EMERGENCY TRIAGE
A 6-year-old Labrador Retriever arrives after being hit by a car. The dog is laterally recumbent, has pale mucous membranes, a heart rate of 180 bpm, weak peripheral pulses, and prolonged capillary refill time. Which problem should receive the highest priority during the initial assessment?
A. A suspected fractured femur
B. Hypovolemic shock
C. A superficial skin laceration
D. Mild hypothermia
B. Hypovolemic shock
Which medication is an opioid analgesic commonly used for moderate-to-severe acute pain?
A. Maropitant
B. Methadone
C. Famotidine
D. Metoclopramide
B. Methadone
A patient is found unconscious and apneic. What should the veterinary team assess immediately?
A. Blood glucose only
B. Pulse and cardiac activity
C. Body weight
D. Urine specific gravity
B. Pulse and cardiac activity
Which finding is most consistent with hypovolemic shock?
A. Strong pulses
B. Pale mucous membranes and tachycardia
C. Bradycardia with hypertension
D. Increased urine production
B. Pale mucous membranes and tachycardia
Before attempting to induce emesis in a poisoned patient, which factor is most important?
A. Breed color
B. Whether vomiting is appropriate for the substance and patient
C. Whether the patient has been groomed
D. Time of day
B. Whether vomiting is appropriate for the substance and patient
A dyspneic cat arrives in the emergency department. Which action should the technician take first?
A. Obtain a complete history
B. Take thoracic radiographs
C. Provide oxygen and minimize stress
D. Obtain a rectal temperature
C. Provide oxygen and minimize stress
Which medication is used to reverse opioid-induced respiratory and CNS depression?
A. Flumazenil
B. Naloxone
C. Atipamezole
D. Diphenhydramine
B. Naloxone
A dog has no palpable pulse and is not breathing. What should be initiated immediately?
A. Thoracic radiographs
B. Complete physical examination
C. CPR
D. Urinalysis
C. CPR
A dog has significant blood loss following trauma. Which blood product would directly provide red blood cells?
A. Fresh frozen plasma
B. Packed red blood cells
C. Cryoprecipitate
D. Platelet-poor plasma
B. Packed red blood cells
Which clinical sign is commonly associated with chocolate toxicosis?
A. Bradycardia only
B. Tremors and tachycardia
C. Severe hypothermia only
D. Blindness in every patient
B. Tremors and tachycardia
A dog presents after being struck by a vehicle. Which finding is most suggestive of poor peripheral perfusion?
A. Pink mucous membranes
B. Bounding pulses
C. Prolonged capillary refill time
D. Normal mentation
C. Prolonged capillary refill time
A patient receiving an opioid becomes profoundly sedated and develops respiratory depression. Which assessment is the highest priority?
A. Body weight
B. Respiratory rate and effort
C. Capillary refill time only
D. Appetite
B. Respiratory rate and effort
Which cardiac arrest rhythm is generally considered shockable?
A. Asystole
B. Pulseless electrical activity
C. Ventricular fibrillation
D. Sinus bradycardia
C. Ventricular fibrillation
Which parameter is particularly useful for evaluating perfusion and response to resuscitation?
A. Lactate
B. Hair coat quality
C. Body condition score
D. Dental calculus score
A. Lactate
A dog presents after ingesting an unknown substance. The owner brought the product container. What is the most useful immediate information for the veterinary team?
A. The color of the dog's collar
B. The product name and active ingredients
C. The owner's occupation
D. The dog's favorite food
B. The product name and active ingredients
During triage, a dog is found to have severe inspiratory difficulty, cyanotic mucous membranes, and marked anxiety. Which category of the primary survey should receive immediate attention?
A. Circulation
B. Disability
C. Airway/Breathing
D. Exposure
C. Airway/Breathing
A dog has received dexmedetomidine for sedation. Which medication can be used to reverse its effects?
A. Naloxone
B. Flumazenil
C. Atipamezole
D. Diphenhydramine
C. Atipamezole
During CPR, which finding is most concerning regarding the quality of chest compressions?
A. Appropriate chest recoil
B. Compression rate within the recommended range
C. Incomplete chest recoil between compressions
D. Rotation of compressors every few minutes
C. Incomplete chest recoil between compressions
A patient with suspected hemorrhagic shock continues to deteriorate despite initial fluid therapy. Which concern should be prioritized?
A. The patient needs more food
B. Ongoing hemorrhage
C. Mild dental disease
D. Excessive grooming
B. Ongoing hemorrhage
A dog has ingested a corrosive substance. Why may inducing vomiting be contraindicated?
A. Vomiting can cause additional injury to the esophagus and oral cavity
B. Vomiting always causes hypoglycemia
C. Vomiting prevents toxin absorption in every case
D. Vomiting causes permanent blindness
A. Vomiting can cause additional injury to the esophagus and oral cavity
A dog presents after a traumatic injury. It is initially alert but becomes increasingly obtunded over 20 minutes. The heart rate decreases from 160 to 80 bpm, and the mucous membranes become pale. Which interpretation is most concerning?
A. The patient is improving
B. The patient is becoming more relaxed
C. The patient may be experiencing decompensated shock
D. The patient is developing normal physiologic bradycardia
C. The patient may be experiencing decompensated shock
A hospitalized patient has severe acute pain despite receiving an opioid. Which approach is most consistent with multimodal analgesia?
A. Increasing the opioid indefinitely
B. Using analgesics with different mechanisms of action
C. Discontinuing all analgesics
D. Using only a sedative
B. Using analgesics with different mechanisms of action
A patient achieves return of spontaneous circulation (ROSC) after CPR. Which intervention remains particularly important during post-arrest care?
A. Discontinue monitoring
B. Maintain adequate oxygenation and perfusion
C. Prevent all movement
D. Immediately discharge the patient
B. Maintain adequate oxygenation and perfusion
A dog with severe hemorrhage is receiving fluid resuscitation. The technician should recognize that excessive crystalloid administration can potentially contribute to:
A. Improved clot formation
B. Hemodilution and worsening coagulopathy
C. Increased red blood cell concentration
D. Permanent immunity
B. Hemodilution and worsening coagulopathy
A poisoned patient develops seizures. Which intervention should take priority?
A. Ignore the seizures until the toxin is identified
B. Protect the patient and provide appropriate seizure control and supportive care
C. Force the patient to drink water
D. Induce vomiting immediately regardless of the toxin
B. Protect the patient and provide appropriate seizure control and supportive care