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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Emergency Medicine / Critical Care | 7% | - Triage, shock, respiratory/cardiac emergencies - Toxicology, trauma, first aid procedures |
| Topic 2: Surgical Nursing | 13% | - Surgical preparation, instrumentation, aseptic technique - Wound management, suture materials and techniques - Intraoperative and postoperative care |
| Topic 3: Animal Care and Nursing | 20% | - Husbandry, nutrition, fluid therapy - Specialized care for exotic, large or neonatal patients - Physical examination, patient assessment - Infection control, sanitation, isolation |
| Topic 4: Dentistry | 7% | - Periodontal care and patient education - Dental anatomy, disease recognition - Dental cleaning, polishing, radiography |
| Topic 5: Diagnostic Imaging | 6% | - Ultrasound, other imaging modalities - Radiography: positioning, safety, technique - Image quality assessment and documentation |
| Topic 6: Laboratory Procedures | 9% | - Parasitology, microbiology, cytology - Sample collection, handling and processing - Hematology, clinical chemistry, urinalysis |
| Topic 7: Anesthesia | 13% | - Recovery and emergency management - Pre-anesthetic assessment and preparation - Anesthetic agents, equipment, monitoring |
| Topic 8: Communication and Veterinary Professional Support Services | 5% | - Client education, communication techniques - Practice management, team collaboration - Medical records, ethics, legal and regulatory compliance |
| Topic 9: Pain Management / Analgesia | 7% | - Pain assessment, pharmacologic and non-pharmacologic control - Multimodal analgesia protocols |
| Topic 10: Pharmacy and Pharmacology | 13% | - Anatomy, physiology, pathophysiology related to agents - Preparation, dispensing, storage, safety and disposal - Drug classification, dosage calculation, administration routes - Controlled substance management |
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NEW QUESTION # 649
An owner is against euthanasi
a. However, her 13-year-old MN Boston Terrier is dying from stage 4 renal failure and unregulated diabetes mellitus. The owner understands that without diabetes treatment, this will have further negative impacts on the kidneys and may have ill effects on the heart, neurological system, and more. However, she does not believe in euthanasia. You and your veterinarian attempt to speak to the owner about suffering and being able to humanely end the pet's suffering. You discuss the quality of life and how it will continue to decline as the pet suffers. However, the owner fails to consent to euthanasia. You discuss hospice care with the owner. However, this, too, she rejects. You struggle with this owner because you feel that her beliefs create undue suffering for her pet. However, moving forward, your job will be to educate her on what to expect with the dying process. You cannot tell her how long it will take, but you can tell her what to expect in the days to weeks ahead. The only treatment the owner agrees to give the pet, if he will tolerate it without stress, is daily subcutaneous fluid therapy to provide minimal hydration. You want to support the owner in the natural death process and prepare her as best as possible for what she will see.
What may the owner see in the days to hours preceding death?
Answer: D
Explanation:
Depending on how fast the pet succumbs will depend on how long the changes will take to occur. However, with hospice care, we assume the initial changes include behavioral changes. Some may become the velcro pet, never leaving an owner's side, while others hide and become withdrawn. Further, signs of dehydration will become more and more evident. If the owner continues to give SQ fluids and they are being absorbed, that is a good sign; however, if the fluids are not getting absorbed, swelling and fluid accumulation becomes evident in the distal limbs, the fluid administration should cease, which suggests worsening condition.
As death comes closer (within one to two weeks or less), animals become agitated, disoriented, and even confused. Additional signs of cognitive dysfunction may become apparent. Blood pressure, body temperature, appetite, and fluid intake will continue to decline.
Days to hours before death, animals may show a "swan song." Owners often describe the day before death as almost puppy-like again, that resurgence of energy before they succumb. Irregular breathing, incontinence, cool extremities, and further drop in blood pressure closely follow this. If there is any appetite, it will continue to decline, as will water consumption. Because this pet is already in renal failure, these changes may occur much more rapidly. The pet may give off a worsening odor "of death" (a combination of uremia and ketosis in this pet). Finally, the heart's rate and rhythm will become slower and more irregular.
In the final moments prior to death, animals will show agonal breathing and may arch their head back, stretching out their limbs. They will usually let go of urine and feces. They may continue to gasp for breath before finally going into cardiac arrest. The eyes will not close but instead remain fixed and dilated, something that owners are never prepared for and expect the opposite.
Sometimes, once you explain all this to an owner, they become horrified that they may have to watch this and that their pet will suffer. Still, others are so set in their ways, religious beliefs, or desire to spend as much time with the pet as feasible that they prefer this inhumane death to euthanasia. We cannot let our own judgments or opinions interfere. We must permit the owner to say goodbye in a way in which they are comfortable.
NEW QUESTION # 650
In cattle, the preferred location for intramuscular injections is which of the following?
Answer: B
Explanation:
Because cattle ultimately end up in the food chain, intramuscular injections are not recommended. However, now and again, we do need to administer medications in this fashion. If so, cervical muscles are the preferred site. We try to avoid using the gluteals, shoulder, semimembranosus, and semitendinosus muscles because any damage caused by the injection would lead to the carcass being condemned and economic loss to the farmer. Ideally, if any intramuscular injection is needed, ensure that you place it cranial to the shoulder in the neck where blemished tissue can easily be discarded without causing the whole carcass to be condemned at slaughter inspection.
The landmark for cervical injections in cattle would be the triangle created by the shoulder, spinal column, and nuchal ligament in the lateral cervical muscles. Note that when giving intramuscular injections in cattle, it is commonplace to place the needle without the syringe and then attach it after the fact.
However, if injections are needed, and concern for future use in the food chain is not present, pelvic limb muscles, including the gluteals and hamstring groups, can be used. In the thoracic limbs, the triceps brachii can be used. Finally, as above, the cervical muscles, such as the trapezius muscle, can receive intramuscular injections.
NEW QUESTION # 651
Which of the following procedures can assess metastasis in lymph nodes?
Answer: C
Explanation:
Fine needle aspiration uses needles to sample cells in a minimally invasive way. Cytology is the term for evaluating the cells under a microscope. A pathologist can evaluate the cell appearance for evidence of malignancy (cancer metastasis).
A urinalysis evaluates the characteristics of urine. A culture and sensitivity identifies microorganisms and their susceptibility to antimicrobial drugs. A complete blood count quantifies blood cell elements including red blood cells, white blood cells, and platelets.
NEW QUESTION # 652
When checking for leaks in the low-pressure system using a non-rebreather system for leaks, you can confidently say there are no leaks when the bag remains inflated for at least how long?
Answer: C
Explanation:
When checking for leaks in non-rebreathing systems, one occludes the patient connector and scavenging hose or pressure relief valve. The oxygen is then turned on to fill the bag. Once the bag is filled, turn the flowmeter off. If, after at least 10 seconds, the bag still remains inflated, then there are no leaks in the system.
Use the flowmeter to fill the reservoir bag to a pressure of 30 centimeters of water. If a leak is detected, turn the flowmeter back on just enough to return to the 30 centimeters of water. If more than 300 mL/minute is necessary to fill it to the starting point, the machine should not be used, and the leak should be found.
NEW QUESTION # 653
The oxygen flush valve delivers pure oxygen at what rate directly to the breathing system? What is it bypassing when you use this?
Answer: D
Explanation:
The oxygen flush valve delivers pure oxygen to the breathing circuit, bypassing the flowmeter and the vaporizer. It is designed to rapidly fill an empty reservoir bag with fresh oxygen. However, when doing so, this dilutes the concentration of any inhalant within the circuit. The flush valve also functions as an oxygen delivery method for a critically ill patient or to push the inhalant out of the circuit once recovery is initiated or during a crisis.
To flush the circuit properly, turn off the vaporizer, using gentle manual pressure on the reservoir bag. Then, press the valve to refill the bag. Never use more than short bursts when using the valve. You must avoid overinflation of the bag and prevent damage to the patient's lungs secondary to barotrauma (pressure buildup).
NEW QUESTION # 654
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