National Licensure Examination for Veterinarians (NLEV) · Nepal · Nepal Veterinary Council (NVC Act 2055 BS)
Original practice questions written to the published syllabus · not past papersThe first hour of an emergency: triage, shock, CPR, fluids and blood, poisoning and trauma, oxygen, and humane euthanasia.
In the exams: AVMA COE clinical competency on emergencies; EAEVE Day One competences on emergencies and euthanasia; NAVLE clinical practice
How our questions for National Licensure Examination for Veterinarians spread across the units of Emergency & Critical Care, Fluid Therapy and Euthanasia. Difficulty: 13 easy, 10 medium, 1 hard.
| Fluid therapy | 4 | |
| Cardiopulmonary resuscitation | 3 | |
| Blood transfusion | 3 | |
| Trauma | 3 | |
| Humane euthanasia | 3 | |
| Triage | 2 | |
| Shock | 2 | |
| Toxicological emergencies | 2 | |
| Oxygen therapy | 2 |
Choose an answer, then open the working. Each explanation says why the right answer is right and why the others are not.
A dog with head trauma has a modified Glasgow Coma Scale score of 8. How is this interpreted?
A. A low score on a 3-18 scale, indicating a poor prognosis
The modified Glasgow Coma Scale adds motor activity, brainstem reflexes and level of consciousness, each scored 1-6, for a total of 3-18; lower is worse, and a score of 8 is associated with a poor prognosis. Students often reverse the direction because the Animal Trauma Triage score runs the other way (higher is worse).
Further reading: Silverstein & Hopper, Small Animal Critical Care Medicine; BSAVA Manual of Canine and Feline Emergency and Critical Care
Using 80 x BW(kg)^0.75 mL/day, what is the hourly maintenance rate for a 4 kg cat?
A. About 9 mL/h
4^0.75 = 2.83; 80 x 2.83 = 226 mL/day; /24 = about 9.4 mL/h. 226 mL/h confuses daily with hourly; 16 mL/h comes from using the canine 132 factor; 13 mL/h from 80 x 4 without the exponent.
Further reading: DiBartola, Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice; 2013 AAHA/AAFP Fluid Therapy Guidelines
What is the widely taught maximum rate of intravenous potassium supplementation?
D. 0.5 mmol/kg/h
Potassium should not exceed about 0.5 mmol (mEq)/kg/h because faster infusion risks fatal arrhythmia. For this reason potassium-supplemented fluid is never used for boluses.
Further reading: DiBartola, Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice; 2013 AAHA/AAFP Fluid Therapy Guidelines
A DEA 1-negative dog that has never been transfused receives DEA 1-positive blood. What is expected?
C. Usually no acute haemolysis, but the dog may become sensitised to DEA 1
Dogs lack clinically important natural antibodies to DEA 1, so a first mismatched transfusion rarely causes acute haemolysis, but it sensitises the recipient so that a later mismatched transfusion can. Fatal haemolysis at first exposure is the feline type B pattern.
Further reading: Yagi & Holowaychuk, Manual of Veterinary Transfusion Medicine and Blood Banking
Within what time should a unit of blood usually be completed once the transfusion has started?
D. About 4 hours
Blood is started slowly while the patient is watched, then given so the unit finishes within about 4 hours, to limit bacterial growth at room temperature. Ten minutes risks volume overload and missed reactions.
Further reading: Yagi & Holowaychuk, Manual of Veterinary Transfusion Medicine and Blood Banking
A 20 kg dog ate chewing gum containing a total of 3 g of xylitol. Using commonly cited thresholds (hypoglycaemia above about 0.1 g/kg, liver failure above about 0.5 g/kg), what risk applies?
C. 0.15 g/kg: hypoglycaemia risk, below the liver threshold
3 g / 20 kg = 0.15 g/kg: above the hypoglycaemic threshold but below the hepatotoxic one, so glucose monitoring and dextrose are needed. 1.5 g/kg and 0.015 g/kg are decimal slips.
Further reading: Peterson & Talcott, Small Animal Toxicology; Gupta, Veterinary Toxicology; Merck Veterinary Manual
Which form of vitamin K is used to treat anticoagulant rodenticide poisoning?
A. Vitamin K1 (phytonadione)
Vitamin K1 is effective, given for several weeks for second-generation compounds with a prothrombin time check 48-72 hours after the last dose. Vitamin K3 is ineffective; protamine reverses heparin, not vitamin K antagonists.
Further reading: Peterson & Talcott, Small Animal Toxicology; Gupta, Veterinary Toxicology; Merck Veterinary Manual
How do pulmonary contusions typically behave after blunt chest trauma?
B. They often worsen over the first 24-48 hours before improving
Contusions are the commonest thoracic injury in trauma; haemorrhage and oedema progress so that radiographic and clinical signs often worsen for 24-48 hours. A dog that looks stable on arrival must therefore be monitored.
Further reading: Silverstein & Hopper, Small Animal Critical Care Medicine, trauma chapters
A dog hit by a car breathes rapidly and shallowly with quiet lung sounds dorsally. What is the most likely problem?
A. Pneumothorax
A rapid, shallow, restrictive pattern with quiet dorsal lung sounds points to air in the pleural space. Laryngeal paralysis and tracheal collapse cause noisy upper-airway breathing; lower airway disease causes expiratory effort and wheezes.
Further reading: Silverstein & Hopper, Small Animal Critical Care Medicine, trauma chapters
A conscious feral kitten cannot be restrained for intravenous injection. Which route for barbiturate euthanasia is acceptable?
A. Intraperitoneal injection, accepting a slower onset
Intraperitoneal barbiturate is acceptable in small animals when IV access is impractical, though onset is slower. Intracardiac injection requires unconsciousness, and potassium chloride requires general anaesthesia.
Further reading: AVMA Guidelines for the Euthanasia of Animals, 2020 Edition
Ten here, 24 in the app. The Laisha app has every practice question we have written to National Licensure Examination for Veterinarians in this subject, marked as you go, with timed papers, a jump-to-unanswered list and a certificate when you pass at 70 per cent.
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