Neonatal and Pediatric Respiratory Care 5thEdition Walsh Test Bank A+

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Neonatal and Pediatric v v v




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Respiratory Care 5th Editionv v v v


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Walsh Test Bank A+
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Chapter 1: Fetal Lung Development Test Bank
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MULTIPLEvCHOICEv
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,1.v
Whichvofvthevfollowingvphasesvofvhumanvlungvdevelopmentvisvcharacterizedvbyvthevformationvofvav
capillaryvnetworkvaroundvairwayvpassages?v

a. Pseudoglandularv

b. Saccularv

c. Alveolarv

d. Canalicularv
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ANS:vDv

Thevcanalicularvphasevfollowsvthevpseudoglandularvphase,vlastingvfromvapproximatelyv17vweeksvtov
26vweeksvofvgestation.vThisvphasevisvsovnamedvbecausevofvthevappearancevofvvascularvchannels,vorvc
apillaries,vwhichvbeginvtovgrowvbyvformingvavcapillaryvnetworkvaroundvthevairvpassages.vDuringvthe
vpseudoglandularvstage,vwhichvbeginsvatvdayv52vandvextendsvtovweekv16vofvgestation,vthevairwayvsys

temvsubdividesvextensivelyvandvthevconductingvairwayvsystemvdevelops,vendingvwithvthevterminalv
bronchioles.vThevsaccularvstagevofvdevelopment,vwhichvtakesvplacevfromvweeksv29vtov36vofvgestatio
n,visvcharacterizedvbyvthevdevelopmentvofvsacsvthatvlatervbecomevalveoli.vDuringvthevsaccularvphase,
vavtremendousvincreasevinvthevpotentialvgas-

vexchangingvsurfacevareavoccurs.vThevdistinctionvbetween vthevsaccularvstagevandvthevalveolarvstagev

isvarbitrary.vThevalveolarvstagevstretchesvfromv39vweeksvofvgestationvtovterm.vThisvstagevisvrepresent
edvbyvthevestablishmentvofvalveoli.v
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REF:vpp.v3-5v
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2.v
Regardingvpostnatalvlungvgrowth,vbyvapproximatelyvwhatvagevdovmostvofvthevalveolivthatvwillvbevpr
esentvinvthevlungsvforvlifevdevelop?v

a. 6vmonthsv
b. 1vyearv

c. 1.5vyearsv

d. 2vyearsv
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ANS:vCv

,Mostvofvthevpostnatalvformationvofvalveolivinvthevinfantvoccursvovervthevfirstv1.5vyearsvofvlife.vAtv2vy
earsvofvage,vthevnumbervofvalveolivvariesvsubstantiallyvamongvindividuals.vAfterv2vyearsvofvage,vmal
esvhavevmorevalveolivthanvdovfemales.vAftervalveolarvmultiplicationvends,vthevalveolivcontinuevtovin
creasevinvsizevuntilvthoracicvgrowthvisvcompleted.v
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REF:vp.v6v
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3.v
Thevrespiratoryvtherapistvisvevaluatingvavnewbornvwithvmildvrespiratoryvdistressvduevtovtrachealvsten
osis.vDuringvwhichvperiodvofvlungvdevelopmentvdidvthisvproblemvdevelop?v

a. Embryonalv

b. Saccularv

c. Canalicularv

d. Alveolarv
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ANS:vAv

Thevinitialvstructuresvofvthevpulmonaryvtreevdevelopvduringvthevembryonalvstage.vErrorsvinvdevelop
mentvduringvthisvtimevmayvresultvinvlaryngeal,vtracheal,vorvesophagealvatresiavorvstenosis.vPulmonar
yvhypoplasia,vanvincompletevdevelopmentvofvthevlungsvcharacterizedvbyvanvabnormallyvlowvnumber
vand/orvsizevofvbronchopulmonaryvsegmentsvand/orvalveoli,vcanvdevelopvduringvthevpseudoglandula

rvphase.vIfvthevfetusvisvbornvduringvthevcanalicularvphasev(i.e.,vprematurely),vseverevrespiratoryvdistr
essvcanvbevexpectedvbecausevthevinadequatelyvdevelopedvairways,valongvwithvinsufficientvandvimm
aturevsurfactantvproductionvbyvalveolarvtypevIIvcells,vgivesvrisevtovthevconstellationvofvproblemsvkno
wnvasvinfantvrespiratoryvdistressvsyndrome.v
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REF:vvp.v6v
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4.v
Whichvofvthevfollowingvmechanismsvisv(are)vresponsiblevforvthevpossiblevassociationvbetweenvoligo
hydramniosvandvlungvhypoplasia?v
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I. Abnormalvcarbohydratevmetabolismv

II. Mechanicalvrestrictionvofvthevchestvwallv

, III. InterferencevwithvfetalvbreathingvIV.v Failurevtovproducevfetalvlungvliquidv


a. IvandvIIIvonlyv

b. IIvandvIIIvonlyv

c. I,vII,vandvIVvonlyv

d. II,vIII,vandvIVvonlyv
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ANS:vDv

Oligohydramnios,vavreducedvquantityvofvamnioticvfluidvpresentvforvanvextendedvperiodvofvtime,vwit
hvorvwithoutvrenalvanomalies,visvassociatedvwithvlungvhypoplasia.vThevmechanismsvbyvwhichvamnio
ticvfluidvvolumevinfluencesvlungvgrowthvremainvunclear.vPossiblevexplanationsvforvreducedvquantit
yvofvamnioticvfluidvincludevmechanicalvrestrictionvofvthevchestvwall,vinterferencevwithvfetalvbreathin
g,vorvfailurevtovproducevfetalvlungvliquid.vThesevclinicalvandvexperimentalvobservationsvpossiblyvpoi
ntvtovavcommonvdenominator,vlungvstretch,vasvbeingvavmajorvgrowthvstimulant.v
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REF:vpp.v6-7v
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5.v WhatvisvthevpurposevofvthevsubstancevsecretedvbyvthevtypevIIvpneumocyte?v
a. Tovincreasevthevgasvexchangevsurfacevareav

b. Tovreducevsurfacevtensionv

c. Tovmaintainvlungvelasticityv

d. Tovpreservevthevvolumevofvthevamnioticvfluidv
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ANS:vBv

Thevprimaryvrolevofvmammalianvsurfactantvisvtovlowervthevsurfacevtensionvwithinvthevalveolus,vspeci
ficallyvatvthevair–
liquidvinterface.vThisvallowsvthevdelicatevstructurevofvthevalveolusvtovexpandvwhenvfilledvwithvair.vW
ithoutvsurfactant,vthevalveolusvremainsvcollapsedvbecausevofvthev
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highvsurfacevtensionvofvthevmoistvalveolarvsurface.vSurfactantvisvcomposedvpredominantlyvofvanvintr
icatevblendvofvphospholipids,vneutralvlipids,vandvproteins.v