Neonatal and Pediatric Respiratory Care, 5th Edition, Brian K. Walsh Test Bank
Table of Contents
Chapter 1. Fetal Lung Development
Chapter 2. Fetal Gas
... [Show More] Exchange and Circulation
Chapter 3. Antenatal Assessment and High-Risk Delivery
Chapter 4. Examination and Assessment of the Neonatal and Pediatric Patient
Chapter 5. Pulmonary Function Testing and Bedside Pulmonary Mechanics
Chapter 6. Radiographic Assessment
Chapter 7. Pediatric Flexible Bronchoscopy
Chapter 8. Invasive Blood Gas Analysis and Cardiovascular Monitoring
Chapter 9. Noninvasive Monitoring in Neonatal and Pediatric Care
Chapter 10. Oxygen Administration
Chapter 11. Aerosols and Administration of Inhaled Medications
Chapter 12. Airway Clearance Techniques and Hyperinflation Therapy
Chapter 13. Airway Management
Chapter 14. Surfactant Replacement Therapy
Chapter 15. Noninvasive Mechanical Ventilation and Continuous Positive Pressure of the Neonate
Chapter 16. Noninvasive Mechanical Ventilation of the Infant and Child
Chapter 17. Invasive Mechanical Ventilation of the Neonate and Pediatric Patient
Chapter 18. Administration of Gas Mixtures
Chapter 19. Extracorporeal Membrane Oxygenation
Chapter 20. Pharmacology
Chapter 21. Thoracic Organ Transplantation
Chapter 22. Neonatal Pulmonary Disorders
Chapter 23. Surgical Disorders in Childhood that Affect Respiratory Care
Chapter 24. Congenital Cardiac Defects
Chapter 25. Pediatric Sleep-Disordered Breathing
Chapter 26. Pediatric Airway Disorders and Parenchymal Lung Diseases
Chapter 27. Asthma
Chapter 28. Cystic Fibrosis
Chapter 29. Acute Respiratory Distress Syndrome
Chapter 30. Shock
Chapter 31. Pediatric Trauma
Chapter 32. Disorders of the Pleura
Chapter 33. Neurological and Neuromuscular Disorders
Chapter 34. Pediatric Emergencies
Chapter 35. Home Care of the Postpartum Family
Chapter 36. Quality and SafetyChapter 1: Fetal Lung Development
Walsh: Neonatal & Pediatric Respiratory Care 5th Edition Test Bank (2020)
MULTIPLE CHOICE
1. Which of the following phases of human lung development is characterized by the formation
of a capillary network around airway passages?
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: D
The canalicular phase follows the pseudoglandular phase, lasting from approximately 17
weeks to 26 weeks of gestation. This phase is so named because of the appearance of vascular
channels, or capillaries, which begin to grow by forming a capillary network around the air
passages. During the pseudoglandular stage, which begins at day 52 and extends to week 16
of gestation, the airway system subdivides extensively and the conducting airway system
develops, ending with the terminal bronchioles. The saccular stage of development, which
takes place from weeks 29 to 36 of gestation, is characterized by the development of sacs that
later become alveoli. During the saccular phase, a tremendous increase in the potential gasexchanging surface area occurs. The distinction between the saccular stage and the alveolar
stage is arbitrary. The alveolar stage stretches from 39 weeks of gestation to term. This stage
is represented by the establishment of alveoli.
REF: pp. 3-5
2. Regarding postnatal lung growth, by approximately what age do most of the alveoli that will
be present in the lungs for life develop?
a. 6 months
b. 1 year
c. 1.5 years
d. 2 years
ANS: C
Most of the postnatal formation of alveoli in the infant occurs over the first 1.5 years of life.
At 2 years of age, the number of alveoli varies substantially among individuals. After 2 years
of age, males have more alveoli than do females. After alveolar multiplication ends, the
alveoli continue to increase in size until thoracic growth is completed.
REF: p. 6
3. The respiratory therapist is evaluating a newborn with mild respiratory distress due to tracheal
stenosis. During which period of lung development did this problem develop?a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS: A
The initial structures of the pulmonary tree develop during the embryonal stage. Errors in
development during this time may result in laryngeal, tracheal, or esophageal atresia or
stenosis. Pulmonary hypoplasia, an incomplete development of the lungs characterized by an
abnormally low number and/or size of bronchopulmonary segments and/or alveoli, can
develop during the pseudoglandular phase. If the fetus is born during the canalicular phase
(i.e., prematurely), severe respiratory distress can be expected because the inadequately
developed airways, along with insufficient and immature surfactant production by alveolar
type II cells, gives rise to the constellation of problems known as infant respiratory distress
syndrome.
REF: p. 6
4. Which of the following mechanisms is (are) responsible for the possible association between
oligohydramnios and lung hypoplasia?
I. Abnormal carbohydrate metabolism
II. Mechanical restriction of the chest wall
III. Interference with fetal breathing
IV. Failure to produce fetal lung liquid
a. I and III only
b. II and III only
c. I, II, and IV only
d. II, III, and IV only
ANS: D
Oligohydramnios, a reduced quantity of amniotic fluid present for an extended period of time,
with or without renal anomalies, is associated with lung hypoplasia. The mechanisms by
which amniotic fluid volume influences lung growth remain unclear. Possible explanations for
reduced quantity of amniotic fluid include mechanical restriction of the chest wall,
interference with fetal breathing, or failure to produce fetal lung liquid. These clinical and
experimental observations possibly point to a common denominator, lung stretch, as being a
major growth stimulant.
REF: pp. 6-7
5. What is the purpose of the substance secreted by the type II pneumocyte?
a. To increase the gas exchange surface area
b. To reduce surface tension
c. To maintain lung elasticity
d. To preserve the volume of the amniotic fluidANS: B
The primary role of mammalian surfactant is to lower the surface tension within the alveolus,
specifically at the air–liquid interface. This allows the delicate structure of the alveolus to
expand when filled with air. Without surfactant, the alveolus remains collapsed because of the
high surface tension of the moist alveolar surface. Surfactant is composed predominantly of
an intricate blend of phospholipids, neutral lipids, and proteins.
REF: p. 8
6. Which of the following tests of the amniotic fluid have been shown to be sensitive indicators
of lung maturity?
a. Levels of prednisone
b. Levels of epidermal growth factor
c. Levels of prostaglandins
d. Levels of phosphatidylglycerol and phosphatidylcholine
ANS: D
Of clinical relevance during late gestation, analysis of amniotic fluid for the concentration of
phosphatidylglycerol and phosphatidylcholine has been shown to be a sensitive indicator of
the state of fetal lung maturity.
REF: p. 8Chapter 2: Fetal Gas Exchange and Circulation
Test Bank
MULTIPLE CHOICE
1. Which of the following embryonic germ layers gives formation to the respiratory system?
a. Endoderm
b. Mesoderm
c. Ectoderm
d. Periderm
ANS: A
The respiratory system—pharynx, lungs, and epithelial lining of the trachea and lungs—
originates in the endoderm. Refer to Box 2-1 in the textbook to see the list of various tissue
systems found in the three embryonic layers.
REF: p. 13
2. What is the function of Wharton’s jelly inside the umbilical cord?
a. To help provide nutrition to the fetus
b. To prevent the vessels inside the cord from kinking
c. To help protect the fetus
d. To regulate the temperature between the fetus and the mother
ANS: B
Wharton's jelly, a gelatinous substance inside the umbilical cord, helps protect the vessels of
the fetus and may prevent the cord from kinking.
REF: p. 13
3. Which of the following organs is considered to be the first to form?
a. Heart
b. Brain
c. Lungs
d. Kidneys
ANS: A
The heart is considered to be the first complete organ formed. By 8 weeks of gestation, the
normal fetal heart is fully functional, complete with all chambers, valves, and major vessels.
REF: p. 14
4. A pregnant woman is coming for an early prenatal evaluation and wants to know if she can
listen to the baby’s heartbeat. How early can the fetal heartbeat be detected?
a. Day 8
b. Day [Show Less]
