Exam 1

Question 1

What is the purpose of triage in the emergency setting?

Answer 1

To determine who needs immediate care and to prioritize the rest

Question 2

Which is an additional stressor that veterinary personnel must experience than those in human emergency medicine do not?

Answer 2

Euthanasia

Question 3

Which scenario best contributes to patient stabilization of an emergent patient?

a. A client stands by the treatment table to soothe the patient during stabilization.
b. The team allows access to the treatment room to calm a hysterical client.
c. A client waits in an exam room while stabilization is initiated.
d. A client sits in a chair and soothes the patient during stabilization.

Answer 3

c. A client waits in an exam room while stabilization is initiated.

Question 4

Which step comes first in approaching a new arrival in the emergency room?

a. Call primary veterinarian to ensure pet is UTD on vaccines
b. Greet the pet by saying its name and note response.
c. Obtain vitals (temperature, pulse, respiration—TPR).
d. Instruct owner to fill out new patient paperwork.

Answer 4

b. Greet the pet by saying its name and note response.

Question 5

Which items are most essential on any stabilization cart or stand?

a. Fluid packs
b. Chest tap kit
c. Blocked cat kit
d. Scrub and IV catheters

Answer 5

d. Scrub and IV catheters

Question 6

Which step should come first when a patient is in a life-threatening situation?

a. Ask client to fill out new patient paperwork so patient information can be added to computer and a detailed estimate for treatment can b. Inform client that immediate stabilization is needed; verbal and signed consent are obtained.
c. Inform client of concerns and escort them to exam room for a full TPR.
d. Obtain complete history so proper stabilization technique can be administered.

Answer 6

b. Inform client that immediate stabilization is needed; verbal and signed consent are obtained.

Question 7

Which CPR code commonly indicates “open chest included if necessary”?

Answer 7

Green

Question 8

Which treatment relies on electrical repolarization to help the heart resume normal activity?

Answer 8

Defibrillation

Question 9

A team initiates basic life support on a cat and starts intubation even as chest compressions are being performed. Which patient position is best?

Answer 9

Lateral recumbency

Question 10

What does interposed abdominal compression (IAC) involve?

a. Alternating abdominal and chest compressions
b. Interposed aortic and chest compressions
c. Internal abdominal compressions
d. Internal aortic compressions

Answer 10

a. Alternating abdominal and chest compressions

Question 11

Which effect is expected with ROSC in a patient undergoing CPR?

a. Stable, unchanging ETCO2
b. Absence of ETCO2
c. Drop in ETCO2
d. Rise in ETCO2

Answer 11

d. Rise in ETCO2

Question 12

A veterinary ER team questions whether or not a patient is in cardiopulmonary arrest (CPA). Which step should be performed first?

a. Put the patient on ventilation and airway support; then begin CPR.
b. Conduct basic ECG for 30 to 60 seconds; then reassess.
c. Assess agonal breaths for 30 to 60 seconds.
d. Initiate chest compressions immediately.

Answer 12

d. Initiate chest compressions immediately.

Question 13

What are the most prominent effects of atropine?

a. Antidiuretic
b. α-adrenergic
c. Parasympatholytic
d. Class 1 antiarrhythmic

Answer 13

c. Parasympatholytic

Question 14

Shortly before experiencing cardiac arrest, a patient was administered an opioid. Which is best to administer to this patient?

a. Naloxone
b. Epinephrine
c. Flumazenil
d. Atipamezole

Answer 14

a. Naloxone

Question 15

Internal cardiac compression should not be considered in the presence of:

a. rib fracture.
b. pleural effusion.
c. pneumothorax.
d. ROSC within 5 minutes of cardiac arrest

Answer 15

d. ROSC within 5 minutes of cardiac arrest

Question 16

Which drug’s strong α-adrenergic properties cause vasoconstriction?

a. Sodium bicarbonate
b. Epinephrine
c. Lidocaine
d. Atropine

Answer 16

b. Epinephrine

Question 17

Which route of drug administration is most often preferred during CPR?

a. Intracardial
b. Intratracheal
c. Intraosseous
d. Central venous

Answer 17

d. Central venous

Question 18

A veterinary team begins performing CPR on a dog. At what point should intubation be performed?

a. In recovery, so as not to interfere with CPR
b. Before beginning chest compressions
c. After establishing a heartbeat
d. During CPR procedure

Answer 18

d. During CPR procedure

Question 19

How many people are needed for effective cardiopulmonary resuscitation (CPR) in a Labrador Retriever?

Answer 19

3 to 5

Question 20

Which drug is a class 1 antiarrhythmic agent and is most commonly used to treat ventricular tachycardia?

a. Atropine
b. Lidocaine
c. Epinephrine
d. Vasopressin

Answer 20

b. Lidocaine

Question 21

Why is a grated surgical prep table not recommended for performing CPR?

a. The grated surface is not firm enough.
b. Drainage holes allow too much loss of blood.
c. The surface is too abrasive against skin that is not oxygenated.
d. The porous surface does not allow retention of valuable body heat.

Answer 21

a. The grated surface is not firm enough.

Question 22

What type of shock results from decreased intravascular volume?

a. Obstructive
b. Distributive
c. Cardiogenic
d. Hypovolemic

Answer 22

d. Hypovolemic

Question 23

Vasoconstriction causes which of the following?

a. Thready pulse
b. Increased vessel size
c. Elevated stroke volume
d. Increased intravascular volume

Answer 23

a. Thready pulse

Question 24

Which most frequently causes cardiogenic shock?

a. Heart failure
b. Caval syndrome
c. Cardiac tamponade
d. Decreased intravascular volume

Answer 24

a. Heart failure

Question 25

Which of the following would you expect to see in distributive shock?

a. Diminished preload
b. Increased cardiac output
c. Increase in stroke volume
d. Total decrease in blood volume

Answer 25

a. Diminished preload

Question 26

A patient suffers anaphylaxis and sepsis. Which type of shock is this patient most likely to develop?

a. Hypovolemic
b. Cardiogenic
c. Distributive
d. Obstructive

Answer 26

c. Distributive

Question 27

A veterinary technician sees the abbreviation “DO2” in a patient’s chart. Which does this stand for?

a. Stroke volume
b. Total cardiac output
c. Blood oxygen content
d. Volume of oxygen transported to the tissues

Answer 27

d. Volume of oxygen transported to the tissues

Question 28

A patient has a faster than normal CRT, indicating the presence of which condition?

a. Diminished perfusion
b. Severe anemia
c. Vasodilation
d. Bradycardia

Answer 28

c. Vasodilation

Question 29

Which condition is associated more with obstructive shock than other forms of shock?

a. Blood loss
b. Fluid losses
c. Gastric torsion
d. Third-space loss

Answer 29

c. Gastric torsion

Question 30

Which of the following is most effective in treating hypovolemic shock?

a. Dextrose in water
b. Half-strength saline
c. Isotonic crystalloids
d. Half-strength lactated Ringer’s

Answer 30

c. Isotonic crystalloids

Question 31

Which best defines shock?

a. Low blood flow
b. Poor tissue perfusion
c. Inadequate cellular energy production
d. Unevenly distributed blood circulation

Answer 31

c. Inadequate cellular energy production

Question 32

Which is the simplest method of oxygen delivery?

a. Mask oxygen
b. Flow-by oxygen
c. Trans-tracheal oxygen
d. Nasal cannula

Answer 32

b. Flow-by oxygen

Question 33

While inserting a nasopharyngeal catheter, once inserted into the nostril, how should the catheter be directed?

a. Ventromedially
b. Ventrolaterally
c. Dorsomedially
d. Dorsolaterally

Answer 33

a. Ventromedially

Question 34

Which comes first in approaching a traumatic emergency patient?

a. Action
b. Assessment
c. Recognition
d. Reassessment

Answer 34

c. Recognition

Question 35

Which must always be the first step in assessing the traumatic injury patient?

a. Airway
b. Body temperature
c. Fracture assessment
d. Soft tissue or organ damage

Answer 35

a. Airway

Question 36

During emergency surgery, a large volume of the patient’s blood is aspirated from the abdominal cavity and infused directly back into the blood stream using a closed system. Which is necessary during this procedure?

a. Bleach
b. Small careful measures of air infusion
c. Anticoagulant
d. Blood filter

Answer 36

d. Blood filter

Question 37

In treating hypothermia, the core should be warmed because warming the periphery leads to:

a. Narrowed blood vessels
b. Reduced blood flow
c. Core hyperthermia
d. Vasodilation

Answer 37

d. Vasodilation

Question 38

Which type of muzzle is usually preferred in treating a dog with a traumatic injury?

a. Standard professional muzzle that fits firmly over the bridge of the nose
b. Plastic basket muzzle with holes that covers entire nose and mouth
c. Soft blanket or large jacket to cover the animal’s head
d. Tie or belt wrapped around the dog’s muzzle

Answer 38

b. Plastic basket muzzle with holes that covers entire nose and mouth

Question 39

Which is a sign of immediate respiratory distress?

a. Absence of abdominal wall movement with respiration
b. Paradoxical chest wall movement
c. Flexed head and neck
d. Adducted elbows

Answer 39

b. Paradoxical chest wall movement

Question 40

Which is not an appropriate question when taking a patient’s history, according to the AMPLE mnemonic?

a. Does the animal have Allergies?
b. What Medications does this animal take regularly?
c. Is the patient in any Pain?
d. When was the patient’s last meal, urination/defecation, and medication?

Answer 40

c. Is the patient in any Pain?

Question 41

Which is a part of the “trauma triad of death”?

a. Hemophilia
b. Hyperthermia
c. Hyperoxemia
d. Metabolic acidosis

Answer 41

d. Metabolic acidosis

Question 42

Which of the following is one of the signs of decompensated shock?

a. Eupnea
b. Delayed capillary refill
c. Rapid eye movement
d. Fever

Answer 42

b. Delayed capillary refill

Question 43

An emergency patient is receiving O2 and IV fluids; which size catheter is preferred for the fluids?

a. Long, large-bore
b. Long, small-bore
c. Short, large-bore
d. Short, small-bore

Answer 43

c. Short, large-bore

Question 44

Which is most effective for resuscitation for a patient in shock from blood loss?

a. Hydroxyethyl starch combination
b. Interstitial crystalloids
c. Synthetic colloids
d. Whole blood

Answer 44

d. Whole blood

Question 45

Before clipping and cleaning a puncture wound, how can the technician keep hair from getting lodged in the wound?

a. Rinse with a surgical disinfecting solution
b. Apply sterile water-soluble lubricant
c. Flush with tap water under pressure
d. Rinse with tap water

Answer 45

b. Apply sterile water-soluble lubricant

Question 46

How often should a recumbent patient be turned?

a. Every 30 minutes
b. Every 60 minutes
c. Every 2 hours
d. Twice daily

Answer 46

c. Every 2 hours

Question 47

Which of the following injuries most likely represents penetrating trauma?

a. Animal is stepped on
b. Animal is hit by a car
c. Animal is partially impaled
d. Animal has fallen into a hole

Answer 47

c. Animal is partially impaled

Question 48

A technician knows not to remove an impaled object from a trauma patient until the wound tract is explored completely. What is the only exception to this rule?

a. The object is touching the heart.
b. The object is lodged in the abdominal aorta.
c. The object is severely compromising respiration.
d. The object is in the patient’s lower abdominal side.

Answer 48

c. The object is severely compromising respiration.

Question 49

Which emergency presentation is most indicative of canine heartworm disease?

a. Pulmonary edema
b. Caval syndrome
c. Arrhythmia
d. Cyanosis

Answer 49

b. Caval syndrome

Question 50

Which agent can best help to increase heart contractility?

a. Dopamine
b. Furosemide
c. Butorphanol
d. Procainamide

Answer 50

a. Dopamine

Question 51

Which drug is preferred for the treatment of 2nd degree AV block arrhythmias?

a. Atropine
b. Propranolol
c. Epinephrine
d. Calcium gluconate

Answer 51

a. Atropine

Question 52

Which test uses the length of the thoracic vertebrae as a reference for determining heart size?

a. Auscultation
b. VHS technique
c. Echocardiography
d. Electrocardiography

Answer 52

b. VHS technique

Question 53

Which factor in systolic function is multiplied by stroke volume to determine the volume of blood pumped in 1 minute (i.e., cardiac output)?

a. Preload
b. Afterload
c. Heart rate
d. Contractility

Answer 53

c. Heart rate

Question 54

Which factor is a measure of how much the ventricle is stretched at the end of diastole?

a. Preload
b. Afterload
c. Heart rate
d. Contractility

Answer 54

a. Preload

Question 55

Which factor’s increase will make it harder for blood to leave the heart, causing a decrease in stroke volume?

a. Preload
b. Afterload
c. Heart rate
d. Contractility

Answer 55

b. Afterload

Question 56

For which emergency condition is pericardiocentesis most useful?

a. Atrial fibrillation
b. Cardiac tamponade
c. Cardiac arrhythmia
d. Ventricular tachycardia

Answer 56

b. Cardiac tamponade

Question 57

Which disorder is best improved with the use of a pacemaker?

a. Supraventricular arrhythmia
b. Pericardial effusion
c. Cardiac tamponade
d. Severe bradyarrhythmia

Answer 57

d. Severe bradyarrhythmia

Question 58

A cat survives a blood clot that travels from the heart to a systemic artery but loses part of a leg to ischemic necrosis and needs treatment with heparin and strong analgesics. Which condition does this most closely describe?

a. Congestive heart failure
b. Cardiogenic shock
c. Caval syndrome
d. Feline aortic thromboembolism (FATE)

Answer 58

d. Feline aortic thromboembolism (FATE)

Question 59

Which is a typical symptom of laryngeal paralysis?

a. Groggy
b. Cyanotic
c. Pruritic
d. Hypothermic

Answer 59

b. Cyanotic

Question 60

Which best describes inspiratory stridor?

a. Dry, hacking cough
b. Wet, constant “tickle”-type cough
c. Harsh, raspy sounds during inspiration
d. Wheezing, whooping sounds during inspiration

Answer 60

c. Harsh, raspy sounds during inspiration

Question 61

Which is a key component of emergency treatment for laryngeal paralysis?

a. Avoid sedation.
b. Protect against heat loss.
c. Administer butorphanol.
d. Avoid immediate oxygen supplementation.

Answer 61

c. Administer butorphanol.

Question 62

Which surgery is most often recommended for laryngeal paralysis?

a. Unilateral arytenoid lateralization
b. Internal rib fixation
c. Thoracentesis
d. Thoracotomy

Answer 62

a. Unilateral arytenoid lateralization

Question 63

Which anatomic feature is most likely to contribute to a patient developing BAS?

a. Shortened soft palates
b. Shortened nasal passages
c. Hyperplastic trachea
d. Enlarged nares

Answer 63

b. Shortened nasal passages

Question 64

A feline patient with pulmonary edema is intubated, and the tube immediately fills with a foamy edema fluid. What is the best immediate response?

a. Elevate hind end and chest
b. Administer oxygen therapy
c. Administer diuretic therapy
d. Administer mechanical ventilation

Answer 64

a. Elevate hind end and chest

Question 65

Which type of pneumonia is most frequently associated with megaesophagus?

a. Viral pneumonia
b. Fungal pneumonia
c. Bacterial pneumonia
d. Aspiration pneumonia

Answer 65

d. Aspiration pneumonia

Question 66

Which treatment strategy is appropriate in treating brachycephalic airway syndrome?

a. Keeping the animal alert
b. Physical movement
c. Active cooling
d. Slow warming

Answer 66

c. Active cooling

Question 67

This ECG tracing is an example of:

a. Ventricular fibrillation
b. Atrial fibrillation
c. Ventricular tachycardia
d. 3rd degree AV block

Answer 67

a. Ventricular fibrillation

Question 68

This ECG tracing is an example of:

a. Supraventricular tachycardia
b. Premature Ventricular Contraction
c. Normal sinus rhythm
d. Sinus arrhythmia

Answer 68

d. Sinus arrhythmia

Question 69

This ECG tracing is an example of:

a. 1st degree AV block
b. 2nd degree AV block
c. 3rd dergee AV block
d. 4th degree AV block

Answer 69

b. 2nd degree AV block

Question 70

This ECG tracing is an example of:

a. Premature ventricular contraction
b. Sinus tachycardia
c. Premature atrial contraction
d. Electrical interference

Answer 70

a. Premature ventricular contraction

Question 71

Squishy, the 26# cat needs a CRI of Lipozene at 5mg/kg/hr. Lipozene comes in a concentration of 100mg/mL. The veterinarian asks you to put the Lipozene in Squishy’s fluids that are running at 25mL/hr. Squishy has 500mL left in her fluid bag. How many mL of Lipozene will you add to the fluids?

Answer 71

26/2.2 = 11.82kg

11.82 x 5 / 100 = 0.59mL/hr

500/25 = 20hr

0.56 x 20 = 11.8mL

Answer: 11.8 ml

Question 72

Chompers, the very aggressive 154# mastiff, ate 5 grapes and needs to be hospitalized in your clinic for 72 hours on IV fluids. The veterinarian wants Chompers to receive 75mL/kg/day of fluids. After sedating Chompers with dexmedetomidine so an IVC could be placed, the doctor decides to keep Chompers on a CRI of dexmedetomidine. The CRI will be set at 5mcg/kg/hr and will be placed on a syringe pump. The doctor says to draw up just enough medication to last the dog’s entire hospitalization stay. Dexmedetomidine’s concentration is 500mcg/mL.

How many mL/hr will you set the syringe pump to run?
How many mL of dexmedetomidine will you draw up?
How many mL/hr of IV fluids will Chompers receive?

Answer 72

154/2.2 = 70kg

70 x 5mcg/kg/hr / 500 = 0.7mL/hr

0.7 x 72 = 50.4mL

70 x 75ml/kg/day = 5250mL/day / 24 = 219mL/hr

Answers:
a. 1 ml/hr
b. 50.4 ml
c. 219 ml/hr

Question 73

Sweet Tart, the diabetic cat, needs a dextrose in her fluids. She needs 3% dextrose in her 500mL bag of saline. Dextrose comes in a 50% solution. How will you make this happen?

Answer 73

50 x X = 3 x 500

X= 30mL

Remove 30mL saline from fluid bag and add 30mL of 50% dextrose to bag to create 3% soultion for Sweet Tart.