Neonatal and Pediatric Respiratory Care – Brian K. Walsh, 6th Edition | Complete Test Bank

Test Bank for Neonatal and
Pediatric Respiratory Care, 6th
Edition
by Brian K. Walsh

,Chapter 1:Fetal Lung Development
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Test Bank
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MULTIPLE CHOICE we




1. Which of the following phases of human lung development is characterized by the formationof a
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capillary network around airway passages? we we we we




a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: D w e




The canalicular phase follows the pseudoglandular phase, lasting from approximately 17 weeks t
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o 26 weeks of gestation. This phase is so named because of the appearance of vascularchannels, or c
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apillaries, which begin to grow by forming a capillary network around the air passages. During th
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e pseudoglandular stage, which begins at day 52 and extends to week 16 of gestation, the airway s
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ystem subdivides extensively and the conducting airway system develops, ending with the termi
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nal bronchioles. The saccular stage of development, which takes place from weeks 29 to 36 of gest
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ation, is characterized by the development of sacs thatlater become alveoli. During the saccular p
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hase, a tremendous increase in the potential
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gas-
exchanging surface area occurs. The distinction between the saccular stage and the alveolar s we we we we we we we we we we we we we




tage is arbitrary. The alveolar stage stretches from 39 weeks of gestation to term.This stage is
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represented by the establishment of alveoli. we we we we we




REF: pp. 3-5 w e wewew e




2. Regarding postnatal lung growth, by approximately what age do most of the alveoli that willbe we we we we we we we we we we we we we we w
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present in the lungs for life develop? we we we we we we




a. 6 months we




b. 1 year we




c. 1.5 years we




d. 2 years we




ANS: C w e




Most of the postnatal formation of alveoli in the infant occurs over the first 1.5 years of life. At 2 y
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ears of age, the number of alveoli varies substantially among individuals. After 2 yearsof age, mal
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es have more alveoli than do females. After alveolar multiplication ends, the alveoli continue to i
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ncrease in size until thoracic growth is completed. we we we we we we we




REF: p. 6 w e we




3. The respiratory therapist is evaluating a newborn with mild respiratory distress due to trachealst
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enosis. During which period of lung development did this problem develop?
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a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS: A w e

, The initial structures of the pulmonary tree develop during the embryonal stage. Errors in deve
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lopment during this time may result in laryngeal, tracheal, or esophageal atresia or stenosis. Pul
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monary hypoplasia, an incomplete development of the lungs characterized by anabnormally low
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number and/or size of bronchopulmonary segments and/or alveoli, can develop during the pse
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udoglandular phase. If the fetus is born during the canalicular phase (i.e., prematurely), severe re we we we we we we we we we we we we we we




spiratory distress can be expected because the inadequately developed airways, along with insuf
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ficient and immature surfactant production by alveolar type II cells, gives rise to the constellatio
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n of problems known as infant respiratory distress syndrome.
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REF: p. 6 wewew e we




4. Which of the following mechanisms is (are) responsible for the possible association betweenolig
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ohydramnios and lung hypoplasia? we we we




I. Abnormal carbohydrate metabolism we we




II. Mechanical restriction of the chest wall we we we we we




III. Interference with fetal breathing we we we




IV. Failure to produce fetal lung liquid we we we we we




a. I and III only we we we




b. II and III only we we we




c. I, II, and IV only we we we we




d. II, III, and IV only we we we we




ANS: D w e




Oligohydramnios, a reduced quantity of amniotic fluid present for an extended period of time, we we we we we we we we we we we we we




with or without renal anomTaE
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gMhypoplasia. The mechanisms by which we we we w
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amniotic fluid volume influences lung growth remain unclear. Possible explanations for
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reduced quantity of amniotic fluid include mechanical restriction of the chest wall, interference
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with fetal breathing, or failure to produce fetal lung liquid. These clinical and experimental obse
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rvations possibly point to a common denominator, lung stretch, as being amajor growth stimul
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ant.

REF: pp. 6-7 w e we




5. What is the purpose of the substance secreted by the type II pneumocyte?
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a. To increase the gas exchange surface area we we we we we we




b. To reduce surface tension we we we




c. To maintain lung elasticity we we we




d. To preserve the volume of the amniotic fluid we we we we we we we




ANS: B w e




The primary role of mammalian surfactant is to lower the surface tension within the alveolus, spe
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cifically at the air– we we we




liquid interface. This allows the delicate structure of the alveolus to expand when filled with air.
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Without surfactant, the alveolus remains collapsed because of thehigh surface tension of the mois
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t alveolar surface. Surfactant is composed predominantly of an intricate blend of phospholipids, n
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eutral lipids, and proteins. we we we




REF: p. 8 w e we

, 6. Which of the following tests of the amniotic fluid have been shown to be sensitive indicatorsof lu
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ng maturity? we




a. Levels of prednisone we we




b. Levels of epidermal growth factor we we we we




c. Levels of prostaglandins we we




d. Levels of phosphatidylglycerol and phosphatidylcholine we we we we




ANS: D w e




Of clinical relevance during late gestation, analysis of amniotic fluid for the concentration ofpho
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sphatidylglycerol and phosphatidylcholine has been shown to be a sensitive indicator of the stat we we we we we we we we we we we we we




e of fetal lung maturity.
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REF: p. 8 w e we




7. Approximately how much fetal lung fluid is secreted daily?
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a. About 150 to 200 ml
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b. About 250 to 300 ml
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c. About 350 to 400 ml
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d. About 450 to 500 ml
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ANS: B we




Fetal lungs are secretory organs that make breathing-
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like movements but serve no respiratory function before birth. They secrete
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about 250 to 300 ml of liquid per day.
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8. The lung bud emerges from which of the following structures?
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a. The pharynx
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b. The foregut
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c. The mesenchyme
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d. The tubular epithelium
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ANS: A we




The embryonal phase includes primitive lung development and is generally regarded to encompass the first 2 months o
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f gestation.
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The lung begins to emerge as a bud from the pharynx 26 days after conception.
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