VTNE EMERGENCY AND CRITICAL CARE EXAM
COMPREHENSIVE PRACTICE
2026/2027 EDITION • 200 Questions • Full Explanatory Rationales
Aligned with the current American Association of Veterinary State Boards (AAVSB) VTNE Test Plan and evidence-based
emergency and critical care veterinary technology competencies. Covers triage, shock, cardiopulmonary resuscitation,
respiratory and neurologic crises, surgical emergencies, toxicology, emergency procedures, and exotic species.
Domain Section Questions Core Competency Focus
1. Triage & Initial Assessment 25 Qs (Q1–Q25) ABCs, primary/secondary survey, triage categories, vital
signs
2. Shock & Fluid Therapy 30 Qs (Q26–Q55) Shock classification, crystalloids, colloids, hypertonic saline,
CVP
3. Cardiopulmonary Resuscitation 25 Qs (Q56–Q80) RECOVER guidelines, compression rates, drug routes,
arrest rhythms
4. Respiratory Emergencies 25 Qs (Q81–Q105) Pneumothorax, flail chest, feline asthma, blood gases,
oxygen
5. Neurologic Emergencies 15 Qs (Q106–Q120) Status epilepticus, TBI, MGCS, Cushing's reflex, spinal
lesions
6. Traumatic & Surgical Emergencies 20 Qs (Q121–Q140) Wound healing, hemoabdomen, GDV, bite wounds, burn
care
7. Toxicologic & Metabolic Crises 20 Qs (Q141–Q160) Emesis contraindications, permethrin, rodenticides, lilies,
DKA
8. Emergency Procedures & 20 Qs (Q161–Q180) Abdominocentesis, IO lines, C-section, pericardiocentesis,
Techniques tube care
9. Special Species & Ocular 10 Qs (Q181–Q190) Avian PTFE, ferret insulinoma, rabbit GI stasis, proptosis,
Emergencies glaucoma
10. Integrated Clinical Scenarios 10 Qs (Q191–Q200) Multi-system complex case synthesis and prioritization
EXAM SPECIFICATIONS & INSTRUCTIONS
• Cognitive Distribution: 30% Recall (definitions, normal values, drug dosages), 50% Application (clinical judgment, priority
intervention), 20% Analysis (complex data interpretation, differentiating shock types).
• Format: 200 Multiple-Choice Questions (A–D, one correct answer marked [CORRECT]) followed by official Answer and
Rationale.
• Simulated Test Strategy: Answer independently without looking at the marked key first, then review every clinical rationale to
reinforce critical care concepts.
Turn the page to begin the examination. Maintain clinical focus throughout.
VTNE Emergency and Critical Care Practice Exam (2026/2027 Edition) | Page 1
,Section 1: Triage & Initial Patient Assessment – Triage, Primary Survey,
Stabilization (25 questions)
Assessment of airway, breathing, circulation, mentation, triage categories, vital signs, and immediate stabilization.
Q1: Which of the following best defines the primary purpose of veterinary triage in an emergency setting?
A. Sorting patients rapidly based on the urgency of their need for immediate medical intervention [CORRECT]
B. Diagnosing underlying chronic medical conditions before starting therapy
C. Completing a full secondary survey and billing estimate before treatment
D. Administering broad-spectrum antibiotics to all incoming trauma patients
Correct Answer: A
Rationale: Triage rapidly prioritizes patients according to clinical urgency to save lives; diagnosing chronic disease, billing, and
routine antibiotics are not primary triage goals.
Q2: Four patients arrive simultaneously at an emergency clinic. Which patient must the veterinary technician attend
to first?
A. A 5-year-old Golden Retriever with a bleeding paw laceration
B. A 3-year-old cat in severe respiratory distress with cyanotic mucous membranes [CORRECT]
C. A 2-year-old Beagle with non-productive retching and a soft, non-painful abdomen
D. A 7-year-old cat with a 2-day history of anorexia and lethargy
Correct Answer: B
Rationale: Respiratory failure with cyanosis is an immediate life threat requiring instant oxygenation and stabilization; stable
lacerations, mild anorexia, and non-emergent presentations are lower priority.
Q3: What are the three core physiological systems evaluated during the initial primary emergency survey (ABCs)?
A. Gastrointestinal, musculoskeletal, and integumentary systems
B. Renal, hepatic, and endocrine systems
C. Cardiovascular, respiratory, and central nervous systems [CORRECT]
D. Ophthalmic, reproductive, and lymphatic systems
Correct Answer: C
Rationale: The primary survey assesses Airway/Breathing (respiratory), Circulation (cardiovascular), and Mentation/Disability
(central nervous system); non-vital organ systems are evaluated during the secondary survey.
Q4: A veterinary technician assesses a trauma patient and notes pale-gray mucous membranes, a capillary refill
time (CRT) of 3.5 seconds, and weak femoral pulses. These findings primarily indicate:
A. Adequate tissue perfusion but severe hypothermia
B. Primary neurologic dysfunction without vascular involvement
C. Normal physiological compensation following excitement
D. Severe compromise of peripheral perfusion and cardiovascular shock [CORRECT]
Correct Answer: D
Rationale: Pale/gray membranes, prolonged CRT (>2 sec), and weak pulses are classic signs of poor tissue perfusion and shock;
they do not reflect normal excitement or isolated neurologic disease.
Q5: Which level of consciousness is characterized by a patient that is unconscious, completely unresponsive to all
environmental stimuli including noxious/painful stimuli?
A. Comatose [CORRECT]
B. Stuporous
C. Obtunded
D. Demented
Correct Answer: A
VTNE Emergency and Critical Care Practice Exam (2026/2027 Edition) | Page 2
, Rationale: Coma is complete unresponsiveness even to noxious stimuli; stuporous patients respond only to painful stimuli, and
obtunded patients are dull but rousable.
Q6: When should a comprehensive secondary survey (complete head-to-toe physical examination) be performed on
an emergency patient?
A. Immediately upon arrival before establishing an airway or vascular access
B. Only after the primary survey is complete and immediate life-threatening abnormalities are stabilized [CORRECT]
C. Prior to performing any point-of-care triage ultrasound (POCUS)
D. Concurrently with emergency cardiopulmonary resuscitation
Correct Answer: B
Rationale: The secondary survey is conducted only after the patient's airway, breathing, and circulatory life threats have been
identified and stabilized; doing it earlier delays vital resuscitation.
Q7: An owner calls the emergency hospital stating their 6-year-old male Great Dane is pacing, salivating profusely,
and attempting to vomit without producing anything. What is the most appropriate telephone triage advice?
A. Administer 3% hydrogen peroxide orally to induce emesis immediately
B. Withhold food for 12 hours and monitor if the pacing subsides
C. Transport the dog to the emergency hospital immediately, as this is a life-threatening emergency (suspected GDV)
[CORRECT]
D. Administer an over-the-counter antacid and call back in the morning
Correct Answer: C
Rationale: Unproductive retching, restlessness, and deep-chested conformation strongly suggest Gastric Dilatation-Volvulus
(GDV), a surgical emergency requiring immediate transport; emetics are contraindicated.
Q8: An owner calls regarding a 4-year-old male neutered domestic shorthair cat that is vocalizing in the litter box
and straining to urinate for the past 6 hours. What instruction must the technician provide?
A. Switch the cat to canned food and monitor urination overnight
B. Express the cat's bladder manually at home before driving in
C. Give pediatric acetaminophen for discomfort and recheck in 24 hours
D. Bring the cat to the emergency clinic immediately because urethral obstruction can cause fatal hyperkalemia and
post-renal azotemia within 24–48 hours [CORRECT]
Correct Answer: D
Rationale: Feline urethral obstruction is a life-threatening emergency leading to severe hyperkalemia, cardiac arrest, and uremia;
acetaminophen is toxic to cats and manual expression risks bladder rupture.
Q9: During triage, a cat presents with extended neck, abducted elbows, open-mouth breathing, and abdominal
effort. This posture is termed:
A. Orthopneic posture [CORRECT]
B. Decerebellate posture
C. Schiff-Sherrington posture
D. Kyphosis posture
Correct Answer: A
Rationale: Orthopneic positioning (extended neck, abducted elbows, open mouth) maximizes airway diameter in respiratory
distress; Schiff-Sherrington and decerebellate are distinct neurologic postures.
Q10: While auscultating a canine trauma patient's heart while simultaneously palpating the femoral pulse, the
technician notes fewer femoral pulses than auscultated heartbeats. This finding is documented as:
A. Normal respiratory sinus arrhythmia
B. Pulse deficit, indicating an asynchronous cardiac arrhythmia [CORRECT]
C. Hyperdynamic water-hammer pulse
D. Paradoxical pulse pressure
VTNE Emergency and Critical Care Practice Exam (2026/2027 Edition) | Page 3
, Correct Answer: B
Rationale: B pulse deficit occurs when cardiac contractions fail to generate an effective stroke volume/perfusion wave, typical of
arrhythmias such as VPCs; it is not a normal sinus variation.
Q11: Which physical exam parameter is most reliable for distinguishing intravascular volume deficit
(hypoperfusion/shock) from interstitial dehydration?
A. Skin turgor test and corneal moisture
B. Body weight changes and dry feces
C. Capillary refill time, mucous membrane color, and pulse quality [CORRECT]
D. Urine specific gravity alone
Correct Answer: C
Rationale: Perfusion parameters (CRT, MM color, pulse quality, extremity temp) reflect intravascular volume; skin turgor and
sunken globes primarily reflect interstitial fluid loss.
Q12: A triage category system commonly assigns patients to 'Resuscitation / Immediate' (Red), 'Emergent'
(Orange/Yellow), 'Urgent' (Green), and 'Non-urgent' (Blue/White). Which patient belongs in the 'Resuscitation /
Immediate' category?
A. A dog with a closed radial fracture and normal vital signs
B. A cat with chronic flea allergy dermatitis and excoriations
C. A dog with a superficial skin tear and mild limping
D. A cat in cardiopulmonary arrest or agonal breathing [CORRECT]
Correct Answer: D
Rationale: Cardiopulmonary arrest and agonal respiration require immediate, zero-delay resuscitation; fractures, superficial
wounds, and chronic dermatitis are urgent or non-urgent.
Q13: In feline emergency triage, the 'feline shock triad' is a critical clinical syndrome characterized by:
A. Hypothermia, bradycardia, and hypotension [CORRECT]
B. Hypertension, tachycardia, and hyperthermia
C. Hyperglycemia, tachypnea, and bounding pulses
D. Polyuria, polydipsia, and stridor
Correct Answer: A
Rationale: Cats in hypovolemic/distributive shock frequently present with the triad of hypothermia (<99°F), bradycardia (<140
bpm), and hypotension, unlike dogs which typically exhibit tachycardia.
Q14: What are the four rapid point-of-care laboratory tests commonly referred to as the emergency 'Big Four'
database in veterinary triage?
A. ALT, ALP, Total Bilirubin, and Albumin
B. Packed Cell Volume (PCV), Total Solids (TS), Blood Glucose (BG), and Blood Urea Nitrogen (BUN / Azo stick)
[CORRECT]
C. Urine Cortisol, Bile Acids, T4, and Lipase
D. Troponin, Amylase, Creatine Kinase, and Fibrinogen
Correct Answer: B
Rationale: The emergency 'Big Four' comprises PCV, TS, BG, and BUN (or Lactate), providing immediate essential data on
oxygen carrying capacity, plasma protein/hydration, glycemic state, and renal function.
Q15: During the primary survey of a dog hit by a car, the technician observes loud, high-pitched inspiratory sounds
localized to the upper cervical region. This sound is best termed:
A. Crackles (rales)
B. Wheezes (rhonchi)
C. Stridor [CORRECT]
D. Stertor
VTNE Emergency and Critical Care Practice Exam (2026/2027 Edition) | Page 4
COMPREHENSIVE PRACTICE
2026/2027 EDITION • 200 Questions • Full Explanatory Rationales
Aligned with the current American Association of Veterinary State Boards (AAVSB) VTNE Test Plan and evidence-based
emergency and critical care veterinary technology competencies. Covers triage, shock, cardiopulmonary resuscitation,
respiratory and neurologic crises, surgical emergencies, toxicology, emergency procedures, and exotic species.
Domain Section Questions Core Competency Focus
1. Triage & Initial Assessment 25 Qs (Q1–Q25) ABCs, primary/secondary survey, triage categories, vital
signs
2. Shock & Fluid Therapy 30 Qs (Q26–Q55) Shock classification, crystalloids, colloids, hypertonic saline,
CVP
3. Cardiopulmonary Resuscitation 25 Qs (Q56–Q80) RECOVER guidelines, compression rates, drug routes,
arrest rhythms
4. Respiratory Emergencies 25 Qs (Q81–Q105) Pneumothorax, flail chest, feline asthma, blood gases,
oxygen
5. Neurologic Emergencies 15 Qs (Q106–Q120) Status epilepticus, TBI, MGCS, Cushing's reflex, spinal
lesions
6. Traumatic & Surgical Emergencies 20 Qs (Q121–Q140) Wound healing, hemoabdomen, GDV, bite wounds, burn
care
7. Toxicologic & Metabolic Crises 20 Qs (Q141–Q160) Emesis contraindications, permethrin, rodenticides, lilies,
DKA
8. Emergency Procedures & 20 Qs (Q161–Q180) Abdominocentesis, IO lines, C-section, pericardiocentesis,
Techniques tube care
9. Special Species & Ocular 10 Qs (Q181–Q190) Avian PTFE, ferret insulinoma, rabbit GI stasis, proptosis,
Emergencies glaucoma
10. Integrated Clinical Scenarios 10 Qs (Q191–Q200) Multi-system complex case synthesis and prioritization
EXAM SPECIFICATIONS & INSTRUCTIONS
• Cognitive Distribution: 30% Recall (definitions, normal values, drug dosages), 50% Application (clinical judgment, priority
intervention), 20% Analysis (complex data interpretation, differentiating shock types).
• Format: 200 Multiple-Choice Questions (A–D, one correct answer marked [CORRECT]) followed by official Answer and
Rationale.
• Simulated Test Strategy: Answer independently without looking at the marked key first, then review every clinical rationale to
reinforce critical care concepts.
Turn the page to begin the examination. Maintain clinical focus throughout.
VTNE Emergency and Critical Care Practice Exam (2026/2027 Edition) | Page 1
,Section 1: Triage & Initial Patient Assessment – Triage, Primary Survey,
Stabilization (25 questions)
Assessment of airway, breathing, circulation, mentation, triage categories, vital signs, and immediate stabilization.
Q1: Which of the following best defines the primary purpose of veterinary triage in an emergency setting?
A. Sorting patients rapidly based on the urgency of their need for immediate medical intervention [CORRECT]
B. Diagnosing underlying chronic medical conditions before starting therapy
C. Completing a full secondary survey and billing estimate before treatment
D. Administering broad-spectrum antibiotics to all incoming trauma patients
Correct Answer: A
Rationale: Triage rapidly prioritizes patients according to clinical urgency to save lives; diagnosing chronic disease, billing, and
routine antibiotics are not primary triage goals.
Q2: Four patients arrive simultaneously at an emergency clinic. Which patient must the veterinary technician attend
to first?
A. A 5-year-old Golden Retriever with a bleeding paw laceration
B. A 3-year-old cat in severe respiratory distress with cyanotic mucous membranes [CORRECT]
C. A 2-year-old Beagle with non-productive retching and a soft, non-painful abdomen
D. A 7-year-old cat with a 2-day history of anorexia and lethargy
Correct Answer: B
Rationale: Respiratory failure with cyanosis is an immediate life threat requiring instant oxygenation and stabilization; stable
lacerations, mild anorexia, and non-emergent presentations are lower priority.
Q3: What are the three core physiological systems evaluated during the initial primary emergency survey (ABCs)?
A. Gastrointestinal, musculoskeletal, and integumentary systems
B. Renal, hepatic, and endocrine systems
C. Cardiovascular, respiratory, and central nervous systems [CORRECT]
D. Ophthalmic, reproductive, and lymphatic systems
Correct Answer: C
Rationale: The primary survey assesses Airway/Breathing (respiratory), Circulation (cardiovascular), and Mentation/Disability
(central nervous system); non-vital organ systems are evaluated during the secondary survey.
Q4: A veterinary technician assesses a trauma patient and notes pale-gray mucous membranes, a capillary refill
time (CRT) of 3.5 seconds, and weak femoral pulses. These findings primarily indicate:
A. Adequate tissue perfusion but severe hypothermia
B. Primary neurologic dysfunction without vascular involvement
C. Normal physiological compensation following excitement
D. Severe compromise of peripheral perfusion and cardiovascular shock [CORRECT]
Correct Answer: D
Rationale: Pale/gray membranes, prolonged CRT (>2 sec), and weak pulses are classic signs of poor tissue perfusion and shock;
they do not reflect normal excitement or isolated neurologic disease.
Q5: Which level of consciousness is characterized by a patient that is unconscious, completely unresponsive to all
environmental stimuli including noxious/painful stimuli?
A. Comatose [CORRECT]
B. Stuporous
C. Obtunded
D. Demented
Correct Answer: A
VTNE Emergency and Critical Care Practice Exam (2026/2027 Edition) | Page 2
, Rationale: Coma is complete unresponsiveness even to noxious stimuli; stuporous patients respond only to painful stimuli, and
obtunded patients are dull but rousable.
Q6: When should a comprehensive secondary survey (complete head-to-toe physical examination) be performed on
an emergency patient?
A. Immediately upon arrival before establishing an airway or vascular access
B. Only after the primary survey is complete and immediate life-threatening abnormalities are stabilized [CORRECT]
C. Prior to performing any point-of-care triage ultrasound (POCUS)
D. Concurrently with emergency cardiopulmonary resuscitation
Correct Answer: B
Rationale: The secondary survey is conducted only after the patient's airway, breathing, and circulatory life threats have been
identified and stabilized; doing it earlier delays vital resuscitation.
Q7: An owner calls the emergency hospital stating their 6-year-old male Great Dane is pacing, salivating profusely,
and attempting to vomit without producing anything. What is the most appropriate telephone triage advice?
A. Administer 3% hydrogen peroxide orally to induce emesis immediately
B. Withhold food for 12 hours and monitor if the pacing subsides
C. Transport the dog to the emergency hospital immediately, as this is a life-threatening emergency (suspected GDV)
[CORRECT]
D. Administer an over-the-counter antacid and call back in the morning
Correct Answer: C
Rationale: Unproductive retching, restlessness, and deep-chested conformation strongly suggest Gastric Dilatation-Volvulus
(GDV), a surgical emergency requiring immediate transport; emetics are contraindicated.
Q8: An owner calls regarding a 4-year-old male neutered domestic shorthair cat that is vocalizing in the litter box
and straining to urinate for the past 6 hours. What instruction must the technician provide?
A. Switch the cat to canned food and monitor urination overnight
B. Express the cat's bladder manually at home before driving in
C. Give pediatric acetaminophen for discomfort and recheck in 24 hours
D. Bring the cat to the emergency clinic immediately because urethral obstruction can cause fatal hyperkalemia and
post-renal azotemia within 24–48 hours [CORRECT]
Correct Answer: D
Rationale: Feline urethral obstruction is a life-threatening emergency leading to severe hyperkalemia, cardiac arrest, and uremia;
acetaminophen is toxic to cats and manual expression risks bladder rupture.
Q9: During triage, a cat presents with extended neck, abducted elbows, open-mouth breathing, and abdominal
effort. This posture is termed:
A. Orthopneic posture [CORRECT]
B. Decerebellate posture
C. Schiff-Sherrington posture
D. Kyphosis posture
Correct Answer: A
Rationale: Orthopneic positioning (extended neck, abducted elbows, open mouth) maximizes airway diameter in respiratory
distress; Schiff-Sherrington and decerebellate are distinct neurologic postures.
Q10: While auscultating a canine trauma patient's heart while simultaneously palpating the femoral pulse, the
technician notes fewer femoral pulses than auscultated heartbeats. This finding is documented as:
A. Normal respiratory sinus arrhythmia
B. Pulse deficit, indicating an asynchronous cardiac arrhythmia [CORRECT]
C. Hyperdynamic water-hammer pulse
D. Paradoxical pulse pressure
VTNE Emergency and Critical Care Practice Exam (2026/2027 Edition) | Page 3
, Correct Answer: B
Rationale: B pulse deficit occurs when cardiac contractions fail to generate an effective stroke volume/perfusion wave, typical of
arrhythmias such as VPCs; it is not a normal sinus variation.
Q11: Which physical exam parameter is most reliable for distinguishing intravascular volume deficit
(hypoperfusion/shock) from interstitial dehydration?
A. Skin turgor test and corneal moisture
B. Body weight changes and dry feces
C. Capillary refill time, mucous membrane color, and pulse quality [CORRECT]
D. Urine specific gravity alone
Correct Answer: C
Rationale: Perfusion parameters (CRT, MM color, pulse quality, extremity temp) reflect intravascular volume; skin turgor and
sunken globes primarily reflect interstitial fluid loss.
Q12: A triage category system commonly assigns patients to 'Resuscitation / Immediate' (Red), 'Emergent'
(Orange/Yellow), 'Urgent' (Green), and 'Non-urgent' (Blue/White). Which patient belongs in the 'Resuscitation /
Immediate' category?
A. A dog with a closed radial fracture and normal vital signs
B. A cat with chronic flea allergy dermatitis and excoriations
C. A dog with a superficial skin tear and mild limping
D. A cat in cardiopulmonary arrest or agonal breathing [CORRECT]
Correct Answer: D
Rationale: Cardiopulmonary arrest and agonal respiration require immediate, zero-delay resuscitation; fractures, superficial
wounds, and chronic dermatitis are urgent or non-urgent.
Q13: In feline emergency triage, the 'feline shock triad' is a critical clinical syndrome characterized by:
A. Hypothermia, bradycardia, and hypotension [CORRECT]
B. Hypertension, tachycardia, and hyperthermia
C. Hyperglycemia, tachypnea, and bounding pulses
D. Polyuria, polydipsia, and stridor
Correct Answer: A
Rationale: Cats in hypovolemic/distributive shock frequently present with the triad of hypothermia (<99°F), bradycardia (<140
bpm), and hypotension, unlike dogs which typically exhibit tachycardia.
Q14: What are the four rapid point-of-care laboratory tests commonly referred to as the emergency 'Big Four'
database in veterinary triage?
A. ALT, ALP, Total Bilirubin, and Albumin
B. Packed Cell Volume (PCV), Total Solids (TS), Blood Glucose (BG), and Blood Urea Nitrogen (BUN / Azo stick)
[CORRECT]
C. Urine Cortisol, Bile Acids, T4, and Lipase
D. Troponin, Amylase, Creatine Kinase, and Fibrinogen
Correct Answer: B
Rationale: The emergency 'Big Four' comprises PCV, TS, BG, and BUN (or Lactate), providing immediate essential data on
oxygen carrying capacity, plasma protein/hydration, glycemic state, and renal function.
Q15: During the primary survey of a dog hit by a car, the technician observes loud, high-pitched inspiratory sounds
localized to the upper cervical region. This sound is best termed:
A. Crackles (rales)
B. Wheezes (rhonchi)
C. Stridor [CORRECT]
D. Stertor
VTNE Emergency and Critical Care Practice Exam (2026/2027 Edition) | Page 4
