Test Bank for Neonatal and Pediatric Respiratory
Care, 6th Edition
by Brian K. Walsh
,Chapter 1: Fetal Lung Development
oi oi oi oi io
Test Bank
oi
MULTIPLE CHOICE oi
1. Which of the following phases of human lung development is characterized by the formation
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
of a capillary network around airway passages?
oi oi oi oi oi oi
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: D oi
The canalicular phase follows the pseudoglandular phase, lasting from approximately 17 wee
oi oi oi oi oi oi oi oi oi oi oi
ks to 26 weeks of gestation. This phase is so named because of the appearance of vascularchann
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
els, or capillaries, which begin to grow by forming a capillary network around the air passages
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
. During the pseudoglandular stage, which begins at day 52 and extends to week 16 of gestatio
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
n, the airway system subdivides extensively and the conducting airway system develops, endi
oi oi oi oi oi oi oi oi oi oi oi oi
ng with the terminal bronchioles. The saccular stage of development, which takes place from
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
weeks 29 to 36 of gestation, is characterized by the development of sacs thatlater become alveo
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
li. During the saccular phase, a tremendous increase in the potential
oi oi oi oi oi oi oi oi oi oi
gas-
exchanging surface area occurs. The distinction between the saccular stage and the alveola
oi oi oi oi oi oi oi oi oi oi oi oi
r stage is arbitrary. The alveolar stage stretches from 39 weeks of gestation to term.This st
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
age is represented by the establishment of alveoli.
oi oi oi oi oi oi oi
REF: pp. 3-5 o i oioio i
2. Regarding postnatal lung growth, by approximately what age do most of the alveoli that will
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
be present in the lungs for life develop?
oi oi oi oi oi oi oi
a. 6 months oi
b. 1 year oi
c. 1.5 years oi
d. 2 years oi
ANS: C oi
Most of the postnatal formation of alveoli in the infant occurs over the first 1.5 years of life. A
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
t 2 years of age, the number of alveoli varies substantially among individuals. After 2 yearsof a
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
ge, males have more alveoli than do females. After alveolar multiplication ends, the alveoli co
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
ntinue to increase in size until thoracic growth is completed.
oi oi oi oi oi oi oi oi oi
REF: p. 6 oi oi
3. The respiratory therapist is evaluating a newborn with mild respiratory distress due to trachea
oi oi oi oi oi oi oi oi oi oi oi oi oi
lstenosis. During which period of lung development did this problem develop?
oi oi oi oi oi oi oi oi oi oi oi
a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS: A oi
, The initial structures of the pulmonary tree develop during the embryonal stage. Errors in d
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
evelopment during this time may result in laryngeal, tracheal, or esophageal atresia or steno oi oi oi oi oi oi oi oi oi oi oi oi oi
sis. Pulmonary hypoplasia, an incomplete development of the lungs characterized by anabnor
oi oi oi oi oi oi oi oi oi oi oi oi
mally low number and/or size of bronchopulmonary segments and/or alveoli, can develop d
oi oi oi oi oi oi oi oi oi oi oi oi
uring the pseudoglandular phase. If the fetus is born during the canalicular phase (i.e., prema
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
turely), severe respiratory distress can be expected because the inadequately developed airwa
oi oi oi oi oi oi oi oi oi oi oi
ys, along with insufficient and immature surfactant production by alveolar type II cells, gives
oi oi oi oi oi oi oi oi oi oi oi oi oi
rise to the constellation of problems known as infant respiratory distress syndrome.
oi oi oi oi oi oi oi oi oi oi oi oi
REF: p. 6 oioioi oi
4. Which of the following mechanisms is (are) responsible for the possible association betweeno
oi oi oi oi oi oi oi oi oi oi oi oi oi
ligohydramnios and lung hypoplasia? oi oi oi
I. Abnormal carbohydrate metabolism oi oi
II. Mechanical restriction of the chest wall oi oi oi oi oi
III. Interference with fetal breathing oi oi oi
IV. Failure to produce fetal lung liquid oi oi oi oi oi
a. I and III only oi oi oi
b. II and III only oi oi oi
c. I, II, and IV only oi oi oi oi
d. II, III, and IV only oi oi oi oi
ANS: D oi
Oligohydramnios, a reduced quantity of amniotic fluid present for an extended period of time, oi oi oi oi oi oi oi oi oi oi oi oi oi
with or without renal anomTaE
oi lieSsT
, iB
sAasNsoKcS
iaE
teLdLwEitR
oihlu
. CnO
gMhypoplasia. The mechanisms by whi oi oi oi oi oi oi oi oi oi oioi
ch amniotic fluid volume influences lung growth remain unclear. Possible explanations for
oi oi oi oi oi oi oi oi oi oi oi
reduced quantity of amniotic fluid include mechanical restriction of the chest wall, interferen
oi oi oi oi oi oi oi oi oi oi oi oi
ce with fetal breathing, or failure to produce fetal lung liquid. These clinical and experimenta
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
l observations possibly point to a common denominator, lung stretch, as being amajor growt
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
h stimulant.
oi
REF: pp. 6-7 oi oi
5. What is the purpose of the substance secreted by the type II pneumocyte?
oi oi oi oi oi oi oi oi oi oi oi oi
a. To increase the gas exchange surface area oi oi oi oi oi oi
b. To reduce surface tension oi oi oi
c. To maintain lung elasticity oi oi oi
d. To preserve the volume of the amniotic fluid oi oi oi oi oi oi oi
ANS: B oi
The primary role of mammalian surfactant is to lower the surface tension within the alveolus,
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
specifically at the air– oi oi oi
liquid interface. This allows the delicate structure of the alveolus to expand when filled with ai
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
r. Without surfactant, the alveolus remains collapsed because of thehigh surface tension of the
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
moist alveolar surface. Surfactant is composed predominantly of an intricate blend of phospho
oi oi oi oi oi oi oi oi oi oi oi oi
lipids, neutral lipids, and proteins. oi oi oi oi
REF: p. 8 oi oi
, 6. Which of the following tests of the amniotic fluid have been shown to be sensitive indicatorso
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
f lung maturity?
oi oi
a. Levels of prednisone oi oi
b. Levels of epidermal growth factor oi oi oi oi
c. Levels of prostaglandins oi oi
d. Levels of phosphatidylglycerol and phosphatidylcholine oi oi oi oi
ANS: D oi
Of clinical relevance during late gestation, analysis of amniotic fluid for the concentration ofp
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
hosphatidylglycerol and phosphatidylcholine has been shown to be a sensitive indicator of th oi oi oi oi oi oi oi oi oi oi oi oi
e state of fetal lung maturity.
oi oi oi oi oi
REF: p. 8 oi oi
7. Approximately how much fetal lung fluid is secreted daily?
oi oi oi oi oi oi oi oi oi
a. About 150 to 200 ml
oi oi oi oi oi
b. About 250 to 300 ml
oi oi oi oi oi
c. About 350 to 400 ml
oi oi oi oi oi
d. About 450 to 500 ml
oi oi oi oi oi
ANS: B oi
Fetal lungs are secretory organs that make breathing-
oi oi oi oi oi oi oi
like movements but serve no respiratory function before birth. They secrete
oi oi oi oi oi oi oi oi oi oi oi
about 250 to 300 ml of liquid per day.
oi oi oi oi oi oi oi oi
8. The lung bud emerges from which of the following structures?
oi oi oi oi oi oi oi oi oi oi oi
a. The pharynx
oi oi
b. The foregut
oi oi
c. The mesenchyme
oi oi
d. The tubular epithelium
oi oi oi
ANS: A oi
The embryonal phase includes primitive lung development and is generally regarded to encompass the first 2 mon
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
ths of gestation.
oi oi oi
The lung begins to emerge as a bud from the pharynx 26 days after conception.
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
Care, 6th Edition
by Brian K. Walsh
,Chapter 1: Fetal Lung Development
oi oi oi oi io
Test Bank
oi
MULTIPLE CHOICE oi
1. Which of the following phases of human lung development is characterized by the formation
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
of a capillary network around airway passages?
oi oi oi oi oi oi
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: D oi
The canalicular phase follows the pseudoglandular phase, lasting from approximately 17 wee
oi oi oi oi oi oi oi oi oi oi oi
ks to 26 weeks of gestation. This phase is so named because of the appearance of vascularchann
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
els, or capillaries, which begin to grow by forming a capillary network around the air passages
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
. During the pseudoglandular stage, which begins at day 52 and extends to week 16 of gestatio
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
n, the airway system subdivides extensively and the conducting airway system develops, endi
oi oi oi oi oi oi oi oi oi oi oi oi
ng with the terminal bronchioles. The saccular stage of development, which takes place from
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
weeks 29 to 36 of gestation, is characterized by the development of sacs thatlater become alveo
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
li. During the saccular phase, a tremendous increase in the potential
oi oi oi oi oi oi oi oi oi oi
gas-
exchanging surface area occurs. The distinction between the saccular stage and the alveola
oi oi oi oi oi oi oi oi oi oi oi oi
r stage is arbitrary. The alveolar stage stretches from 39 weeks of gestation to term.This st
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
age is represented by the establishment of alveoli.
oi oi oi oi oi oi oi
REF: pp. 3-5 o i oioio i
2. Regarding postnatal lung growth, by approximately what age do most of the alveoli that will
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
be present in the lungs for life develop?
oi oi oi oi oi oi oi
a. 6 months oi
b. 1 year oi
c. 1.5 years oi
d. 2 years oi
ANS: C oi
Most of the postnatal formation of alveoli in the infant occurs over the first 1.5 years of life. A
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
t 2 years of age, the number of alveoli varies substantially among individuals. After 2 yearsof a
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
ge, males have more alveoli than do females. After alveolar multiplication ends, the alveoli co
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
ntinue to increase in size until thoracic growth is completed.
oi oi oi oi oi oi oi oi oi
REF: p. 6 oi oi
3. The respiratory therapist is evaluating a newborn with mild respiratory distress due to trachea
oi oi oi oi oi oi oi oi oi oi oi oi oi
lstenosis. During which period of lung development did this problem develop?
oi oi oi oi oi oi oi oi oi oi oi
a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS: A oi
, The initial structures of the pulmonary tree develop during the embryonal stage. Errors in d
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
evelopment during this time may result in laryngeal, tracheal, or esophageal atresia or steno oi oi oi oi oi oi oi oi oi oi oi oi oi
sis. Pulmonary hypoplasia, an incomplete development of the lungs characterized by anabnor
oi oi oi oi oi oi oi oi oi oi oi oi
mally low number and/or size of bronchopulmonary segments and/or alveoli, can develop d
oi oi oi oi oi oi oi oi oi oi oi oi
uring the pseudoglandular phase. If the fetus is born during the canalicular phase (i.e., prema
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
turely), severe respiratory distress can be expected because the inadequately developed airwa
oi oi oi oi oi oi oi oi oi oi oi
ys, along with insufficient and immature surfactant production by alveolar type II cells, gives
oi oi oi oi oi oi oi oi oi oi oi oi oi
rise to the constellation of problems known as infant respiratory distress syndrome.
oi oi oi oi oi oi oi oi oi oi oi oi
REF: p. 6 oioioi oi
4. Which of the following mechanisms is (are) responsible for the possible association betweeno
oi oi oi oi oi oi oi oi oi oi oi oi oi
ligohydramnios and lung hypoplasia? oi oi oi
I. Abnormal carbohydrate metabolism oi oi
II. Mechanical restriction of the chest wall oi oi oi oi oi
III. Interference with fetal breathing oi oi oi
IV. Failure to produce fetal lung liquid oi oi oi oi oi
a. I and III only oi oi oi
b. II and III only oi oi oi
c. I, II, and IV only oi oi oi oi
d. II, III, and IV only oi oi oi oi
ANS: D oi
Oligohydramnios, a reduced quantity of amniotic fluid present for an extended period of time, oi oi oi oi oi oi oi oi oi oi oi oi oi
with or without renal anomTaE
oi lieSsT
, iB
sAasNsoKcS
iaE
teLdLwEitR
oihlu
. CnO
gMhypoplasia. The mechanisms by whi oi oi oi oi oi oi oi oi oi oioi
ch amniotic fluid volume influences lung growth remain unclear. Possible explanations for
oi oi oi oi oi oi oi oi oi oi oi
reduced quantity of amniotic fluid include mechanical restriction of the chest wall, interferen
oi oi oi oi oi oi oi oi oi oi oi oi
ce with fetal breathing, or failure to produce fetal lung liquid. These clinical and experimenta
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
l observations possibly point to a common denominator, lung stretch, as being amajor growt
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
h stimulant.
oi
REF: pp. 6-7 oi oi
5. What is the purpose of the substance secreted by the type II pneumocyte?
oi oi oi oi oi oi oi oi oi oi oi oi
a. To increase the gas exchange surface area oi oi oi oi oi oi
b. To reduce surface tension oi oi oi
c. To maintain lung elasticity oi oi oi
d. To preserve the volume of the amniotic fluid oi oi oi oi oi oi oi
ANS: B oi
The primary role of mammalian surfactant is to lower the surface tension within the alveolus,
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
specifically at the air– oi oi oi
liquid interface. This allows the delicate structure of the alveolus to expand when filled with ai
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
r. Without surfactant, the alveolus remains collapsed because of thehigh surface tension of the
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
moist alveolar surface. Surfactant is composed predominantly of an intricate blend of phospho
oi oi oi oi oi oi oi oi oi oi oi oi
lipids, neutral lipids, and proteins. oi oi oi oi
REF: p. 8 oi oi
, 6. Which of the following tests of the amniotic fluid have been shown to be sensitive indicatorso
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
f lung maturity?
oi oi
a. Levels of prednisone oi oi
b. Levels of epidermal growth factor oi oi oi oi
c. Levels of prostaglandins oi oi
d. Levels of phosphatidylglycerol and phosphatidylcholine oi oi oi oi
ANS: D oi
Of clinical relevance during late gestation, analysis of amniotic fluid for the concentration ofp
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
hosphatidylglycerol and phosphatidylcholine has been shown to be a sensitive indicator of th oi oi oi oi oi oi oi oi oi oi oi oi
e state of fetal lung maturity.
oi oi oi oi oi
REF: p. 8 oi oi
7. Approximately how much fetal lung fluid is secreted daily?
oi oi oi oi oi oi oi oi oi
a. About 150 to 200 ml
oi oi oi oi oi
b. About 250 to 300 ml
oi oi oi oi oi
c. About 350 to 400 ml
oi oi oi oi oi
d. About 450 to 500 ml
oi oi oi oi oi
ANS: B oi
Fetal lungs are secretory organs that make breathing-
oi oi oi oi oi oi oi
like movements but serve no respiratory function before birth. They secrete
oi oi oi oi oi oi oi oi oi oi oi
about 250 to 300 ml of liquid per day.
oi oi oi oi oi oi oi oi
8. The lung bud emerges from which of the following structures?
oi oi oi oi oi oi oi oi oi oi oi
a. The pharynx
oi oi
b. The foregut
oi oi
c. The mesenchyme
oi oi
d. The tubular epithelium
oi oi oi
ANS: A oi
The embryonal phase includes primitive lung development and is generally regarded to encompass the first 2 mon
oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi oi
ths of gestation.
oi oi oi
The lung begins to emerge as a bud from the pharynx 26 days after conception.
oi oi oi oi oi oi oi oi oi oi oi oi oi oi
