The short answer
This guide holds 12 original practice questions, with answer rationales, on emergency and critical care topics. The questions cover triage and perfusion assessment, shock and fluid therapy, transfusion, cardiopulmonary resuscitation (CPR) and oral decontamination. Our desk wrote every question from the cited Merck Veterinary Manual chapters and Today's Veterinary Nurse articles. They are not real exam items and do not predict exam content.
Key takeaways
- The Merck Veterinary Manual triage table treats a capillary refill time of 1 to 2 seconds as normal and links a time under 1 second to a hyperdynamic state [2].
- A Today's Veterinary Nurse (TVN) overview divides circulatory shock into cardiogenic, hypovolemic and distributive types and gives a normal blood lactate as under 2 mmol/L [5].
- Merck classes lactated Ringer's solution and 0.9% NaCl as isotonic crystalloids and says hypotonic fluids should not be used for resuscitation [6].
- Merck and TVN's summary of the 2024 RECOVER guidelines both give a single-rescuer compression-to-ventilation ratio of 30:2, with compressions at 100 to 120 per minute in 2-minute cycles [3][4].
- According to TVN, the 2024 RECOVER update raised the end-tidal CO2 target to 18 mm Hg and set compression depth at about 25% of chest diameter for wide-chested animals on their backs [4].
- An ASPCA Animal Poison Control Center author writing in TVN says hydrogen peroxide is not recommended as an emetic in cats [7].
About these questionsPractice questions written by our editorial team for study purposes. These are not real VTNE items and are not affiliated with AAVSB.
Emergency medicine and critical care on the VTNE
The American Association of Veterinary State Boards (AAVSB) publishes a content outline for the VTNE and calls it "one of the most important materials to review before taking the VTNE" [1]. According to the AAVSB, the exam spans 10 domain areas, and its practice tests assess strengths and weaknesses in each of those 10 domains [1]. The AAVSB page we cite does not list the domains by name or state how many items each carries, so this guide does not report a share for emergency and critical care. The questions below draw only on the clinical references in the References list.
Triage and perfusion assessment
Question 1
A technician triaging a dog records a capillary refill time of under 1 second. Per the Merck triage table, this finding is most consistent with which of the following?
- A. Normal perfusion with a normal PCV
- B. Severe hypoxemia from airway obstruction
- C. A hyperdynamic state, such as early compensatory hypovolemic shock
- D. Increased serum bilirubin from hemolysis
Answer: C. Merck lists 1 to 2 seconds as normal and ties a time under 1 second to a "Hyperdynamic state," which the chapter says may occur with fever, heatstroke, distributive shock or the early compensatory phase of hypovolemic shock [2].
Question 2
According to the Merck Veterinary Manual, which presenting complaint justifies moving the patient straight back for treatment, whatever the physical exam shows?
- A. A male cat that is unable to urinate
- B. A dog due for a booster vaccination
- C. A cat presented for a routine nail trim
- D. A dog booked for suture removal
Answer: A. Merck includes difficulty or inability to urinate in male cats among complaints that can need rapid intervention or "lead to rapid decompensation," alongside paleness and weakness and prolapsed organs [2].
Question 3
A dog in respiratory distress shows chest expansion on inspiration while the abdomen draws inward, and its lung sounds are muffled. Which problem does this pattern indicate, according to Merck?
- A. Lung parenchymal disease
- B. Pleural space disease
- C. Extrathoracic upper airway obstruction
- D. Pharyngeal disease causing stertor
Answer: B. Merck describes asynchronous, or paradoxical, breathing with muffled lung sounds as the pattern of pleural space disease, while parenchymal disease moves chest and abdomen in the same direction [2].
Shock, fluids and transfusion
Question 4
A septic dog has an elevated temperature, hyperemic mucous membranes, strong pulses and a rapid capillary refill time. Which category of shock do these signs fit best, per the TVN shock overview?
- A. Cardiogenic
- B. Hypovolemic from hemorrhage
- C. Late decompensatory hypovolemic
- D. Distributive
Answer: D. The TVN article says the signs of distributive shock differ from other types, listing strong pulses, hyperemic membranes, rapid refill and fever, and it names sepsis as a common cause [5].
Question 5
Which value does the TVN shock overview give as a normal blood lactate level?
- A. 3 to 4 mmol/L
- B. Less than 2 mmol/L
- C. 4 to 6 mmol/L
- D. Greater than 6 mmol/L
Answer: B. The article gives "<2 mmol/L" as normal and assigns the higher ranges to mild, moderate and severe hypoperfusion; it explains that lactate comes from anaerobic metabolism when oxygen delivery falls [5].
Question 6
Which of the following does the Merck Veterinary Manual classify as an isotonic crystalloid?
- A. 5% dextrose in water
- B. 0.45% sodium chloride
- C. Lactated Ringer's solution
- D. 7% hypertonic saline
Answer: C. Merck names lactated Ringer's and 0.9% NaCl as isotonic, classes D5W and half-strength saline as hypotonic fluids that "should not be used as resuscitation fluids," and groups 7% NaCl with hypertonic solutions [6].
Question 7
Using the method in the Merck fluid resuscitation chapter, what is the estimated fluid deficit of a 20-kg dog judged to be 5% dehydrated?
- A. 100 mL
- B. 400 mL
- C. 1,000 mL
- D. 2,000 mL
Answer: C. Merck multiplies body weight in kilograms by the dehydration percentage as a decimal to get liters, then by 1,000 for milliliters, so 20 x 0.05 = 1 L, or 1,000 mL; the chapter cautions that dehydration estimates are always partly subjective [6].
Question 8
A technician is setting up a packed red blood cell transfusion. According to the TVN transfusion article, which fluid may run in the same line as the red cells?
- A. 0.9% saline
- B. Lactated Ringer's solution
- C. 5% dextrose in water
- D. Any balanced isotonic crystalloid
Answer: A. The article says only 0.9% saline may share the line, because lactated Ringer's binds with red cells and starts clotting, and 5% dextrose lyses them [8].
CPR and oral decontamination
Question 9
A lone rescuer starts CPR on an unresponsive cat that is not intubated. What compression-to-ventilation ratio do the cited references give for a single rescuer?
- A. 15:2
- B. 5:1
- C. 10:1
- D. 30:2
Answer: D. Merck and TVN's summary of the 2024 RECOVER guidelines both give 30:2 for a single rescuer [3][4].
Question 10
How deep should compressions be in a wide-chested dog placed in dorsal recumbency, according to TVN's summary of the 2024 RECOVER guidelines?
- A. About 25% of the anterior-to-posterior chest diameter
- B. One-third to one-half of chest width
- C. As deep as the rescuer can push
- D. 5% of chest depth
Answer: A. TVN reports the revised depth as "approximately 25% of the anterior-to-posterior chest diameter," because structures such as the spine and epaxial muscles cannot be compressed; one-third to one-half applies to lateral recumbency [4].
Question 11
During CPR on an intubated dog, which end-tidal CO2 value is the current target for adequate compressions?
- A. 5 mm Hg or less
- B. 10 mm Hg
- C. 15 mm Hg
- D. 18 mm Hg or higher
Answer: D. TVN reports that the 2024 RECOVER guidelines raised the target from 15 mm Hg to 18 mm Hg, and Merck likewise treats a reading above 18 mm Hg as a sign of adequate CPR [4][3].
Question 12
According to the ASPCA Animal Poison Control Center author writing in TVN, which agent can be used to induce emesis in a cat?
- A. 3% hydrogen peroxide
- B. Dexmedetomidine
- C. Table salt
- D. Syrup of ipecac
Answer: B. The article says dexmedetomidine "can also be used as an effective emetic in cats," while hydrogen peroxide is not recommended in cats because of gastritis, salt risks hypernatremia, and ipecac was removed from the market [7].
