test bank for neonatal and pediatric respiratory
care 5th edition by brian k. walsh phd latest
update.all chapters covered
,table of contents
chapter 1: fetal lung development ...................................................................... 4
chapter 2: fetal gas exchange and circulation ..................................................... 8
chapter 3: antenatal assessment and high risk delivery .................................... 12
chapter 4: exam and assessment of the neonatal and pediatric patient ............ 28
chapter 5: pulmonary function testing and bedside pulmonary mechanics ....... 52
chapter 6: radiographic assessment .................................................................. 63
chapter 7: bronchoscopy ................................................................................... 76
chapter 8: invasive blood gas analysis and monitoring ..................................... 89
chapter 9: noninvasive monitoring in neonatal and pediatric care .................. 103
chapter 10: oxygen administration ................................................................. 115
chapter 11: aerosols and administration of medication .................................. 125
chapter 12: airway clearance techniques and lung volume expansion............. 139
chapter 13: airway management .................................................................... 152
14: surfactant replacement therapy ................................................................ 168
chapter 15: non-invasive mechanical ventilation and continuous positive
pressure of the neonate .................................................................................. 171
chapter 16: noninvasive mechanical ventilation of the infant and child .......... 183
chapter 17- invasive mechanical ventilation of the neonate and pediatric patient
....................................................................................................................... 195
chapter 18: administration of gas mixtures ..................................................... 205
chapter 19, extracorporeal membrane oxygenation ....................................... 221
pharmacology- chapter 20 .............................................................................. 226
chapter 21: thoracic organ transplantation ..................................................... 235
chapter 22: neonatal pulmonary disorders answers to case studies ................ 253
chapter 23 surgical disorders in childhood that affect respiratory care ........... 255
chapter 24: congenital cardiac defects ............................................................ 263
chapter 25 pediatric sleep-disordered breathing ............................................. 280
,chapter 26: pediatric airway disorders and parenchymal lung diseases .......... 296
chapter 27: asthma test bank ......................................................................... 312
chapter 28: cystic fibrosis ................................................................................ 326
chapter 29: acute respiratory distress syndrome ............................................. 338
chapter 30: shock ............................................................................................ 351
chapter 31: pediatric trauma .......................................................................... 361
chapter 32: disorders of the pleura ................................................................. 398
chapter 33: neurological and neuromuscular disorders ................................... 405
chapter 34 pediatric emergencies ................................................................... 414
chapter 35: home care of the postpartum family ............................................ 436
chapter 36: quality and safety ........................................................................ 444
,chapter 1: fetal lung development
walsh: neonatal & pediatric respiratory care 5th edition test bank (2020)
multiple choice
1. which of the following phases of human lung development is
characterized by the formation of a capillary network around airway passages?
a. pseudoglandular
b. saccular
c. alveolar
d. canalicular
CORRECT ANSWER>>d
the canalicular phase follows the pseudoglandular phase, lasting from
approximately 17 weeks to 26 weeks of gestation. this phase is so named
because of the appearance of vascular channels, or capillaries, which begin to
grow by forming a capillary network around the air passages. during the
pseudoglandular stage, which begins at day 52 and extends to week 16 of
gestation, the airway system subdivides extensively and the conducting airway
system develops, ending with the terminal bronchioles. the saccular stage of
development, which takes place from weeks 29 to 36 of gestation, is
characterized by the development of sacs that later become alveoli. during the
saccular phase, a tremendous increase in the potential gas- exchanging surface
area occurs. the distinction between the saccular stage and the alveolar stage is
arbitrary. the alveolar stage stretches from 39 weeks of gestation to term. this
stage is represented by the establishment of alveoli.
ref: pp. 3-5
,2. regarding postnatal lung growth, by approximately what age do most of
the alveoli that will be present in the lungs for life develop?
a. 6 months
b. 1 year
c. 1.5 years
d. 2 years
CORRECT ANSWER>>c
most of the postnatal formation of alveoli in the infant occurs over the first 1.5
years of life. at 2 years of age, the number of alveoli varies substantially among
individuals. after 2 years of age, males have more alveoli than do females. after
alveolar multiplication ends, the alveoli continue to increase in size until thoracic
growth is completed.
ref: p. 6
3. the respiratory therapist is evaluating a newborn with mild respiratory
distress due to tracheal stenosis. during which period of lung development did
this problem develop?
a. embryonal
b. saccular
c. canalicular
d. alveolar
CORRECT ANSWER>>a
the initial structures of the pulmonary tree develop during the embryonal stage.
errors in development during this time may result in laryngeal, tracheal, or
,esophageal atresia or stenosis. pulmonary hypoplasia, an incomplete
development of the lungs characterized by an abnormally low number and/or
size of bronchopulmonary segments and/or alveoli, can develop during the
pseudoglandular phase. if the fetus is born during the canalicular phase (i.e.,
prematurely), severe respiratory distress can be expected because the
inadequately developed airways, along with insufficient and immature
surfactant production by alveolar type ii cells, gives rise to the constellation of
problems known as infant respiratory distress syndrome.
ref: p. 6
4. which of the following mechanisms is (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
CORRECT ANSWER>>d
oligohydramnios, a reduced quantity of amniotic fluid present for an extended
period of time, with or without renal anomalies, is associated with lung
hypoplasia. the mechanisms by which amniotic fluid volume influences lung
growth remain unclear. possible explanations for reduced quantity of amniotic
fluid include mechanical restriction of the chest wall, interference with fetal
, breathing, or failure to produce fetal lung liquid. these clinical and experimental
observations possibly point to a common denominator, lung stretch, as being a
major growth stimulant.
ref: pp. 6-7
5. what is the purpose of the substance secreted by the type ii pneumocyte?
a. to increase the gas exchange surface area
b. to reduce surface tension
c. to maintain lung elasticity
d. to preserve the volume of the amniotic fluid
CORRECT ANSWER>>b
the primary role of mammalian surfactant is to lower the surface tension within
the alveolus, specifically at the air–liquid interface. this allows the delicate
structure of the alveolus to expand when filled with air. without surfactant, the
alveolus remains collapsed because of the high surface tension of the moist
alveolar surface. surfactant is composed predominantly of an intricate blend of
phospholipids, neutral lipids, and proteins.
ref: p. 8
6. which of the following tests of the amniotic fluid have been shown to be
sensitive indicators of lung maturity?
a. levels of prednisone
b. levels of epidermal growth factor
c. levels of prostaglandins
care 5th edition by brian k. walsh phd latest
update.all chapters covered
,table of contents
chapter 1: fetal lung development ...................................................................... 4
chapter 2: fetal gas exchange and circulation ..................................................... 8
chapter 3: antenatal assessment and high risk delivery .................................... 12
chapter 4: exam and assessment of the neonatal and pediatric patient ............ 28
chapter 5: pulmonary function testing and bedside pulmonary mechanics ....... 52
chapter 6: radiographic assessment .................................................................. 63
chapter 7: bronchoscopy ................................................................................... 76
chapter 8: invasive blood gas analysis and monitoring ..................................... 89
chapter 9: noninvasive monitoring in neonatal and pediatric care .................. 103
chapter 10: oxygen administration ................................................................. 115
chapter 11: aerosols and administration of medication .................................. 125
chapter 12: airway clearance techniques and lung volume expansion............. 139
chapter 13: airway management .................................................................... 152
14: surfactant replacement therapy ................................................................ 168
chapter 15: non-invasive mechanical ventilation and continuous positive
pressure of the neonate .................................................................................. 171
chapter 16: noninvasive mechanical ventilation of the infant and child .......... 183
chapter 17- invasive mechanical ventilation of the neonate and pediatric patient
....................................................................................................................... 195
chapter 18: administration of gas mixtures ..................................................... 205
chapter 19, extracorporeal membrane oxygenation ....................................... 221
pharmacology- chapter 20 .............................................................................. 226
chapter 21: thoracic organ transplantation ..................................................... 235
chapter 22: neonatal pulmonary disorders answers to case studies ................ 253
chapter 23 surgical disorders in childhood that affect respiratory care ........... 255
chapter 24: congenital cardiac defects ............................................................ 263
chapter 25 pediatric sleep-disordered breathing ............................................. 280
,chapter 26: pediatric airway disorders and parenchymal lung diseases .......... 296
chapter 27: asthma test bank ......................................................................... 312
chapter 28: cystic fibrosis ................................................................................ 326
chapter 29: acute respiratory distress syndrome ............................................. 338
chapter 30: shock ............................................................................................ 351
chapter 31: pediatric trauma .......................................................................... 361
chapter 32: disorders of the pleura ................................................................. 398
chapter 33: neurological and neuromuscular disorders ................................... 405
chapter 34 pediatric emergencies ................................................................... 414
chapter 35: home care of the postpartum family ............................................ 436
chapter 36: quality and safety ........................................................................ 444
,chapter 1: fetal lung development
walsh: neonatal & pediatric respiratory care 5th edition test bank (2020)
multiple choice
1. which of the following phases of human lung development is
characterized by the formation of a capillary network around airway passages?
a. pseudoglandular
b. saccular
c. alveolar
d. canalicular
CORRECT ANSWER>>d
the canalicular phase follows the pseudoglandular phase, lasting from
approximately 17 weeks to 26 weeks of gestation. this phase is so named
because of the appearance of vascular channels, or capillaries, which begin to
grow by forming a capillary network around the air passages. during the
pseudoglandular stage, which begins at day 52 and extends to week 16 of
gestation, the airway system subdivides extensively and the conducting airway
system develops, ending with the terminal bronchioles. the saccular stage of
development, which takes place from weeks 29 to 36 of gestation, is
characterized by the development of sacs that later become alveoli. during the
saccular phase, a tremendous increase in the potential gas- exchanging surface
area occurs. the distinction between the saccular stage and the alveolar stage is
arbitrary. the alveolar stage stretches from 39 weeks of gestation to term. this
stage is represented by the establishment of alveoli.
ref: pp. 3-5
,2. regarding postnatal lung growth, by approximately what age do most of
the alveoli that will be present in the lungs for life develop?
a. 6 months
b. 1 year
c. 1.5 years
d. 2 years
CORRECT ANSWER>>c
most of the postnatal formation of alveoli in the infant occurs over the first 1.5
years of life. at 2 years of age, the number of alveoli varies substantially among
individuals. after 2 years of age, males have more alveoli than do females. after
alveolar multiplication ends, the alveoli continue to increase in size until thoracic
growth is completed.
ref: p. 6
3. the respiratory therapist is evaluating a newborn with mild respiratory
distress due to tracheal stenosis. during which period of lung development did
this problem develop?
a. embryonal
b. saccular
c. canalicular
d. alveolar
CORRECT ANSWER>>a
the initial structures of the pulmonary tree develop during the embryonal stage.
errors in development during this time may result in laryngeal, tracheal, or
,esophageal atresia or stenosis. pulmonary hypoplasia, an incomplete
development of the lungs characterized by an abnormally low number and/or
size of bronchopulmonary segments and/or alveoli, can develop during the
pseudoglandular phase. if the fetus is born during the canalicular phase (i.e.,
prematurely), severe respiratory distress can be expected because the
inadequately developed airways, along with insufficient and immature
surfactant production by alveolar type ii cells, gives rise to the constellation of
problems known as infant respiratory distress syndrome.
ref: p. 6
4. which of the following mechanisms is (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
CORRECT ANSWER>>d
oligohydramnios, a reduced quantity of amniotic fluid present for an extended
period of time, with or without renal anomalies, is associated with lung
hypoplasia. the mechanisms by which amniotic fluid volume influences lung
growth remain unclear. possible explanations for reduced quantity of amniotic
fluid include mechanical restriction of the chest wall, interference with fetal
, breathing, or failure to produce fetal lung liquid. these clinical and experimental
observations possibly point to a common denominator, lung stretch, as being a
major growth stimulant.
ref: pp. 6-7
5. what is the purpose of the substance secreted by the type ii pneumocyte?
a. to increase the gas exchange surface area
b. to reduce surface tension
c. to maintain lung elasticity
d. to preserve the volume of the amniotic fluid
CORRECT ANSWER>>b
the primary role of mammalian surfactant is to lower the surface tension within
the alveolus, specifically at the air–liquid interface. this allows the delicate
structure of the alveolus to expand when filled with air. without surfactant, the
alveolus remains collapsed because of the high surface tension of the moist
alveolar surface. surfactant is composed predominantly of an intricate blend of
phospholipids, neutral lipids, and proteins.
ref: p. 8
6. which of the following tests of the amniotic fluid have been shown to be
sensitive indicators of lung maturity?
a. levels of prednisone
b. levels of epidermal growth factor
c. levels of prostaglandins
