NEONATAL &PEDIATRIC RESPIRATORY
L
.F
Y
T L
.F
Y
T LL
.F
Y .F
T YT
CARE L
Y. F T
5th Edition, Walsh
L
.F
Y
T L
.F
Y
T
TEST BANK Y . F T L
,Neonatal and Pediatric Respiratory Care, 5th Edition, Brian K. Walsh Test Bank
YFL
.T Y.FT L Y.FT L Y.FT L YFL
.T Y. FT L YF
.T L Y.FT L YF
.TL Y.FT L Y.FT L
Table of Contents
L
Y.FT Y .FT L
Chapter 1. Fetal Lung Development
YF
.T L Y.FT L Y .FT L YFL
.T
Chapter 2. Fetal Gas Exchange and Circulation
YFL
.T Y.FT L L
Y.FT Y.FT L Y.FT L YFL
.T
Chapter 3. Antenatal Assessment and High-Risk Delivery
L
YF
T
. Y.FT L Y.FTL YFL
.T L
Y.FT Y.FT L
Chapter 4. Examination and Assessment of the Neonatal and Pediatric Patient
L
YF
T
. YFL
.T L
Y.FT L
Y.FT L
Y.FT YF
.T L YFL
.T L
Y.FT YF
.TL L
Y.FT
Chapter 5. Pulmonary Function Testing and Bedside Pulmonary Mechanics
L
YF
T
. Y.FT L Y.F
T L Y.FT L YF
.T L Y. FT L YFL
.T L
Y.F
T
Chapter 6. Radiographic Assessment
YF
.T L YF
.T L Y.FT L
Chapter 7. Pediatric Flexible Bronchoscopy
YF
.T L YF
.T L Y.FT L Y.FT L
Chapter 8. Invasive Blood Gas Analysis and Cardiovascular Monitoring
L
YF
T
. Y.F T L YFL
.T L
Y.FT YFL
.T L
Y.FT L
Y.FT YFL
.T
Chapter 9. Noninvasive Monitoring in Neonatal and Pediatric Care
YF
.T L Y.FT L Y.FT L YF
.T L YFL
.T Y. FT L Y.FT L L
Y.FT
Chapter 10. Oxygen Administration
YF
.T L YF
.T L Y.F T L
Chapter 11. Aerosols and Administration of Inhaled Medications
L
YF
T
. L
Y.FT YF
.T L Y.FTL L
Y.FT Y.FT L YFL
.T
Chapter 12. Airway Clearance Techniques and Hyperinflation Therapy
L
YF
T
. Y.FT L L
Y
T
F
. Y.FTL Y. F T L L
Y.F T Y.FT L
Chapter 13. Airway Management
Y.FT L L
Y.FT L
Y
T
F
.
Chapter 14. Surfactant Replacement Therapy
YF
.T L YF
.T L Y.FT L Y.FT L
Chapter 15. Noninvasive Mechanical Ventilation and Continuous Positive Pressure of the Neonate
YF
.T L YFL
.T Y.F T L Y.FT L L
Y.FT YFL
.T L
Y.FT YF
.T L YFL
.T YFL
.T YFL
.T
Chapter 16. Noninvasive Mechanical Ventilation of the Infant and Child
YFL
.T YFL
.T L
Y.F T L
Y.FT L
Y.FT L
YF
T
. Y .FT L YFL
.T Y.FT L
Chapter 17. Invasive Mechanical Ventilation of the Neonate and Pediatric Patient
L
YF
T
. Y.FT L Y.FT L Y.FT L Y.FT L L
Y.FT YFL
.T YF
.T L YFL
.T L
Y.FT
Chapter 18. Administration of Gas Mixtures
YF
.T L YF
.T L YFL
.T YF
.T L L
Y.FT
Chapter 19. Extracorporeal Membrane Oxygenation
YF
.T L YFL
.T L
Y.FT YF
.T L
Chapter 20. Pharmacology
YF
.T L Y.FT L
Chapter 21. Thoracic Organ Transplantation
YF
.T L YF
.T L YF
.T L Y.FT L
Chapter 22. Neonatal Pulmonary Disorders
YF
.T L Y.FT L L
Y.F T Y.FT L
Chapter 23. Surgical Disorders in Childhood that Affect Respiratory Care
YF
.T L YF
.T L Y.FT L L
Y.FT L
Y.FT YFL
.T Y.FT L Y.FT L L
Y
T
F
.
Chapter 24. Congenital Cardiac Defects
YF
.T L YF
.T L Y.FTL Y.FTL
Chapter 25. Pediatric Sleep-Disordered Breathing
YF
.T L YF
.T L YF
.TL Y.FT L
Chapter 26. Pediatric Airway Disorders and Parenchymal Lung Diseases
L
YF
T
. Y.FT L Y.FTL L
YF
T
. YFL
.T Y.FTL Y .F T L Y.FT L
Chapter 27. AsthmaYF
.T L Y.FT L
Chapter 28. Cystic Fibrosis
YF
.T L YF
.T L L
Y. F T
Chapter 29. Acute Respiratory Distress Syndrome
YF
.T L YF
.T L YFL
.T YFL
.T L
Y.FT
Chapter 30. Shock YF
.T L Y.FT L
Chapter 31. Pediatric Trauma
YF
.T L YF
.T L YF
.T L
Chapter 32. Disorders of the Pleura
YF
.T L YF
.T L L
Y.FT Y.F T L Y.FT L
Chapter 33. Neurological and Neuromuscular Disorders
YFL
.T YFL
.T Y.FT L YF
.T L YFL
.T
Chapter 34. Pediatric Emergencies
YF
.T L YF
.T L YF
.T L
Chapter 35. Home Care of the Postpartum Family
YF
.T L Y.FT L Y.FTL L
Y.FT Y.FT L Y.FT L L
Y.FT
Chapter 36. Quality and Safety
YF
.T L Y.FT L L
YF
T
. Y .FT L
,Chapter 1: Fetal Lung Development
L
Y
T
F
. L
Y
T
F
. Y
T
F
. L L
Y.F
T
Walsh: Neonatal & Pediatric Respiratory Care 5th Edition Test Bank (2020)
L
Y.F
T Y.FT L L
YF
T
. Y.FT L Y.FT L Y. FT L YF
.T L Y.FT L YFL
.T Y.FT L
MULTIPLE CHOICE L
YF
T
.
1. Which of the following phases of human lung development is characterized by the formation
YF
T
. L L
YF
.T L
Y.F
T L
Y
T
F
. YF
.T L YFL
.T L
YF
.T L
Y
T
F
. Y.FTL YFL
.T L
Y.FT L
Y
T
F
. YF
.T L
Y.FT L of a capillary network around airway passages?
Y. FT L Y.F T L Y .FT L Y.FT L Y.FT L Y.F T L
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: D Y . F T L
The canalicular phase follows the pseudoglandular phase, lasting from approximately 17
Y.F T L Y.F T L Y.F T L Y.FT L Y. FT L Y.FTL Y.F T L Y.F T L Y. FT L Y.F T L
weeks to 26 weeks of gestation. This phase is so named because of the appearance of vascular
Y.FT L L
Y
T
F
. L
Y
T
F
. L
YF
T
. YFL
.T Y.FT L L
Y
T
F
. YFL
.T L
YF
T
. L
YF
T
. YFL
.T L
YF
T
. L
YF
T
. L
YF
T
. L
Y.F
T L
Y.FT YF
T
. L
channels, or capillaries, which begin to grow by forming a capillary network around the
Y.FT L Y.F T L Y.FT L L
Y.F T Y .FT L Y.F T L Y.FTL Y.FT L Y.FT L Y.F T L Y.FT L Y.F T L Y.FT L Y.F T L
air passages. During the pseudoglandular stage, which begins at day 52 and extends to
Y.FT L Y. FT L Y.FT L Y.FT L Y. FT L Y. FT L Y.FT L Y. FT L Y. FT L Y.FT L Y.FTL Y.F T L Y.F T L Y. FT L
week 16 of gestation, the airway system subdivides extensively and the conducting
Y.FT L Y.F T L L
Y.F T Y.F TL Y.FT L Y.F T L Y.F T L Y. FT L Y.F T L L
Y.F T Y.F TL Y. FT L
airway system develops, ending with the terminal bronchioles. The saccular stage of
Y.FT L Y.F T L Y.F T L Y.F T L Y.FT L Y.F T L Y.F T L Y.F T L Y.FT L L
Y.F T Y.F T L Y.FT L
development, which takes place from weeks 29 to 36 of gestation, is characterized by the
Y.FT L Y.FT L Y.F T L YF
.T L YFL
.T YF
.T L Y.FT L YF
.T L YF
.T L Y.FT L YFL
.T YF
.TL YF
.T L L
Y.FT L
Y
T
F
.
development of sacs that later become alveoli. During the saccular phase, a tremendous
YFL
.T YFL
.T YFL
.T L
Y.FT Y.FT L Y.FT L Y. FT L Y. FT L Y.FT L Y. FT L Y.FT L Y.FT L Y. FT L
increase in the potential gas-exchanging surface area occurs. The distinction between the
Y.FT L Y. FT L Y.F T L Y .FT L Y.F T L Y. FT L Y. FT L Y.FT L L
Y.FT Y.F T L Y.F T L Y.F TL
saccular stage and the alveolar stage is arbitrary. The alveolar stage stretches from 39
Y.FT L Y.FT L L
Y.F T Y. FT L Y.F T L Y.F T L Y.FT L Y. FT L Y .FT L L
Y.FT Y.FTL Y.FT L Y.F T L Y.FT L
weeks of gestation to term. This stage is represented by the establishment of alveoli.
Y.FT L Y.FT L Y .FT L L
Y.FT L
Y.FT L
Y.FT Y.FT L Y.FT L Y. FT L Y.FT L Y.F T L Y. FT L Y.FT L Y.F T L
REF: pp. Y.FT L Y . F T L 3-5
2. Regarding postnatal lung growth, by approximately what age do most of the alveoli that will L
Y
T
F
. L
Y.F
T YF
.TL YF
.T L L
Y
T
F
. L
Y
T
F
. YF
.T L L
YF
.T YF
.T L YFL
.T YF
.T L L
YF
T
. YFL
.T YF
.T L
be present in the lungs for life develop?
Y.FT L Y.F T L Y.FT L Y. FT L L
Y.F T Y.F T L L
Y.F T L
Y.F T
a. 6 months Y.FT L
b. 1 year Y .FT L
c. 1.5 years Y. F T L
d. 2 years Y .FT L
ANS: C Y . F T L
Most of the postnatal formation of alveoli in the infant occurs over the first 1.5 years of life.
L
Y.FT Y.FTL YF
.TL Y.FT L Y.FT L L
Y.FT Y.FTL Y.FT L L
Y.FT Y.FT L Y.FTL L
Y.FT Y.FT L Y.FT L Y.FTL Y.FT L Y.FTL
At 2 years of age, the number of alveoli varies substantially among individuals. After 2 years
Y.FT L L
Y
T
F
. YF
.TL YF
.T L L
Y.F
T YFL
.T YFL
.T L
Y
T
F
. L
YF
T
. YF
.T L L
Y.F
T Y
T
F
.L L
Y
T
F
. L
Y
T
F
. L
Y
T
F
. Y.F T L
of age, males have more alveoli than do females. After alveolar multiplication ends, the
Y.FT L Y. FT L Y.F T L Y.F T L Y.F T L Y. FT L Y.F T L Y. FT L Y.FT L Y.FT L Y.F T L Y. FT L Y. FT L Y.F T L
alveoli continue to increase in size until thoracic growth is completed.
Y.FT L Y.F T L Y. FT L Y.FT L Y. FT L L
Y.F T Y.F T L Y. FT L Y.FT L Y.FT L Y. FT L
REF: p. 6 Y.F T L YF
.TL
3. The respiratory therapist is evaluating a newborn with mild respiratory distress due to tracheal
L
Y
T
F
. Y
T
F
.L YFL
.T Y.FT L YFL
.T L
YF
T
. Y.FT L YF
.T L YFL
.T L
Y
T
F
. Y.FT L YF
.T L YFL
.T
Y.FT L stenosis. During which period of lung development did this problem develop? Y.FT L Y.F T L Y. FT L Y.F T L Y.F T L Y. FT L Y.FT L Y.FT L Y. FT L Y.F T L
, a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS: A Y . F T L
The initial structures of the pulmonary tree develop during the embryonal stage. Errors in
Y.F T L Y.F T L Y.FT L Y. FT L Y.F T L Y.F T L Y.FT L Y.FTL Y. FT L L
Y.F T Y. FT L Y.FT L Y.FTL
development during this time may result in laryngeal, tracheal, or esophageal atresia or
Y.FT L Y.FTL Y.F TL L
Y.F T Y. FT L Y.F T L Y.FT L Y.F T L L
Y.F T Y.F T L Y.FTL Y.F T L Y.F T L
stenosis. Pulmonary hypoplasia, an incomplete development of the lungs characterized byan
Y.FT L L
Y
T
F
. Y
T
F
. L L
Y
T
F
. L
YF
T
. L
YF
T
. YF
.T L L
Y
T
F
. L
Y
T
F
. YF
.TL L
YF
T
. Y
T
F
.L
abnormally low number and/or size of bronchopulmonary segments and/or alveoli, can
Y.FT L Y. FT L Y.F T L Y. FT L Y.FTL Y.F T L Y.F T L L
Y.F T Y.FT L L
Y.FT L
Y.F T
develop during the pseudoglandular phase. If the fetus is born during the canalicular
Y.FT L Y.F T L L
Y.F T Y.F T L Y.F T L Y.FT L Y. FT L Y.FT L Y.F TL Y.F T L Y.F T L Y.F T L L
Y.F T
phase (i.e., prematurely), severe respiratory distress can be expected because the
Y.FT L Y. FT L Y.FT L Y.FT L L
Y.F T L
Y.F T Y. FT L Y.F T L Y.F TL Y.FT L L
Y.F T
inadequately developed airways, along with insufficient and immature surfactant
Y.FT L Y.F T L Y.F T L Y.FT L Y. FT L L
Y.F T Y.FT L Y. FT L Y.FT L
production by alveolar type II cells, gives rise to the constellation of problems known as
Y.FT L Y. FT L Y.F T L Y.FT L Y.F T L Y.FT L Y.FT L L
Y.FT Y.FT L L
Y.FT L
Y.FT Y.FT L Y.FT L Y.FT L L
Y.FT
infant respiratory distress syndrome.
Y.FT L Y.FT L L
Y.FT L
Y. FT
REF: Y . F T L Y . F T L p. 6 YF
.TL
4. Which of the following mechanisms is (are) responsible for the possible association between
Y
T
F
.L L
Y
T
F
. L
Y
T
F
. YFL
.T L
Y.FT L
YF
.T YFL
.T Y.FTL L
Y
T
F
. L
Y
T
F
. YFL
.T YFL
.T
Y.FT oligohydramnios and lung hypoplasia?
L Y. FT L Y. FT L L
Y.F T
I. Abnormal carbohydrate metabolism L
Y
T
F
. YF
.TL
II. Mechanical restriction of the chest wall Y.F
TL Y.FT L YFL
.T YF
.T L YFL
.T
III. Interference with fetal breathing L
Y
T
F
. Y.F
T L L
Y.FT
IV. Failure to produce fetal lung liquid L
Y
T
F
. Y.FT L YFL
.T L
Y.FT YFL
.T
a. I and III only L
YF
T
. Y .F T L Y.FT L
b. II and III only L
YF
T
. Y . F T L L
YF
.T
c. I, II, and IV only YF
.TL YFL
.T Y.F T L L
Y
T
F
.
d. II, III, and IV only YF
.T L Y.FTL Y.F T L Y
T
F
. L
ANS: D Y . F T L
Oligohydramnios, a reduced quantity of amniotic fluid present for an extended period of time, YF
.T L L
Y.F
T YFL
.T L
Y
T
F
. YF
.T L Y.FT L YFL
.T YF
.T L YFL
.T YF
.T L YFL
.T YFL
.T L
YF
.T
with or without renal anomalies, is associated with lung hypoplasia. The mechanisms by
Y.FT L Y .FT L Y.FT L Y.FT L Y.FT L Y.FT L Y. FT L Y.FT L Y.F T L Y. FT L Y.F T L Y. FT L Y.F T L
which amniotic fluid volume influences lung growth remain unclear. Possible explanations for
Y.FT L L
Y
T
F
. L
Y
T
F
. L
YF
.T L
Y
T
F
. Y
T
F
.L L
Y.FT L
Y
T
F
. L
YF
T
. L
Y
T
F
. L
YF
.T L
YF
.T
reduced quantity of amniotic fluid include mechanical restriction of the chest wall,
Y.FT L Y.F T L Y. FT L Y .FT L Y.F T L Y.F T L L
Y.F T Y. FT L Y.F T L Y.F T L Y.FT L L
Y.FT
interference with fetal breathing, or failure to produce fetal lung liquid. These clinical and
Y.FT L Y. FT L Y.F T L Y.F T L Y.F T L Y.FTL Y. FT L Y.FT L Y.FT L Y.F T L Y. FT L Y.F T L Y.F T L L
Y.F T
experimental observations possibly point to a common denominator, lung stretch, as being
Y.FT L Y.FT L Y.F T L Y.F T L Y.FT L Y.FT L Y.F T L Y.F T L Y.FTL Y.F T L Y.FT L Y.F T L
a major growth stimulant.
Y.FT L L
Y.F T Y.F T L Y.FT L
REF: pp. 6-7 Y.FT L L
Y
T
F
.
5. What is the purpose of the substance secreted by the type II pneumocyte?
YFL
.T Y.FT L Y.FT L Y.FTL Y.FTL L
YF
T
. YFL
.T Y.FT L L
Y
T
F
. YF
.T L Y . FT L L
YF
T
.
a. To increase the gas exchange surface area L
Y
T
F
. L
Y
T
F
. Y.FTL YF
.T L Y.FT L L
Y.F
T
b. To reduce surface tension L
Y
T
F
. L
Y
T
F
. L
YF
T
.
c. To maintain lung elasticity L
Y
T
F
. YFL
.T YF
.T L
d. To preserve the volume of the amniotic fluid L
Y
T
F
. Y.F
TL YF
.T L Y.FT L YFL
.T L
YF
.T L
Y.FT