VTNE Emergency and Critical Care Practice Questions 2026 - 20 Free Q&As with Explanations
Prepare for VTNE emergencies with 20 free scenario-based practice questions on triage, CPR and RECOVER guidelines, shock types, toxicology, and critical interventions.
Emergency and critical care accounts for roughly 8% of the VTNE (about 12 questions) and tests fast, accurate decision-making under pressure. Topics include triage, CPR and the RECOVER guidelines, recognizing shock types, and managing common toxins and emergencies. These 20 free scenario-based questions with explanations will help you respond the way an ER technician must.
Domain Quick Facts
- Exam weight: 8% of VTNE (~12 questions)
- Key topics: triage priority, CPR and RECOVER guidelines, shock types, anaphylaxis, GDV, toxicology, urethral obstruction, heat stroke, DIC, pneumothorax
- Difficulty: Medium to Hard - prioritization and recognition under pressure
- Study tip: Always start with airway, breathing, and circulation, and know the antidotes for common toxins.
20 Free VTNE Emergency and Critical Care Practice Questions
Each question below mirrors the real VTNE format: four-option multiple choice with a detailed explanation. Work through them in order, then check your answers.
Question 1 of 20 - Triage
Three patients arrive at once. Which presentation should be triaged as the highest priority?
Correct Answer: B) A cat with airway obstruction and cyanosis
Airway compromise with cyanosis is immediately life-threatening and follows the airway-breathing-circulation priority, so it is seen first. Minor lameness, a small laceration, and a stable recheck are lower priority.
Question 2 of 20 - CPR
During CPR on a medium dog, what is the recommended chest compression rate per the RECOVER guidelines?
Correct Answer: B) 100 to 120 per minute
RECOVER guidelines recommend chest compressions at 100 to 120 per minute for dogs and cats. Slower rates are inadequate and faster rates impair filling and effectiveness.
Question 3 of 20 - CPR
A single rescuer is performing CPR on a dog. What compression-to-ventilation ratio is recommended?
Correct Answer: C) 30:2
For a single rescuer, 30 compressions to 2 ventilations is recommended, with continuous compressions preferred once an airway is secured. The other ratios are not the standard recommendation.
Question 4 of 20 - Shock
A dog presents with severe blood loss from trauma, pale mucous membranes, and weak pulses. Which type of shock is this?
Correct Answer: B) Hypovolemic shock
Significant fluid or blood loss produces hypovolemic shock with pale membranes and weak pulses. Cardiogenic shock is pump failure, distributive shock is vasodilation as in sepsis, and obstructive shock is a physical obstruction to flow.
Question 5 of 20 - Anaphylaxis
A dog develops acute facial swelling, hives, and hypotension after a vaccine. Which drug is the first-line treatment for anaphylaxis?
Correct Answer: A) Epinephrine
Epinephrine is the first-line drug for anaphylaxis because it reverses vasodilation and bronchoconstriction. Furosemide is a diuretic, acepromazine causes vasodilation and is contraindicated, and atropine treats bradycardia.
Question 6 of 20 - GDV
A large-breed dog presents with a distended abdomen, unproductive retching, and signs of shock. Which emergency should you suspect?
Correct Answer: A) Gastric dilatation and volvulus (GDV)
A distended abdomen with unproductive retching and shock in a large-breed dog is classic for GDV, a surgical emergency. Constipation, otitis, and cystitis do not produce this combination of life-threatening signs.
Question 7 of 20 - Toxicology
An owner reports their dog ingested sugar-free gum containing xylitol. Which effects are of greatest concern?
Correct Answer: A) Hypoglycemia and possible liver failure
Xylitol causes a rapid insulin release leading to hypoglycemia and can cause hepatic failure in dogs. The other options understate this life-threatening toxicity.
Question 8 of 20 - Toxicology
A cat is presented after acetaminophen exposure. Which antidote is indicated?
Correct Answer: A) N-acetylcysteine
N-acetylcysteine is the antidote for acetaminophen toxicity and helps protect against methemoglobinemia and liver injury. Vitamin K1 treats anticoagulant rodenticide, atropine treats certain toxins and bradycardia, and naloxone reverses opioids.
Question 9 of 20 - Urethral Obstruction
A male cat presents straining to urinate, vocalizing, and with a large firm bladder. What is the most likely emergency?
Correct Answer: A) Urethral obstruction
A male cat straining with a large firm bladder is likely obstructed, a true emergency that can cause hyperkalemia and death. The other conditions do not explain the urinary signs or bladder findings.
Question 10 of 20 - Heat Stroke
A dog presents collapsed after exercise on a hot day with a temperature of 107°F. Which intervention is appropriate?
Correct Answer: A) Active cooling and IV fluids
Heat stroke is treated with active cooling and IV fluid support while monitoring to avoid overcooling. Warming, withholding fluids, or inducing vomiting would worsen the patient.
Question 11 of 20 - Shock
A patient in shock is being stabilized. Why should acepromazine be avoided in this situation?
Correct Answer: A) It causes vasodilation that can worsen hypotension
Acepromazine causes vasodilation that can dangerously worsen hypotension in a shock patient, so it is contraindicated. It does not raise blood pressure, reverse opioids, or lack circulatory effects.
Question 12 of 20 - DIC
A critically ill patient develops prolonged PT and APTT, low platelets, and low fibrinogen. Which condition does this suggest?
Correct Answer: A) Disseminated intravascular coagulation (DIC)
Prolonged clotting times with consumption of platelets and fibrinogen are classic for DIC, a serious systemic coagulation disorder. These findings are not explained by dehydration, a bruise, or normal coagulation.
Question 13 of 20 - Pneumothorax
A trauma patient has severe respiratory distress with absent lung sounds dorsally and suspected tension pneumothorax. Which intervention is immediately indicated?
Correct Answer: A) Needle thoracocentesis
Tension pneumothorax is relieved by emergency needle thoracocentesis to remove air from the pleural space. Oral antibiotics, a barium study, and withholding oxygen do not address the immediate life threat.
Question 14 of 20 - CPR
During CPR, how often is epinephrine typically administered during the arrest?
Correct Answer: B) Every 3 to 5 minutes
Epinephrine is generally given every 3 to 5 minutes (roughly every other 2-minute cycle) during CPR. More frequent, single-dose, or hourly dosing does not match resuscitation guidelines.
Question 15 of 20 - Triage
How is a patient that is stable now but at risk of rapid deterioration best categorized?
Correct Answer: B) Urgent (stable but deteriorating)
A patient that is currently stable but could decline quickly is triaged as urgent and monitored closely. It is not immediate because it is not currently life-threatening, and it is more serious than non-urgent.
Question 16 of 20 - Toxicology
A dog ingested grapes and raisins. Which organ is at greatest risk?
Correct Answer: A) The kidneys (acute kidney injury)
Grapes and raisins can cause acute kidney injury in dogs, so renal function must be monitored and treated aggressively. The eyes, skin, and thyroid are not the primary targets of this toxicity.
Question 17 of 20 - Toxicology
A dog ingested a large amount of dark chocolate. Which compound is responsible for the toxicity?
Correct Answer: A) Theobromine
Theobromine, a methylxanthine in chocolate, causes the cardiac and neurologic signs of chocolate toxicosis, with darker chocolate being more dangerous. The other substances are not the cause of chocolate toxicity.
Question 18 of 20 - Shock
A septic patient has warm extremities, bright red mucous membranes early on, and low blood pressure from widespread vasodilation. Which shock category is this?
Correct Answer: B) Distributive shock
Sepsis causes distributive shock through widespread vasodilation and maldistribution of blood flow. Hypovolemic shock is from fluid loss, cardiogenic from pump failure, and obstructive from a physical obstruction.
Question 19 of 20 - CPR
When performing chest compressions on a cat or small dog, which technique is appropriate?
Correct Answer: A) Compress over the widest part of the chest or directly over the heart
In cats and small dogs, compressions are delivered over the widest part of the chest or directly over the heart at 100 to 120 per minute. Abdominal-only pressure, slow rates, and avoiding compressions are all incorrect.
Question 20 of 20 - Triage
A patient is brought in unresponsive and not breathing. Following the primary survey, what should you assess and address first?
Correct Answer: A) Airway, then breathing, then circulation
The primary survey follows the airway-breathing-circulation sequence so the most immediately fatal problems are addressed first. Wound care, a full history, and body condition scoring are not the immediate priorities in a non-breathing patient.
How to Score Yourself
- 18-20 correct: Excellent - this domain is a strength
- 14-17 correct: Good - review the questions you missed
- 10-13 correct: Needs work - dedicate extra study time to this domain
- Below 10: Priority domain - start with the study guide below
Key Emergency and Critical Care Topics to Master for the VTNE
Triage and the primary survey follow the airway-breathing-circulation sequence so the most immediately fatal problems are corrected first. Patients are categorized as immediate when life-threatening, urgent when stable but at risk of deterioration, and non-urgent when stable with minor problems.
CPR follows the RECOVER guidelines, with chest compressions at 100 to 120 per minute, a 30:2 compression-to-ventilation ratio for a single rescuer, compressions over the widest part of the chest or heart in small patients, and epinephrine every 3 to 5 minutes.
Recognizing shock type guides treatment. Hypovolemic shock results from fluid loss, distributive shock from vasodilation as in sepsis, cardiogenic shock from pump failure, and obstructive shock from a physical obstruction. Acepromazine is avoided in shock because it worsens vasodilation and hypotension.
Toxicology is high-yield. Xylitol causes hypoglycemia and liver failure, chocolate toxicity is from theobromine, grapes and raisins cause kidney injury, and acetaminophen in cats is treated with N-acetylcysteine. Other emergencies to recognize include GDV, feline urethral obstruction, heat stroke, DIC, and tension pneumothorax.
VTNE Emergency and Critical Care FAQ
How many emergency questions are on the VTNE?
Emergency and critical care makes up about 8% of the VTNE, which is roughly 12 of the 150 scored questions.
What is the CPR compression rate for dogs and cats?
The RECOVER guidelines recommend 100 to 120 chest compressions per minute.
Why is acepromazine avoided in shock?
Acepromazine causes vasodilation that can worsen the hypotension already present in a shock patient.
What is the antidote for acetaminophen toxicity in cats?
N-acetylcysteine is the antidote and helps protect against methemoglobinemia and liver injury.
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