NEONATAL AND PEDIATRIC
RESPIRATORY CARE 5TH EDITION WALSH
TEST BANK EXAMINATION TEST 2026
COMPLETE QUESTIONS AND SOLUTIONS
⩥ What is a classic chest x-ray finding in RDS? Answer: A classic chest
x-ray finding in RDS is a ground-glass appearance with air
bronchograms.
⩥ What is the role of surfactant therapy in RDS? Answer: Surfactant
therapy reduces surface tension in the alveoli, improving lung function
and oxygenation.
⩥ List two prevention strategies for neonatal RDS. Answer: Two
prevention strategies for neonatal RDS include administering antenatal
corticosteroids and avoiding preterm birth.
⩥ What factors contribute to the pathogenesis of bronchopulmonary
dysplasia (BPD)? Answer: Factors contributing to BPD include
mechanical ventilation, oxygen toxicity, and inflammation.
⩥ How is BPD severity classified at 36 weeks postmenstrual age
(PMA)? Answer: BPD severity is classified as mild, moderate, or severe
based on the need for respiratory support.
,⩥ List two strategies to prevent BPD in extremely preterm infants.
Answer: Two strategies to prevent BPD include gentle ventilation
techniques and the use of caffeine therapy.
⩥ Why are infants with BPD at risk for pulmonary hypertension?
Answer: Infants with BPD are at risk for pulmonary hypertension due to
altered pulmonary vascular development and increased pulmonary
vascular resistance.
⩥ Explain the pathophysiology of meconium aspiration syndrome
(MAS). Answer: MAS occurs when meconium is inhaled into the lungs,
causing airway obstruction, inflammation, and impaired gas exchange.
⩥ What chest x-ray findings are typical of MAS? Answer: Typical chest
x-ray findings in MAS include patchy infiltrates and hyperinflation.
⩥ List two treatment options for severe MAS with refractory
hypoxemia. Answer: Two treatment options include high-frequency
ventilation and extracorporeal membrane oxygenation (ECMO).
⩥ Why is MAS rare in preterm infants? Answer: MAS is rare in preterm
infants because they typically do not pass meconium until after birth.
,⩥ What closes the patent foramen ovale (PFO) and patent ductus
arteriosus (PDA) after birth, and on what timeline? Answer: The PFO
and PDA close due to increased systemic pressure and decreased
pulmonary resistance, typically within the first few days to weeks after
birth.
⩥ List three factors that increase pulmonary vascular resistance (PVR).
Answer: Three factors that increase PVR are hypoxia, acidosis, and
hypercapnia.
⩥ List three factors that decrease pulmonary vascular resistance (PVR).
Answer: Three factors that decrease PVR are oxygenation, alkalosis, and
increased blood flow.
⩥ Why can positive pressure ventilation (PPV) reduce right ventricular
(RV) preload? Answer: PPV can reduce RV preload by increasing
intrathoracic pressure, which decreases venous return to the heart.
⩥ Compare left-to-right (acyanotic) vs right-to-left (cyanotic) shunt
physiology. Answer: Left-to-right shunts (acyanotic) allow oxygenated
blood to flow back to the lungs, while right-to-left shunts (cyanotic)
allow deoxygenated blood to enter systemic circulation.
⩥ What are two medical options and one surgical option for patent
ductus arteriosus (PDA) in a preterm infant? Answer: Two medical
, options are indomethacin and ibuprofen; one surgical option is surgical
ligation.
⩥ Which congenital heart defect (CHD) tends to cause earlier congestive
heart failure (CHF) and why: atrial septal defect (ASD) or ventricular
septal defect (VSD)? Answer: VSD tends to cause earlier CHF because
it results in a larger left-to-right shunt and higher volume overload on
the heart.
⩥ What are two airway/extubation considerations for respiratory
therapists (RTs) managing atrioventricular septal defect (AVSD) with
Trisomy 21? Answer: Considerations include potential for airway
obstruction due to hypotonia and the need for careful extubation due to
respiratory compromise.
⩥ What are two ventilation priorities and one suctioning caution for
hypoplastic left heart syndrome (HLHS)? Answer: Ventilation priorities
include maintaining adequate oxygenation and minimizing barotrauma;
suctioning caution involves avoiding excessive negative pressure.
⩥ Define the goal of Glenn/Fontan ventilation strategy and why.
Answer: The goal is to optimize pulmonary blood flow and oxygenation
in patients with single ventricle physiology.
RESPIRATORY CARE 5TH EDITION WALSH
TEST BANK EXAMINATION TEST 2026
COMPLETE QUESTIONS AND SOLUTIONS
⩥ What is a classic chest x-ray finding in RDS? Answer: A classic chest
x-ray finding in RDS is a ground-glass appearance with air
bronchograms.
⩥ What is the role of surfactant therapy in RDS? Answer: Surfactant
therapy reduces surface tension in the alveoli, improving lung function
and oxygenation.
⩥ List two prevention strategies for neonatal RDS. Answer: Two
prevention strategies for neonatal RDS include administering antenatal
corticosteroids and avoiding preterm birth.
⩥ What factors contribute to the pathogenesis of bronchopulmonary
dysplasia (BPD)? Answer: Factors contributing to BPD include
mechanical ventilation, oxygen toxicity, and inflammation.
⩥ How is BPD severity classified at 36 weeks postmenstrual age
(PMA)? Answer: BPD severity is classified as mild, moderate, or severe
based on the need for respiratory support.
,⩥ List two strategies to prevent BPD in extremely preterm infants.
Answer: Two strategies to prevent BPD include gentle ventilation
techniques and the use of caffeine therapy.
⩥ Why are infants with BPD at risk for pulmonary hypertension?
Answer: Infants with BPD are at risk for pulmonary hypertension due to
altered pulmonary vascular development and increased pulmonary
vascular resistance.
⩥ Explain the pathophysiology of meconium aspiration syndrome
(MAS). Answer: MAS occurs when meconium is inhaled into the lungs,
causing airway obstruction, inflammation, and impaired gas exchange.
⩥ What chest x-ray findings are typical of MAS? Answer: Typical chest
x-ray findings in MAS include patchy infiltrates and hyperinflation.
⩥ List two treatment options for severe MAS with refractory
hypoxemia. Answer: Two treatment options include high-frequency
ventilation and extracorporeal membrane oxygenation (ECMO).
⩥ Why is MAS rare in preterm infants? Answer: MAS is rare in preterm
infants because they typically do not pass meconium until after birth.
,⩥ What closes the patent foramen ovale (PFO) and patent ductus
arteriosus (PDA) after birth, and on what timeline? Answer: The PFO
and PDA close due to increased systemic pressure and decreased
pulmonary resistance, typically within the first few days to weeks after
birth.
⩥ List three factors that increase pulmonary vascular resistance (PVR).
Answer: Three factors that increase PVR are hypoxia, acidosis, and
hypercapnia.
⩥ List three factors that decrease pulmonary vascular resistance (PVR).
Answer: Three factors that decrease PVR are oxygenation, alkalosis, and
increased blood flow.
⩥ Why can positive pressure ventilation (PPV) reduce right ventricular
(RV) preload? Answer: PPV can reduce RV preload by increasing
intrathoracic pressure, which decreases venous return to the heart.
⩥ Compare left-to-right (acyanotic) vs right-to-left (cyanotic) shunt
physiology. Answer: Left-to-right shunts (acyanotic) allow oxygenated
blood to flow back to the lungs, while right-to-left shunts (cyanotic)
allow deoxygenated blood to enter systemic circulation.
⩥ What are two medical options and one surgical option for patent
ductus arteriosus (PDA) in a preterm infant? Answer: Two medical
, options are indomethacin and ibuprofen; one surgical option is surgical
ligation.
⩥ Which congenital heart defect (CHD) tends to cause earlier congestive
heart failure (CHF) and why: atrial septal defect (ASD) or ventricular
septal defect (VSD)? Answer: VSD tends to cause earlier CHF because
it results in a larger left-to-right shunt and higher volume overload on
the heart.
⩥ What are two airway/extubation considerations for respiratory
therapists (RTs) managing atrioventricular septal defect (AVSD) with
Trisomy 21? Answer: Considerations include potential for airway
obstruction due to hypotonia and the need for careful extubation due to
respiratory compromise.
⩥ What are two ventilation priorities and one suctioning caution for
hypoplastic left heart syndrome (HLHS)? Answer: Ventilation priorities
include maintaining adequate oxygenation and minimizing barotrauma;
suctioning caution involves avoiding excessive negative pressure.
⩥ Define the goal of Glenn/Fontan ventilation strategy and why.
Answer: The goal is to optimize pulmonary blood flow and oxygenation
in patients with single ventricle physiology.
