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Certificate of Veterinary Nursing in Emergency & Critical Care
Sample question Paper – Paper 2
Cert VN ECC
Sample Question Paper - Questions & Answers
Paper 2
Note: There are usually 6 questions for this paper to be complete within 90 minutes
1.
(12 marks)
A cat is diagnosed with ketoacidosis secondary to diabetes mellitus.
a) Define the term ketoacidosis.
(1 mark)
ANS: An uncontrolled breakdown of fat to produce large number of ketones
b) Describe the presenting clinical signs likely to be seen in this cat
(2 marks)
ANS: (1/2 mark for 4 of the following)
PU/PD; anorexia; V +/-D; dullness and collapse; poor body condition;
tachypnoea/ketoacidotic breathe; +/- dehydration
c) Name 2 biochemistry parameters that should be measured to monitor renal function in this
cat.
(1 mark)
ANS: (1/2 mark each for 2 of the following)
Blood urea, creatinine, phosphorus
d) Which ketone cannot be measured with a urine dipstick?
(1 mark)
ANS: Beta hydroxybutyrate
e) What acid-base abnormality would you expect to see in this cat?
(1 mark)
ANS: Metabolic acidosis
f)
The urine specific gravity is 1.010. What term is used to describe this result?
(1 mark)
ANS: isosthenuric
g) Which type of insulin should be used to treat this cat?
(1 mark)
ANS: Neutral (regular/soluble) insulin
h) Hypophosphotaemia is common following aggressive insulin therapy. What haematological
abnormality can hypophosphotaemia lead to?
(1 mark)
ANS: haemolysis/anaemia
i)
Why should supplemental phosphorous not be given with Hartmann’s?
(1 mark)
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Certificate of Veterinary Nursing in Emergency & Critical Care
Sample question Paper – Paper 2
ANS: Hartmann’s contains calcium, and they can precipitate
j)
During therapy, the cat becomes hypoglycaemic. A dextrose bolus is given and dextrose
added to the cat’s fluids. What is the maximum percentage (%) of dextrose that can be
given through a peripheral IV catheter, and why?
(2 marks)
ANS: 5% or can develop thrombophlebitis
2.
(12 marks)
A 4 year old male castrated cat is presented to your clinic with a blocked bladder (urethral
obstruction).
a) What is the most life-threatening electrolyte abnormality in this cat?
(1 mark)
ANS: Hyperkalaemia
b) What ECG abnormalities would you see with this electrolyte abnormality?
(2 marks)
ANS: (1/2 mark for any of 4 following)
Spike T waves
Wide QRS
Prolonged P-R interval
Absent P waves
Eventual sine wave
c) Name three treatments that could be used for this life-threatening electrolyte abnormality?
(3 marks)
ANS: (accept any 3 of...)
Fluids
Bicarbonate
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Certificate of Veterinary Nursing in Emergency & Critical Care
Sample question Paper – Paper 2
Insulin/dextrose
Calcium gluconate
d) What equipment would you get ready in preparation for unblocking this cat?
(3 marks)
ANS: (1/2 mark for any of the following)
Catheter to unblock
Indwelling urinary catheter
Closed collection system
Lubricant
Sterile gloves
Saline flush
Sedation
Monitoring equipment (ECG et)
e) Why may prazosin or phenoxybenzamine be useful in this case (once he is unblocked)?
(1 mark)
ANS: Prevent urethral spasm
f) In a cat where an indwelling catheter is placed what four nursing care procedures would
you put in place to monitor this patient.
(2 marks)
ANS: (1/2 mark for any of 4 of the following)
Urine scalding; keeping area clean and dry; reblockage of catheter; flushing; infection;
bladder emptying
3.
(12 marks)
Wounds and exotics
Wounds.
a) What are bullous lesions and what condition might they be associated with?
(2 marks)
ANS: intact skin blisters
Immune mediated conditions
b) State the 5 stages of wound healing in order of event
(2 marks)
ANS: haemostasis; inflammation, proliferation, maturation, remodelling
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Certificate of Veterinary Nursing in Emergency & Critical Care
Sample question Paper – Paper 2
c) What is ‘strike through’ and what complication may arise if this occurs?
(1 mark)
ANS:
Fluid from wound soaking the dressing/bandage as this
can lead to bacterial access from the outside.
d) Name two products including their dilution rate which would be suitable for flushing a wound?
(1 mark)
ANS: (2 of the following 3)
0.9% NaCl; 0.01% povidone iodine; 0.05% chlorhexidine
NO MARKS IF Hydrogen peroxide is stated or incorrect % solution of others
Exotics
a) Define the term ectothermic?
(1 mark)
ANS: Dependent on external environmental temperature to maintain body temp.
b) Where do spurs most commonly form on rabbit’s teeth?
(1 mark)
ANS: (1/2 mark for each) Mandibular teeth (tongue side) and Maxillary teeth (cheek side)
c) Describe positioning and intubation of a spontaneous-breathing and non-breathing rabbit
(4 marks)
ANS: (4 of the following main points)
Intubation may be achieved blindly, with the rabbit in sternal recumbency.
The rabbit’s head is lifted and the endotracheal tube (ET) advanced slowly until breathing
sounds are heard through the tube. The tube may then be quickly advanced on inspiration.
If a transparent tube is used then condensation from the rabbit’s breath when the tube is
over the glottis can be seen aiding intubation.
If the rabbit has stopped breathing then this technique becomes extremely difficult,
therefore a laryngoscope with a Wisconsin 0 paediatric blade can be used to visualise the
glottis (Heard 2004).
This is best achieved with the rabbit in dorsal recumbency and the tongue pulled laterally.
A guide wire may be inserted through the glottis first and the ET tube threaded over the top.
Alternatively a fine endoscope or needlescope may be used as a guide wire instead,
threading the ET over the scope prior to intubation.
Once through the glottis, the ET tube maybe advanced and the scope retracted easily.
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Certificate of Veterinary Nursing in Emergency & Critical Care
Sample question Paper – Paper 2
4. (12 marks)
a) Define the following neurological terms:
Neurological term
Proprioception
(6 marks)
Definition
Schiff-Sherrington posture
Spasticity
Spinal reflex
Tetraparesis
Tonus
ANS:
Proprioception
Schiff-Sherrington
posture
Spasticity
Spinal reflex
Tetraparesis
Tonus
Sensory function allowing the normal positioning of a limb.
The forelimbs are not paralysed but there is increased extensor tone
in them. This will be combined with hindlimb .flaccidity Forelimbs are
hyper-extended and hind limbs are flaccid
An increase in the tone/activity of the extensor muscles of limb(s).
Automatic response involving pathways in the spinal cord. Examples
include the patellar reflex, cutaneous trunci reflex and perineal reflex.
Partial loss of muscle function of all 4 limbs.
Increased extensor tone of muscles.
b) A dog is presented with a head tilt, circling, abnormal posture and balance and possible
vomiting. It is diagnosed as being ‘vestibular’. Which cranial nerve is affected? (1 mark)
ANS: VIII
c) Describe what you would expect to see when examining the eyes.
(2 marks)
ANS: Nystagmus
d) A dog has been hit by a car and brought into your clinic. What assessment can be made
from examination of the eyes to ascertain a possible brain injury?
(3 marks)
ANS:
 Pupillary light reflex
 Pupil size
 Different sizes of pupils – anisocoria
 Menace or absence
 Nystagmus
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Certificate of Veterinary Nursing in Emergency & Critical Care
Sample question Paper – Paper 2
5.
(12 marks)
You have been presented with a cat following a road traffic accident. Its respiration remains
compromised. After oxygenation and analgesia and a negative thoracocentesis it is decided to
take a conscious radiograph. This shows the patient has a diaphragmatic rupture with
movement of intestines, liver and stomach in the thoracic cavity.
a) Why is immediate surgical repair required?
(2 marks)
ANS: presence of gas filled viscera in thorax and no improvement to
dyspnoea/congestion of organs and compromise of blood supply to liver
b) Name 5 parameters that you would monitor on this patient during anaesthetic.(5 marks)
ANS:
 Heart rate
 Blood pressure
 SPO2
 ETCO2
 ECG
 Temperature
 Neurological reflexes
c) Give one reason for monitoring each of the above parameters you have mentioned
(5 marks)
ANS:
 Heart rate can become very bradycardic due to vagal stimulation
 Blood pressure can be compromised due to blood loss or pooling of blood in
congested organs
 SPO2 – to ensure IPPV is being effective
 ETCO2 – can become acidotic if ventilation not adequate causing low ph,
decreased cardiac output
 ECG – arrythmias are common
 Temperature – hypothermia is common during long surgeries causing a decrease in
PH , reduced cardiac output and poor perfusion
 Neurological reflexes- eye position pedal reflex anal tone etc loss of neuro function
indicator of impending arrest
6.
(12 marks)
a) A bitch is presented for ingestion of a toxin. Name 3 contraindications for inducing
emesis in this dog.
(3 marks)
ANS:
 The poison was consumed more than four hours ago
 The poison is corrosive i.e. is an acid/alkali or a hydrocarbon
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Certificate of Veterinary Nursing in Emergency & Critical Care
Sample question Paper – Paper 2

The patient is seizuring or in a coma or hypoxic
b) State the 3 acute (1-4 hours) clinical signs post ingestion of ethylene glycol? (3 marks)
ANS: Ataxia, tachycardia, tachypnoea
c) What is the main cause of death in dogs/cats following ethylene glycol intoxication?
(1 mark)
ANS: Acute renal failure
d) What crystal may be found in the urine of an animal suffering from ethylene glycol
intoxication?
(1 mark)
ANS: Oxalate crystals
e) Name 2 treatments for acute ethylene glycol intoxication
ANS: Alcohol, fomepizole, fluids
(2 marks)
f)
What blood parameters would be measured following ethylene glycol intoxication?
(2 marks)
ANS: Urea, creatinine, etc.
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