Test Bank for Neonatal and Pediatric Respiratory Care, 6th Edition
(Walsh)
**1. Which phase of human lung development is characterized by the formation of a capillary
network around airway passages?**
A) Pseudoglandular
B) Saccular
C) Alveolar
D) Canalicular
**Answer: D**
*Rationale:* The canalicular phase (17-26 weeks gestation) is named for vascular channels or
capillaries that grow around air passages. This prepares the lungs for gas exchange .
**2. By approximately what age do most alveoli that will be present for life develop postnatally?**
A) 6 months
B) 1 year
C) 1.5 years
D) 2 years
**Answer: C**
*Rationale:* Most postnatal alveolar formation occurs during the first 1.5 years of life. At 2 years,
alveoli numbers vary substantially among individuals .
**3. A newborn with mild respiratory distress due to tracheal stenosis is being evaluated. During
which period of lung development did this problem most likely develop?**
A) Embryonal
B) Pseudoglandular
C) Canalicular
D) Saccular
**Answer: A**
*Rationale:* The initial pulmonary tree structures develop during the embryonal stage. Errors during
this time may result in laryngeal, tracheal, or esophageal atresia or stenosis .
,**4. Which mechanisms 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
**Answer: D**
*Rationale:* Oligohydramnios causes lung hypoplasia through mechanical chest restriction,
interference with fetal breathing, or failure to produce fetal lung liquid. Lung stretch is a major
growth stimulant .
**5. What is the purpose of the substance secreted by type II pneumocytes?**
A) To increase gas exchange surface area
B) To reduce surface tension
C) To maintain lung elasticity
D) To preserve amniotic fluid volume
**Answer: B**
*Rationale:* Surfactant lowers surface tension at the air-liquid interface in alveoli, preventing alveolar
collapse. Without surfactant, alveoli remain collapsed due to high surface tension .
**6. Which tests of amniotic fluid are 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
**Answer: D**
*Rationale:* Amniotic fluid phosphatidylglycerol and phosphatidylcholine concentrations are
sensitive indicators of fetal lung maturity during late gestation .
**7. Approximately how much fetal lung fluid is secreted daily?**
A) 150-200 ml
,B) 250-300 ml
C) 350-400 ml
D) 450-500 ml
**Answer: B**
*Rationale:* Fetal lungs secrete approximately 250-300 ml of fluid daily, which is important for
normal lung development and amniotic fluid volume .
**8. How many generations of airway branching are typically present in the conducting airways by
birth?**
A) 5-10
B) 10-15
C) 15-20
D) 20-25
**Answer: C**
*Rationale:* The conducting airways typically have about 15-20 generations of branching by the time
of birth.
**9. The embryonic phase of lung development occurs during which weeks of gestation?**
A) 3-7 weeks
B) 7-17 weeks
C) 17-26 weeks
D) 26-36 weeks
**Answer: A**
*Rationale:* The embryonic phase occurs approximately 3-7 weeks of gestation. The pseudoglandular
phase is 5-16 weeks, canalicular is 17-26 weeks, and saccular is 29-36 weeks.
**10. Which embryonic germ layer gives rise to the respiratory system?**
A) Endoderm
B) Mesoderm
C) Ectoderm
D) Periderm
**Answer: A**
*Rationale:* The respiratory system—pharynx, lungs, and epithelial lining of the trachea—originates
from the endoderm.
, **11. The pseudoglandular phase of lung development is characterized by:**
A) Formation of terminal sacs that become alveoli
B) Extensive subdivision of the airway system and development of conducting airways
C) Formation of a capillary network around airways
D) Establishment of definitive alveoli
**Answer: B**
*Rationale:* The pseudoglandular phase (5-16 weeks) involves extensive subdivision of the airway
system and development of conducting airways, ending with terminal bronchioles.
**12. The saccular phase of lung development occurs during which weeks of gestation?**
A) 5-16 weeks
B) 17-26 weeks
C) 29-36 weeks
D) 36-40 weeks
**Answer: C**
*Rationale:* The saccular phase occurs from weeks 29 to 36 of gestation, characterized by the
development of sacs that later become alveoli.
**13. The alveolar phase of lung development begins at:**
A) 16 weeks gestation
B) 26 weeks gestation
C) 39 weeks gestation
D) Birth
**Answer: C**
*Rationale:* The alveolar stage stretches from 39 weeks of gestation to term and is represented by
the establishment of alveoli.
**14. In postnatal lung growth, after alveolar multiplication ends, alveoli continue to:**
A) Decrease in number
B) Increase in size until thoracic growth is completed
C) Remodel into larger structures
D) Remain unchanged
**Answer: B**
(Walsh)
**1. Which phase of human lung development is characterized by the formation of a capillary
network around airway passages?**
A) Pseudoglandular
B) Saccular
C) Alveolar
D) Canalicular
**Answer: D**
*Rationale:* The canalicular phase (17-26 weeks gestation) is named for vascular channels or
capillaries that grow around air passages. This prepares the lungs for gas exchange .
**2. By approximately what age do most alveoli that will be present for life develop postnatally?**
A) 6 months
B) 1 year
C) 1.5 years
D) 2 years
**Answer: C**
*Rationale:* Most postnatal alveolar formation occurs during the first 1.5 years of life. At 2 years,
alveoli numbers vary substantially among individuals .
**3. A newborn with mild respiratory distress due to tracheal stenosis is being evaluated. During
which period of lung development did this problem most likely develop?**
A) Embryonal
B) Pseudoglandular
C) Canalicular
D) Saccular
**Answer: A**
*Rationale:* The initial pulmonary tree structures develop during the embryonal stage. Errors during
this time may result in laryngeal, tracheal, or esophageal atresia or stenosis .
,**4. Which mechanisms 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
**Answer: D**
*Rationale:* Oligohydramnios causes lung hypoplasia through mechanical chest restriction,
interference with fetal breathing, or failure to produce fetal lung liquid. Lung stretch is a major
growth stimulant .
**5. What is the purpose of the substance secreted by type II pneumocytes?**
A) To increase gas exchange surface area
B) To reduce surface tension
C) To maintain lung elasticity
D) To preserve amniotic fluid volume
**Answer: B**
*Rationale:* Surfactant lowers surface tension at the air-liquid interface in alveoli, preventing alveolar
collapse. Without surfactant, alveoli remain collapsed due to high surface tension .
**6. Which tests of amniotic fluid are 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
**Answer: D**
*Rationale:* Amniotic fluid phosphatidylglycerol and phosphatidylcholine concentrations are
sensitive indicators of fetal lung maturity during late gestation .
**7. Approximately how much fetal lung fluid is secreted daily?**
A) 150-200 ml
,B) 250-300 ml
C) 350-400 ml
D) 450-500 ml
**Answer: B**
*Rationale:* Fetal lungs secrete approximately 250-300 ml of fluid daily, which is important for
normal lung development and amniotic fluid volume .
**8. How many generations of airway branching are typically present in the conducting airways by
birth?**
A) 5-10
B) 10-15
C) 15-20
D) 20-25
**Answer: C**
*Rationale:* The conducting airways typically have about 15-20 generations of branching by the time
of birth.
**9. The embryonic phase of lung development occurs during which weeks of gestation?**
A) 3-7 weeks
B) 7-17 weeks
C) 17-26 weeks
D) 26-36 weeks
**Answer: A**
*Rationale:* The embryonic phase occurs approximately 3-7 weeks of gestation. The pseudoglandular
phase is 5-16 weeks, canalicular is 17-26 weeks, and saccular is 29-36 weeks.
**10. Which embryonic germ layer gives rise to the respiratory system?**
A) Endoderm
B) Mesoderm
C) Ectoderm
D) Periderm
**Answer: A**
*Rationale:* The respiratory system—pharynx, lungs, and epithelial lining of the trachea—originates
from the endoderm.
, **11. The pseudoglandular phase of lung development is characterized by:**
A) Formation of terminal sacs that become alveoli
B) Extensive subdivision of the airway system and development of conducting airways
C) Formation of a capillary network around airways
D) Establishment of definitive alveoli
**Answer: B**
*Rationale:* The pseudoglandular phase (5-16 weeks) involves extensive subdivision of the airway
system and development of conducting airways, ending with terminal bronchioles.
**12. The saccular phase of lung development occurs during which weeks of gestation?**
A) 5-16 weeks
B) 17-26 weeks
C) 29-36 weeks
D) 36-40 weeks
**Answer: C**
*Rationale:* The saccular phase occurs from weeks 29 to 36 of gestation, characterized by the
development of sacs that later become alveoli.
**13. The alveolar phase of lung development begins at:**
A) 16 weeks gestation
B) 26 weeks gestation
C) 39 weeks gestation
D) Birth
**Answer: C**
*Rationale:* The alveolar stage stretches from 39 weeks of gestation to term and is represented by
the establishment of alveoli.
**14. In postnatal lung growth, after alveolar multiplication ends, alveoli continue to:**
A) Decrease in number
B) Increase in size until thoracic growth is completed
C) Remodel into larger structures
D) Remain unchanged
**Answer: B**
