VTNE Pain Management & Analgesia Practice Questions
Pain Management & Analgesia makes up 2 of every 50 questions on a Tigertest VTNE practice test. Here are 8 of the 8 questions on it, each with the answer and the reason.
Updated by the Tigertest team. Based on the AAVSB VTNE content outline approved March 2023. The real exam passes on a scaled score of 425; 70% here is a practice target.
1. Giving an analgesic before the surgical incision is intended to:
- A.Lower the induction dose
- B.Prevent wind-up pain
- C.Replace postoperative doses
- D.Shorten anesthetic recovery
Answer: B. Preemptive analgesia blocks the barrage of pain signals that sensitizes the spinal cord (central sensitization or wind-up), so less drug is needed afterward. It supplements, not replaces, postoperative analgesia.
2. Combining an opioid, an NSAID and a local block for one procedure is an example of:
- A.Dissociative anesthesia
- B.Preemptive sedation
- C.Neuroleptanalgesia
- D.Multimodal analgesia
Answer: D. Multimodal analgesia uses drugs that act at different points on the pain pathway, so each can be given at a lower dose with fewer side effects. Neuroleptanalgesia is an opioid plus a tranquilizer for sedation.
3. Which opioid is a kappa agonist and mu antagonist, suited only to mild pain and lasting about 1 to 2 hours?
- A.Butorphanol
- B.Fentanyl
- C.Hydromorphone
- D.Methadone
Answer: A. Butorphanol gives brief, mild analgesia and can partly reverse a full mu agonist already on board. Hydromorphone, methadone and fentanyl are full mu agonists for moderate to severe pain.
4. An NSAID should be withheld from a dog that:
- A.Weighs less than 5 kilograms
- B.Has a closed limb fracture
- C.Is dehydrated or hypotensive
- D.Is older than 7 years of age
Answer: C. NSAIDs block the prostaglandins that keep renal blood flow up, so a dehydrated or hypotensive patient risks kidney injury. Corticosteroid use, kidney or liver disease and GI ulceration are the other main contraindications.
5. Which opioid is well absorbed across the oral mucosa in cats, allowing transmucosal dosing?
- A.Fentanyl citrate
- B.Tramadol
- C.Buprenorphine
- D.Hydromorphone
Answer: C. Buprenorphine is absorbed through the cheek pouch in cats, which makes it practical for at-home dosing after surgery. It is a partial mu agonist with a slow onset and a duration of 6 to 8 hours.
6. Which local anesthetic provides the longest block, about 4 to 8 hours?
- A.Bupivacaine
- B.Mepivacaine
- C.Procaine
- D.Lidocaine
Answer: A. Bupivacaine has a slow onset (15 to 20 minutes) but lasts 4 to 8 hours; it must never be given IV because of cardiotoxicity. Lidocaine works in minutes but lasts only 1 to 2 hours.
7. A low-dose ketamine infusion is added to an analgesia plan because ketamine:
- A.Inhibits COX enzymes
- B.Is a full mu opioid agonist
- C.Reverses alpha-2 sedation
- D.Blocks NMDA receptors
Answer: D. At sub-anesthetic doses ketamine blocks the NMDA receptor, which reduces central sensitization and wind-up. It is often run as part of a morphine, lidocaine and ketamine (MLK) constant rate infusion.
8. On the Glasgow Composite Measure Pain Scale (short form) for dogs, analgesia is recommended at a score of:
- A.18 of 24 or higher
- B.6 of 24 or higher
- C.2 of 24 or higher
- D.12 of 24 or higher
Answer: B. The intervention level is 6 out of 24, or 5 out of 20 when mobility cannot be assessed. Scoring is repeated at intervals so a rising score is treated before pain becomes hard to control.
Practice all 8 pain management & analgesia questions, and the rest of the 200-question bank, in the free VTNE training sets. Questions you miss come back until you have mastered them.
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