Test Bank for Neonatal and Pediatric Respiratory
Care, 6th Edition
by Brian K. Walsh
,Chapter 1: Fetal Lung Development
VBN VBN VBN VBN N
B
V
Test Bank
VBN
MULTIPLE CHOICE VBN
1. Which of the following phases of human lung development is characterized by the formationof a
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
capillary network around airway passages? VBN V BN VBN VBN
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: D V B N
The canalicular phase follows the pseudoglandular phase, lasting from approximately 17 weeks
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN V BN VBN
to 26 weeks of gestation. This phase is so named because of the appearance of vascularchannels, or
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
capillaries, which begin to grow by forming a capillary network around the air passages. During VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
the pseudoglandular stage, which begins at day 52 and extends to week 16 of gestation, the airwa
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN V BN V BN VBN VBN
y system subdivides extensively and the conducting airway system develops, ending with the ter
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
minal bronchioles. The saccular stage of development, which takes place from weeks 29 to 36 of g
VBN VBN VBN VBN VBN VBN VBN V BN VBN VBN VBN VBN VBN VBN VBN VBN
estation, is characterized by the development of sacs thatlater become alveoli. During the saccula VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
r phase, a tremendous increase in the potential
VBN V BN V BN VBN VBN VBN VBN
gas-
exchanging surface area occurs. The distinction between the saccular stage and the alveolar s VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN V BN VBN
tage is arbitrary. The alveolar stage stretches from 39 weeks of gestation to term.This stage is
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
represented by the establishment of alveoli. V BN VBN VBN VBN VBN
REF: pp. 3-5 V B N VBNVBNV B N
2. Regarding postnatal lung growth, by approximately what age do most of the alveoli that willbe VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
present in the lungs for life develop? VBN VBN VBN VBN VBN VBN
a. 6 months VBN
b. 1 year VBN
c. 1.5 years VBN
d. 2 years VBN
ANS: C V B N
Most of the postnatal formation of alveoli in the infant occurs over the first 1.5 years of life. At 2 y
VBN VBN VBN VBN VBN VBN VBN V BN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
ears of age, the numberof alveoli varies substantially among individuals. After 2 yearsof age, mal
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
es have more alveoli than do females. After alveolar multiplication ends, the alveoli continue to i
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN V BN VBN VBN VBN
ncrease in size until thoracic growth is completed. VBN VBN VBN VBN VBN VBN VBN
REF: p. 6 V BN VBN
3. Therespiratory therapist is evaluating a newborn with mild respiratory distress due to trachealst
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
enosis. During which period of lung development did this problem develop? VBN VBN VBN VBN VBN VBN VBN VBN V BN VBN
a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS: A V B N
, The initial structures of the pulmonary tree develop during the embryonal stage. Errors in deve
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
lopment during this time may result in laryngeal, tracheal, or esophageal atresia or stenosis. Pu
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
lmonary hypoplasia, an incomplete development of the lungs characterized by anabnormally lo VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
w number and/or size of bronchopulmonary segments and/or alveoli, can develop during the p
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
seudoglandular phase. If the fetus is born during the canalicular phase (i.e., prematurely), sever VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
e respiratory distress can be expected because the inadequately developed airways, along with i
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
nsufficient and immature surfactant production by alveolar type II cells, gives rise to the conste VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
llation of problems known as infant respiratory distress syndrome.
VBN VBN VBN VBN VBN VBN VBN V BN
REF: p. 6 VBNVBNV B N VBN
4. Which of the following mechanisms is (are) responsible for the possible association betweenolig
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
ohydramnios and lung hypoplasia? VBN VBN VBN
I. Abnormal carbohydrate metabolism VBN VBN
II. Mechanical restriction of the chest wall VBN VBN VBN VBN VBN
III. Interferencewith fetal breathing VBN VBN VBN
IV. Failure to produce fetal lung liquid VBN VBN VBN VBN VBN
a. I and III only VBN VBN VBN
b. II and III only VBN VBN VBN
c. I, II, and IV only VBN VBN VBN VBN
d. II, III, and IV only VBN VBN VBN VBN
ANS: D V B N
Oligohydramnios, a reduced quantity of amniotic fluid present for an extended period of time, VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
with or without renal anomTaE
VBN lieSsT
, iB
sAasNsoKcS
iaE
teLdLwEitR
h.luCnO
gMhypoplasia. The mechanisms by whic
VB N VBN VBN VBN VBN VBN VBN VBN VBN VBN VBNVBN
h amniotic fluid volume influences lung growth remain unclear. Possible explanations for
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
reduced quantity of amniotic fluid include mechanical restriction of the chest wall, interference
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
with fetal breathing, or failure to produce fetal lung liquid. These clinical and experimental obs
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
ervations possibly point to a common denominator, lung stretch, as being amajor growth stimu VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
lant.
REF: pp. 6-7 V BN VBN
5. What is the purpose of the substance secreted by the type IIpneumocyte?
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
a. To increase the gas exchange surface area VBN VBN VBN VBN VBN VBN
b. To reduce surface tension VBN VBN VBN
c. To maintain lung elasticity VBN VBN VBN
d. To preserve the volume of the amniotic fluid VBN VBN VBN VBN VBN VBN VBN
ANS: B V B N
The primary role of mammalian surfactant is to lower the surface tension within the alveolus, spe
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN V BN
cifically at the air– VBN VBN VBN
liquid interface. This allows the delicate structure of the alveolus to expand when filled with air.
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN V BN VBN VBN VBN VBN VBN
Without surfactant, the alveolus remains collapsed because of thehigh surface tension of the mois VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
t alveolar surface. Surfactant is composed predominantly of an intricate blend of phospholipids,
V BN VBN V BN VBN VBN V BN VBN VBN VBN VBN VBN VBN VBN
neutral lipids, and proteins. VBN VBN VBN
REF: p. 8 V BN VBN
, 6. Which of the following tests of the amniotic fluid have been shown to be sensitive indicatorsof lu VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
ng maturity? VBN
a. Levels of prednisone VBN VBN
b. Levels of epidermal growth factor VBN VBN VBN VBN
c. Levels of prostaglandins VBN VBN
d. Levels of phosphatidylglycerol and phosphatidylcholine VBN VBN VBN VBN
ANS: D V B N
Ofclinical relevance during late gestation, analysis of amniotic fluid for the concentration ofpho
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
sphatidylglycerol and phosphatidylcholine has been shown to be a sensitive indicator of the sta VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
te of fetal lung maturity.
VBN VBN VBN V BN
REF: p. 8 V BN VBN
7. Approximately how much fetal lung fluid is secreted daily?
VBN VBN VBN VBN VBN VBN VBN VBN VBN
a. About 150 to 200 ml
VBN VBN VBN VBN VBN
b. About 250 to 300 ml
VBN VBN VBN VBN VBN
c. About 350 to 400 ml
VBN VBN VBN VBN VBN
d. About 450 to 500 ml
VBN VBN VBN VBN VBN
ANS: B VBN
Fetal lungs are secretory organs that make breathing-
VBN VBN VBN VBN VBN VBN VBN
like movements but serve no respiratory function before birth. They secrete
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
about 250 to 300 ml of liquid per day.VBN VBN VBN VBN VBN VBN VBN VBN
8. The lung bud emerges from which of the following structures?
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
a. The pharynx
VBN VBN
b. The foregut
VBN VBN
c. The mesenchyme
VBN VBN
d. The tubular epithelium
VBN VBN VBN
ANS: A VBN
The embryonal phase includes primitive lung development and is generally regarded to encompass the first 2 months
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
of gestation.
VBN VBN
The lung begins to emerge as a bud from the pharynx 26 days after conception.
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
Care, 6th Edition
by Brian K. Walsh
,Chapter 1: Fetal Lung Development
VBN VBN VBN VBN N
B
V
Test Bank
VBN
MULTIPLE CHOICE VBN
1. Which of the following phases of human lung development is characterized by the formationof a
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
capillary network around airway passages? VBN V BN VBN VBN
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: D V B N
The canalicular phase follows the pseudoglandular phase, lasting from approximately 17 weeks
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN V BN VBN
to 26 weeks of gestation. This phase is so named because of the appearance of vascularchannels, or
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
capillaries, which begin to grow by forming a capillary network around the air passages. During VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
the pseudoglandular stage, which begins at day 52 and extends to week 16 of gestation, the airwa
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN V BN V BN VBN VBN
y system subdivides extensively and the conducting airway system develops, ending with the ter
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
minal bronchioles. The saccular stage of development, which takes place from weeks 29 to 36 of g
VBN VBN VBN VBN VBN VBN VBN V BN VBN VBN VBN VBN VBN VBN VBN VBN
estation, is characterized by the development of sacs thatlater become alveoli. During the saccula VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
r phase, a tremendous increase in the potential
VBN V BN V BN VBN VBN VBN VBN
gas-
exchanging surface area occurs. The distinction between the saccular stage and the alveolar s VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN V BN VBN
tage is arbitrary. The alveolar stage stretches from 39 weeks of gestation to term.This stage is
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
represented by the establishment of alveoli. V BN VBN VBN VBN VBN
REF: pp. 3-5 V B N VBNVBNV B N
2. Regarding postnatal lung growth, by approximately what age do most of the alveoli that willbe VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
present in the lungs for life develop? VBN VBN VBN VBN VBN VBN
a. 6 months VBN
b. 1 year VBN
c. 1.5 years VBN
d. 2 years VBN
ANS: C V B N
Most of the postnatal formation of alveoli in the infant occurs over the first 1.5 years of life. At 2 y
VBN VBN VBN VBN VBN VBN VBN V BN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
ears of age, the numberof alveoli varies substantially among individuals. After 2 yearsof age, mal
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
es have more alveoli than do females. After alveolar multiplication ends, the alveoli continue to i
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN V BN VBN VBN VBN
ncrease in size until thoracic growth is completed. VBN VBN VBN VBN VBN VBN VBN
REF: p. 6 V BN VBN
3. Therespiratory therapist is evaluating a newborn with mild respiratory distress due to trachealst
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
enosis. During which period of lung development did this problem develop? VBN VBN VBN VBN VBN VBN VBN VBN V BN VBN
a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS: A V B N
, The initial structures of the pulmonary tree develop during the embryonal stage. Errors in deve
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
lopment during this time may result in laryngeal, tracheal, or esophageal atresia or stenosis. Pu
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
lmonary hypoplasia, an incomplete development of the lungs characterized by anabnormally lo VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
w number and/or size of bronchopulmonary segments and/or alveoli, can develop during the p
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
seudoglandular phase. If the fetus is born during the canalicular phase (i.e., prematurely), sever VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
e respiratory distress can be expected because the inadequately developed airways, along with i
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
nsufficient and immature surfactant production by alveolar type II cells, gives rise to the conste VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
llation of problems known as infant respiratory distress syndrome.
VBN VBN VBN VBN VBN VBN VBN V BN
REF: p. 6 VBNVBNV B N VBN
4. Which of the following mechanisms is (are) responsible for the possible association betweenolig
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
ohydramnios and lung hypoplasia? VBN VBN VBN
I. Abnormal carbohydrate metabolism VBN VBN
II. Mechanical restriction of the chest wall VBN VBN VBN VBN VBN
III. Interferencewith fetal breathing VBN VBN VBN
IV. Failure to produce fetal lung liquid VBN VBN VBN VBN VBN
a. I and III only VBN VBN VBN
b. II and III only VBN VBN VBN
c. I, II, and IV only VBN VBN VBN VBN
d. II, III, and IV only VBN VBN VBN VBN
ANS: D V B N
Oligohydramnios, a reduced quantity of amniotic fluid present for an extended period of time, VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
with or without renal anomTaE
VBN lieSsT
, iB
sAasNsoKcS
iaE
teLdLwEitR
h.luCnO
gMhypoplasia. The mechanisms by whic
VB N VBN VBN VBN VBN VBN VBN VBN VBN VBN VBNVBN
h amniotic fluid volume influences lung growth remain unclear. Possible explanations for
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
reduced quantity of amniotic fluid include mechanical restriction of the chest wall, interference
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
with fetal breathing, or failure to produce fetal lung liquid. These clinical and experimental obs
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
ervations possibly point to a common denominator, lung stretch, as being amajor growth stimu VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
lant.
REF: pp. 6-7 V BN VBN
5. What is the purpose of the substance secreted by the type IIpneumocyte?
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
a. To increase the gas exchange surface area VBN VBN VBN VBN VBN VBN
b. To reduce surface tension VBN VBN VBN
c. To maintain lung elasticity VBN VBN VBN
d. To preserve the volume of the amniotic fluid VBN VBN VBN VBN VBN VBN VBN
ANS: B V B N
The primary role of mammalian surfactant is to lower the surface tension within the alveolus, spe
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN V BN
cifically at the air– VBN VBN VBN
liquid interface. This allows the delicate structure of the alveolus to expand when filled with air.
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN V BN VBN VBN VBN VBN VBN
Without surfactant, the alveolus remains collapsed because of thehigh surface tension of the mois VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
t alveolar surface. Surfactant is composed predominantly of an intricate blend of phospholipids,
V BN VBN V BN VBN VBN V BN VBN VBN VBN VBN VBN VBN VBN
neutral lipids, and proteins. VBN VBN VBN
REF: p. 8 V BN VBN
, 6. Which of the following tests of the amniotic fluid have been shown to be sensitive indicatorsof lu VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
ng maturity? VBN
a. Levels of prednisone VBN VBN
b. Levels of epidermal growth factor VBN VBN VBN VBN
c. Levels of prostaglandins VBN VBN
d. Levels of phosphatidylglycerol and phosphatidylcholine VBN VBN VBN VBN
ANS: D V B N
Ofclinical relevance during late gestation, analysis of amniotic fluid for the concentration ofpho
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
sphatidylglycerol and phosphatidylcholine has been shown to be a sensitive indicator of the sta VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
te of fetal lung maturity.
VBN VBN VBN V BN
REF: p. 8 V BN VBN
7. Approximately how much fetal lung fluid is secreted daily?
VBN VBN VBN VBN VBN VBN VBN VBN VBN
a. About 150 to 200 ml
VBN VBN VBN VBN VBN
b. About 250 to 300 ml
VBN VBN VBN VBN VBN
c. About 350 to 400 ml
VBN VBN VBN VBN VBN
d. About 450 to 500 ml
VBN VBN VBN VBN VBN
ANS: B VBN
Fetal lungs are secretory organs that make breathing-
VBN VBN VBN VBN VBN VBN VBN
like movements but serve no respiratory function before birth. They secrete
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
about 250 to 300 ml of liquid per day.VBN VBN VBN VBN VBN VBN VBN VBN
8. The lung bud emerges from which of the following structures?
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
a. The pharynx
VBN VBN
b. The foregut
VBN VBN
c. The mesenchyme
VBN VBN
d. The tubular epithelium
VBN VBN VBN
ANS: A VBN
The embryonal phase includes primitive lung development and is generally regarded to encompass the first 2 months
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
of gestation.
VBN VBN
The lung begins to emerge as a bud from the pharynx 26 days after conception.
VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN VBN
