Veterinary Nurse Training
Practical Example

PRACTICAL EXAMINATION EXAMPLE

You will see on these pages three examples of the practical tests which you will have to sit at the end of your second year. If you are unfamiliar with the Royal College of Veterinary Surgeons practical examination format for Part 2 of the Veterinary Nursing course, you are in for a shock. The first thing you will think on reading these examinations is that they are impossible. They all must be done within a six-minute time limit, under examination conditions and in an unfamiliar environment faced by unfamiliar examiners and using unfamiliar equipment. At first sight, some students may feel like giving up.

However, DON'T PANIC. We have been using these examinations in our practice for many years now and they have been successfully mastered by many student nurses just like you. What is certain is that if you haven't prepared for this form of exam before being faced with them in your Part 2 finals, you will have to be very, very lucky or very, very good to pass first time.

It's a bit like doing a computer game for the first time - the monster gets you before you've been playing for five seconds. After a few goes, you work out how to get past that one, only to be wiped out by a bigger one round the corner. You think it's impossible to get past, never mind going down various levels to confront new challenges, and you have to take the game designer's assurances that you can. However, as you practice, you get better and better at it and suddenly you think it's easy rather than difficult. It's the same here - we know it can be done, and by anyone who has the ability to have passed the Part One examinations. Trust us - we designed this game to test you to the limit, and if you hope to pass the RCVS examinations you will have to familiarise yourself with the 'monsters' and the traps which lie in wait for you if you are to give yourself the best chance of success.

Senior nurses supervising these examinations are going to have to do quite a bit of work before their students can sit them. The easiest part is assembling the equipment (and red herrings) required by the Preparation instructions in the answer book. Even then, there may be some equipment which your practice does not possess. You must make every effort to get it - everything here is liable to come up in an RCVS practical exam and if your students are unfamiliar with anything itemised here, they will have reduced their chances of passing by a small amount. However, small amounts add up, and your student needs every percentage point you can arrange in her favour if she is going to reward your efforts and time spent teaching her.

REMEMBER THE GOLDEN RULES

READ THE QUESTION

ANSWER THE QUESTION THEY'VE ASKED

DON'T USE UP VALUABLE TIME WITH UNASKED FOR DETAIL

DON'T PANIC

PRACTICAL EXAMINATION 22 - THEATRE PRACTICE TEST 9

PREPARATION BY THE TRAINING NURSE

Supply a toy dog of about Sheltie size.
Provide a wide variety of different types of bandages and dressings and a pair of scissors.

THEATRE PRACTICE TEST 9

1) Select the materials you would require to bandage this animal's eye.

2) Apply a bandage to this animal's right eye.

3) If this was applied over a prolapsed eyeball, how should you prepare the eye before applying the bandage?

4) What other first aid is possible for an animal with a recently prolapsed eyeball?

ANSWERS

1) Materials:
	Swabs Cotton wool Conforming bandage (5 cm) Cohesive bandage Scissors
2) Technique:
	Swab over eye Cotton wool pad over eye Cotton wool pad under chin Bandage with conforming bandage
		figure of 8 starting over right eye behind left ear down under chin and up behind right ear over forehead in front of left ear but above left eye down under chin and up over right eye behind left ear etc... tie off Cohesive bandage to cover
	Must be neat Must be secure
3) Prolapsed eyeball:
	Clean away any debris using saline wash Cover eye in saline soaked swabs Bandage as in 2) above
4) Other first aid for prolapsed eye:
	Clean away any debris using saline wash Lubricate eye, eg. with KY Jelly or obstetrical lubricant Attempt to reduce prolapse If successful, apply saline soaked swabs and bandage to keep in place

PRACTICAL EXAMINATION 23 - THEATRE PRACTICE TEST 10

PREPARATION BY THE TRAINING NURSE

Provide the instruments listed in the question and several other similar instruments, eg. orthopaedic wire, dental elevator with a scoop tip, a dental rasp and a bone chisel. All instruments should be randomly numbered and labelled.
Provide Anprolene chemical indicator discs, spore strips, Browne's tubes and Bowie-Dick tape.
Provide seal & peel pouches, ordinary autoclave nylon film wrap and a metal drum.

THEATRE PRACTICE TEST 10

1) Select all the indicators which can be used to check sterility in an Anprolene steriliser. If there are any others which are not here, describe them.
What are the advantages and disadvantages of each type of indicator, including any you have described.

2) Select the following instruments and pack them for an operation the next day in appropriate material for Anprolene sterilisation (all in one pack):

3) Why is the use of Anprolene regarded as a hazard under the COSHH regulations?

4) How can the risks of using Anprolene be minimised?

ANSWERS

1) Indicator:
	a) Anprolene indicator tape:
		Advantage:
			Visible, yellow stripes go red on contact with Anprolene
		Disadvantages:
			Seals outside of packs, so can't guarantee penetration of pack Doesn't indicate time contact was maintained, so can't guarantee sterility
	b) Anprolene chemical indicator discs:
		Advantages:
			Placed inside bag, so ensures adequate penetration Visible, usually yellow changing to blue Only changes colour when exposed for long enough to guarantee sterility
		No disadvantages
	c) Spore strip:
		Advantage:
			Confirms 100% sterility
		Disadvantage:
			Time consuming - takes 48 hours to get a result
2) Packing:
	The correct instruments must be selected and packed together in a seal & peel pouch. Don't use the autoclave nylon wrap, as Anprolene doesn't penetrate it efficiently. Don't use a metal drum, as it would have to be lined with drape material and the pack size might exceed the penetrative ability of Anprolene. Anprolene chemical indicator discs must be used and in the correct manner. Spore strips cannot be used for a next-day op as they take 48 hours to give a result. ALWAYS READ THE QUESTION. Air expressed Sealed Dated
3) Hazards:
	Caustic Irritant Potential carcinogen
4) Minimise risk
	Use only in a special cupboard Vented to exterior Not opened during cycle

PRACTICAL EXAMINATION 24 - THEATRE PRACTICE TEST 11

PREPARATION BY THE TRAINING NURSE

Provide examples of all the following. There should be no original wrapping. They may have swaged-on needles attached if you wish, but it is not necessary.
Chromic catgut, polydioxanone, polyglactin, silk, monofilament polyamide, sheathed braided polyamide.
For the same reasons as with instrument selections, each example should have an attached, numbered label.

NB. In the exam, you may get the original wrapping with information printed on it. If you do, make the most of it, it is not cheating or they wouldn't have included it. However, you must be able to recognise suture materials without it and do it quickly.

THEATRE PRACTICE TEST 11

1) Divide this selection of suture materials into absorbable and non-absorbable sutures and name each type of suture material.

2) Arrange the absorbable sutures in order from left to right with the quickest to lose strength on the left and the slowest on the right.

3) Demonstrate the technique required to tie knots in a POLYGLACTIN suture material.

4) Which of the nonabsorbable suture materials would you lay out on a kit for

ANSWERS

1) Absorbable:
	chromic catgut polyglactin (Vicryl) polydioxanone (PDS)
Non-absorbable:
	sheathed braided polyamide monofilament polyamide silk
2) Order of absorbables:
	From left to right in this order: chromic catgut polyglactin (Vicryl) polydioxanone (PDS)
3) Surgeon's knot with at least 6 throws and long ears
4) Non-absorbables:
	a) Monofilament polyamide (tendon repair) b) Silk (enterectomy)