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| Section | Weight | Objectives |
|---|---|---|
| Anesthesia | 13% | - Recovery and emergency management - Pre-anesthetic assessment and preparation - Anesthetic agents, equipment, monitoring |
| Diagnostic Imaging | 6% | - Radiography: positioning, safety, technique - Image quality assessment and documentation - Ultrasound, other imaging modalities |
| Dentistry | 7% | - Periodontal care and patient education - Dental cleaning, polishing, radiography - Dental anatomy, disease recognition |
| Laboratory Procedures | 9% | - Hematology, clinical chemistry, urinalysis - Sample collection, handling and processing - Parasitology, microbiology, cytology |
| Emergency Medicine / Critical Care | 7% | - Toxicology, trauma, first aid procedures - Triage, shock, respiratory/cardiac emergencies |
| Communication and Veterinary Professional Support Services | 5% | - Practice management, team collaboration - Client education, communication techniques - Medical records, ethics, legal and regulatory compliance |
| Animal Care and Nursing | 20% | - Infection control, sanitation, isolation - Physical examination, patient assessment - Husbandry, nutrition, fluid therapy - Specialized care for exotic, large or neonatal patients |
| Pharmacy and Pharmacology | 13% | - Preparation, dispensing, storage, safety and disposal - Controlled substance management - Anatomy, physiology, pathophysiology related to agents - Drug classification, dosage calculation, administration routes |
| Surgical Nursing | 13% | - Intraoperative and postoperative care - Surgical preparation, instrumentation, aseptic technique - Wound management, suture materials and techniques |
| Pain Management / Analgesia | 7% | - Pain assessment, pharmacologic and non-pharmacologic control - Multimodal analgesia protocols |
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NEW QUESTION # 509
You are assisting as the sterile surgical technician in a GI foreign body surgery in a dumpster-diver Labrador Retriever. When the surgeon evaluates the stomach before incising, what is key for the surgical assistant?
Answer: C
Explanation:
When assisting in a gastric foreign body surgery and gastrotomy, the surgeon, upon opening the linea and abdominal wall, will visualize the stomach and all abdominal contents in situ. Once no overt abnormalities are noted, the stomach will be isolated. The surgeon will inspect it for lesions, perforations, necrosis, or other abnormalities. While the surgeon is accomplishing this, the remaining abdominal organs must be protected from contamination when the stomach is incised and kept moist to prevent drying. Thus, the surgical nurse at this time should take moistened, sterile laparotomy sponges and pack off the rest of the abdominal contents.
The surgeon will be the one to place the stay sutures. These aid in stomach manipulation while helping to minimize the risk of leakage/spillage of the gastric contents. Using a fresh blade, different from that which incised the skin, a surgeon will make an incision (stab type) into the stomach between the two stay sutures, most commonly between the greater and lesser curvatures where it is least vascular. You will want to anticipate the instruments the veterinarian will need and, at this time, hand the surgeon the Metzenbaum scissors to permit lengthening of the gastric incision to expose the area, and the surgeon can then use Allis tissue forceps to collect and remove the foreign material.
You want to have suction available before making the stab incision so that, if necessary, the gastric contents can be suctioned to permit better visualization of the foreign body and the overall appearance of the stomach. Suction may not be needed in all gastrotomies but should be available.
The packing materials can be removed once the surgeon has closed the stomach and is comfortable with the appearance and surgical site. The sponges may need to be moistened periodically throughout the surgery. This, too, is the job of the surgical assistant.
NEW QUESTION # 510
Which type of solution has an osmotic pressure higher than plasma?
Answer: C
Explanation:
A hypertonic solution has an osmolality higher than plasma. Examples of hypertonic solutions include 3% and 7% hypertonic saline (NaCl). They aid in resuscitation by the expansion of vascular volume. Hypertonic saline can also be used to treat traumatic brain injuries due to its ability to decrease intracranial pressure while increasing blood volume and blood pressure.
Isotonic refers to an osmolality that is the same as plasma. Hypotonic refers to an osmolality lower than plasma. Osmotic refers to the concentration of a solution and does not describe the solution's pressure.
NEW QUESTION # 511
If a patient has been admitted to the emergency service for ataxia, what is the chief complaint given by the pet owner?
Answer: A
Explanation:
Ataxia is a loss of balance and coordination of limbs, head, and/or trunk. This is typically a clinical sign of neurologic disease and can vary in type and severity. Patients will appear to make jerky, spastic, or uncoordinated movements. They may seem wobbly or weak.
Ataxia does not affect the ability to see, breathe, or eat.
NEW QUESTION # 512
You are asked to assist in managing a 6-YO MN Doberman. He presented as a GDV and had surgery 24 hours prior. He is not yet eating and, despite a Nocita incisional block, remains painful on abdominal palpation. You alert the overnight emergency doctor.
He has orders for hydromorphone as needed, but you feel this wouldn't be a good idea for all of the following reasons, except:
Answer: B
Explanation:
In healthy animals, hydromorphone can cause GI upset and vomiting. It is a pure mu-agonist opioid and, like all opioids, can cause significant ileus (gut stops moving or dramatically slows down). This can lead to further GI upset and constipation. It may not be the best option for a patient when getting him to eat is paramount to healing the stomach/GI tract. Further, while it is a reversible drug, it does remain in the system for up to six hours or more, depending on the patient. Many vets also feel that for visceral pain, it is less effective than other pain medication options.
Most likely, this patient received Cerenia, either on presentation or as part of the surgical pre-op protocol. However, vomiting with hydromorphone is common (more so with IM than IV administration). Still, a fentanyl CRI (which can be easily stopped, and any slowing of the GI tract or other abnormalities can be easily resolved) may be a better option. Many feel it is better at controlling visceral pain. Additional options would be dexmedetomidine, lidocaine, or ketamine CRI. All potential options come with their own side effects. Further, depending on the severity of pain, a combination of an opioid and lidocaine +/- ketamine (FLK, for example) may be used to ensure adequate pain supply yet lessen the amount of each drug needed, thereby hopefully improving quality of life and encouraging eating.
If CRIs are not an option, choosing methadone over hydromorphone for intermittent injections may be beneficial, as we see less GI upset (anti-emetic properties). However, it can be costlier and needs to be dosed more frequently. Further, a shortage is ongoing as of October 2023 and, thus, it may not be a viable option.
NEW QUESTION # 513
You are discussing a chelonian's diet with a client. They just got a new tortoise and have no clue how to feed him. They do not know his age but were told he was several years old. The tortoise is underweight and likely has other abnormalities. The owner wants to start by ensuring a healthy diet and proper husbandry. He plans to house the animal outside for most of the year, weather permitting, to provide natural vitamin D, but knows he will need to supplement calcium and provide UVB exposure via a light when kept indoors.
Approximately what percentage of a chelonian's diet should be derived from fruits?
Answer: C
Explanation:
In general, land tortoises are mostly herbivorous. However, they may scavenge for small rodents or insects. In captivity, they require small amounts of protein (5%), varying depending on the species. High-protein sources include properly formulated species-specific commercial rations, eggs, insects, mice, and even some cereals.
10% of the diet should come from fruits. Options include pears, peaches, grapes, plums, dates, strawberries, mangoes, tomatoes, raspberries, melons, and papayas.
Finally, 85%, the majority of the animal's diet should arise from vegetables. This may include collards, dandelions, cabbage, broccoli, summer and winter squash, kale, and more. Seek proper references before recommending additional veggies.
Aquatic turtles will require a much larger portion of the diet from proteins, but they should still be offered veggies.
Even if commercial diets are fed, veterinarians still recommend supplementing with natural fruits, veggies, and, when species-appropriate, live or dead animal proteins to ensure proper nutrition and sufficient enrichment.
NEW QUESTION # 514
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