patient. The RDH plans to tell each patient, in writing, that she receives $25 per kit before recommending one. Is the arrangement permissible?

- A. Yes. Written disclosure satisfies the ethical duty to declare a conflict of interest, so the payment is permissible.
- B. Yes, as long as the hygienist documents that each patient's whitening kit was clinically indicated before dispensing.
- C. No. Accepting a commission or rebate for articles supplied to patients is unprofessional conduct.
- D. No, but only if the office fails to report the payments to the Dental Hygiene Board of California each year.

**Answer C:** No. Accepting a commission or rebate for articles supplied to patients is unprofessional conduct.

BPC § 1950.5(f) makes "accepting or receiving any commission or the rebating in any form or manner of fees for professional services, radiographs, prescriptions, or other services or articles supplied to patients" unprofessional conduct, which exposes the license to revocation, suspension, reprimand, or probation. The ethics codes require a hygienist to "avoid conflicts of interest and declare them when they occur," but declaration is a management method for lawful conflicts — it is not a cure for a payment the statute prohibits outright.

**Common trap:** Options A and B run on the common belief that transparency fixes any conflict. It does not: disclosure never launders a kickback. Candidates also reach for the ADA dentist code here; this exam's named ethics references are the CDHA and ADHA hygiene codes, and the controlling statute is the Dental Hygiene Practice Act, not the Dental Practice Act. Option D invents a reporting cure that no source provides. Note the companion rule: if the incentive also drives extra services, "clearly excessive" treatment measured "by the customary practice and standards of the dental hygiene profession" is both a disciplinary ground and a misdemeanor carrying a $100–$600 fine, 60–180 days of imprisonment, or both, under § 1950.5(n).

Source: [Cal. Bus. & Prof. Code § 1950.5 — Unprofessional Conduct Defined, subds. (a)–(z): fee fraud (a); aiding unlicensed or unlawful practice (b)–(c);…](https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1950.5.&lawCode=BPC)

## Question 3

An RDH in a Sacramento practice learns that a longtime recall patient's personal beliefs and lifestyle conflict sharply with her own religious convictions. She feels she can no longer treat him. The patient is scheduled for periodontal maintenance this afternoon. What is the professionally and legally correct course?

- A. Complete today's appointment at the full standard of care, then give written notice of discontinuation and ample time for him to find another licensed hygienist.
- B. Tell the patient at check-in that she will not treat him and ask the front desk to remove him from her column effective immediately today.
- C. Treat him today but limit the appointment to a coronal polish and skip the periodontal assessment to shorten the visit and the contact.
- D. Continue treating him indefinitely, because a hygienist may never end a professional relationship with an established patient of record for any reason.

**Answer A:** Complete today's appointment at the full standard of care, then give written notice of discontinuation and ample time for him to find another licensed hygienist.

The codes require hygienists to "serve all clients without discrimination and avoid action toward any individual or group that may be interpreted as discriminatory," and complementarity requires "considering the values and perspectives of others before making decisions or taking actions affecting them." California then controls the exit: "abandonment of the patient by the licensee, without written notice to the patient that treatment is to be discontinued and before the patient has ample opportunity" to secure another RDH, RDHAP, or RDHEF, "provided the health of the patient is not jeopardized," is unprofessional conduct.

**Common trap:** Option B feels like the honest choice — better to step aside than treat with resentment — but a same-day refusal is exactly the discriminatory-appearing action the codes ban and the abandonment the statute disciplines. Option C is the quiet version of the same error: silently reducing the standard of care is discrimination in effect. Option D overcorrects; a values-based exit is permitted when it is managed with written notice, transition time, and a safe hand-off.

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 4

A patient files a complaint alleging that his hygienist never told him about worsening periodontal pockets. Reviewing the chart, the RDH sees that her entry from 14 months ago is thin and does not mention the conversation she remembers having. The office manager suggests she "clean up" the old entry to include the recommendation. What should she do?

- A. Rewrite the 14-month-old entry to reflect the conversation she remembers, since the chart should read accurately.
- B. Leave the original entry unchanged and document the current facts and what she recalls in a new dated entry.
- C. Delete the thin entry entirely so that it cannot later be quoted out of context against her in the complaint.
- D. Add the missing recommendation to the old entry and initial it with today's date beside the original signature.

**Answer B:** Leave the original entry unchanged and document the current facts and what she recalls in a new dated entry.

"The alteration of a patient's record with intent to deceive" is unprofessional conduct under BPC § 1950.5(q), and options A, C, and D all change what the contemporaneous record says in order to improve the licensee's position in a complaint. Honest documentation is the last line of professional objectivity: the chart must reflect what actually happened, not what the clinician wishes had happened, and the code's duty to "provide oral health care utilizing high levels of professional knowledge, judgment, and skill" is measured against the profession's standards and its peer-review and quality-assurance structures, not against a tidied file.

**Common trap:** Option D is the most tempting because it looks like a good-faith late entry, but the addition is being made to the original entry after a complaint and for the purpose of defeating it — the intent, not the formatting, is what § 1950.5(q) reaches. Candidates also assume a stronger chart is always the safer chart; here, an altered chart converts a defensible care dispute into an independent disciplinary ground.

Source: [Cal. Bus. & Prof. Code § 1950.5 — Unprofessional Conduct Defined, subds. (a)–(z): fee fraud (a); aiding unlicensed or unlawful practice (b)–(c);…](https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1950.5.&lawCode=BPC)

## Question 5

An RDH's parent died four days ago. She has slept about three hours a night since, is taking a sedating antihistamine, and feels foggy and slow. The office is short-staffed and her column is full, including two scaling and root planing appointments with local anesthesia. What does the ethics framework require?

- A. Work the full schedule, because the office is short-staffed today and her colleagues are depending on her to cover it.
- B. Work the schedule but decline to administer local anesthesia, keeping all of the remaining hygiene procedures.
- C. Tell the supervising dentist she cannot practice safely today and have the appointments rescheduled or reassigned.
- D. Work the schedule and document in each chart that she was fatigued, which shifts responsibility to the employer.

**Answer C:** Tell the supervising dentist she cannot practice safely today and have the appointments rescheduled or reassigned.

The codes direct hygienists to "have realistic expectations of ourselves and recognize our limitations" and to maintain a lifestyle that supports optimal health, precisely so patients never inherit the clinician's worst day. Non-maleficence — the "fundamental obligation to provide services in a manner that protects all clients and minimizes harm to them, and others involved in their treatment" — does not pause for personal hardship, so a hygienist who cannot meet the standard of care must reduce, reschedule, or hand off clinical duties and seek support.

**Common trap:** Option A is the loyalty answer that 3B items are built to punish; "pushing through for the team" is never the keyed response when the stem establishes degraded capacity. Option B assumes impairment is procedure-specific — it is not; the test is whether this clinician can deliver care at the standard the patient is owed right now, whatever the cause. Option D confuses documentation with protection: charting a hazard does not authorize creating it.

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)

## Next step

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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.