Test Bank for Neonatal and Pediatric Respiratory
R R R R R R
Care, 6th Edition
R R R
by Brian K. Walsh
R R R
,Chapter R1: RFetal RLung
RDevelopmentRTest RBank
MULTIPLE RCHOICE
1. Which Rof Rthe Rfollowing Rphases Rof Rhuman Rlung Rdevelopment Ris Rcharacterized Rby Rthe
RformationRof Ra Rcapillary Rnetwork Raround Rairway Rpassages?
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: R D
The Rcanalicular Rphase Rfollows Rthe Rpseudoglandular Rphase, Rlasting Rfrom Rapproximately
R17 Rweeks Rto R26 Rweeks Rof Rgestation. RThis Rphase Ris Rso Rnamed Rbecause Rof Rthe
Rappearance Rof RvascularRchannels, Ror Rcapillaries, Rwhich Rbegin Rto Rgrow Rby Rforming Ra
Rcapillary Rnetwork Raround Rthe Rair Rpassages. RDuring Rthe Rpseudoglandular Rstage, Rwhich
Rbegins Rat Rday R52 Rand Rextends Rto Rweek R16 Rof Rgestation, Rthe Rairway Rsystem Rsubdivides
Rextensively Rand Rthe Rconducting Rairway Rsystem Rdevelops, Rending Rwith Rthe Rterminal
Rbronchioles. RThe Rsaccular Rstage Rof Rdevelopment, Rwhich Rtakes Rplace Rfrom Rweeks R29 Rto
R36 Rof Rgestation, Ris Rcharacterized Rby Rthe Rdevelopment Rof Rsacs RthatRlater Rbecome Ralveoli.
RDuring Rthe Rsaccular Rphase, Ra Rtremendous Rincrease Rin Rthe Rpotential
gas-exchanging Rsurface Rarea Roccurs. RThe Rdistinction Rbetween Rthe Rsaccular Rstage Rand
Rthe Ralveolar Rstage Ris Rarbitrary. RThe Ralveolar Rstage Rstretches Rfrom R39 Rweeks Rof
Rgestation Rto Rterm.RThis Rstage Ris Rrepresented Rby Rthe Restablishment Rof Ralveoli.
REF: R pp. R R R 3-5
2. Regarding Rpostnatal Rlung Rgrowth, Rby Rapproximately Rwhat Rage Rdo Rmost Rof Rthe Ralveoli
R that RwillRbe Rpresent Rin Rthe Rlungs Rfor Rlife Rdevelop?
a. 6 Rmonths
b. 1 Ryear
c. 1.5 Ryears
d. 2 Ryears
ANS: R C
Most Rof Rthe Rpostnatal Rformation Rof Ralveoli Rin Rthe Rinfant Roccurs Rover Rthe Rfirst R1.5
Ryears Rof Rlife. RAt R2 Ryears Rof Rage, Rthe Rnumber Rof Ralveoli Rvaries Rsubstantially Ramong
Rindividuals. RAfter R2 RyearsRof Rage, Rmales Rhave Rmore Ralveoli Rthan Rdo Rfemales. RAfter
Ralveolar Rmultiplication Rends, Rthe Ralveoli Rcontinue Rto Rincrease Rin Rsize Runtil Rthoracic
Rgrowth Ris Rcompleted.
REF: R p. R6
3. The Rrespiratory Rtherapist Ris Revaluating Ra Rnewborn Rwith Rmild Rrespiratory Rdistress Rdue
Rto RtrachealRstenosis. RDuring Rwhich Rperiod Rof Rlung Rdevelopment Rdid Rthis Rproblem
Rdevelop?
a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS: R A
, The Rinitial Rstructures Rof Rthe Rpulmonary Rtree Rdevelop Rduring Rthe Rembryonal Rstage.
RErrors Rin Rdevelopment Rduring Rthis Rtime Rmay Rresult Rin Rlaryngeal, Rtracheal, Ror
Resophageal Ratresia Ror Rstenosis. RPulmonary Rhypoplasia, Ran Rincomplete Rdevelopment Rof
Rthe Rlungs Rcharacterized Rby RanRabnormally Rlow Rnumber Rand/or Rsize Rof
Rbronchopulmonary Rsegments Rand/or Ralveoli, Rcan Rdevelop Rduring Rthe Rpseudoglandular
Rphase. RIf Rthe Rfetus Ris Rborn Rduring Rthe Rcanalicular Rphase R(i.e., Rprematurely), Rsevere
Rrespiratory Rdistress Rcan Rbe Rexpected Rbecause Rthe Rinadequately Rdeveloped Rairways,
Ralong Rwith Rinsufficient Rand Rimmature Rsurfactant Rproduction Rby Ralveolar Rtype RII Rcells,
Rgives Rrise Rto Rthe Rconstellation Rof Rproblems Rknown Ras Rinfant Rrespiratory Rdistress
Rsyndrome.
REF: R R R p. R6
4. Which Rof Rthe Rfollowing Rmechanisms Ris R(are) Rresponsible Rfor Rthe Rpossible Rassociation
RbetweenRoligohydramnios Rand Rlung Rhypoplasia?
I. Abnormal Rcarbohydrate Rmetabolism
II. Mechanical Rrestriction Rof Rthe Rchest Rwall
III. Interference Rwith Rfetal Rbreathing
IV. Failure Rto Rproduce Rfetal Rlung Rliquid
a. I Rand RIII Ronly
b. II Rand RIII Ronly
c. I, RII, Rand RIV Ronly
d. II, RIII, Rand RIV Ronly
ANS: R D
Oligohydramnios, Ra Rreduced Rquantity Rof Ramniotic Rfluid Rpresent Rfor Ran Rextended Rperiod Rof
Rtime,
with Ror Rwithout Rrenal RanomTaE lieSsT
, RiB
s RA
asNsoKcS
iaE
teLdLwEitR
hRlu
. CnO
gRM
hypoplasia. RThe Rmechanisms
Rby R Rwhich Ramniotic Rfluid Rvolume Rinfluences Rlung Rgrowth Rremain Runclear. RPossible
Rexplanations Rfor
reduced Rquantity Rof Ramniotic Rfluid Rinclude Rmechanical Rrestriction Rof Rthe Rchest Rwall,
Rinterference Rwith Rfetal Rbreathing, Ror Rfailure Rto Rproduce Rfetal Rlung Rliquid. RThese
Rclinical Rand Rexperimental Robservations Rpossibly Rpoint Rto Ra Rcommon Rdenominator,
Rlung Rstretch, Ras Rbeing RaRmajor Rgrowth Rstimulant.
REF: R pp. R6-7
5. What Ris Rthe Rpurpose Rof Rthe Rsubstance Rsecreted Rby Rthe Rtype RII Rpneumocyte?
a. To Rincrease Rthe Rgas Rexchange Rsurface Rarea
b. To Rreduce Rsurface Rtension
c. To Rmaintain Rlung Relasticity
d. To Rpreserve Rthe Rvolume Rof Rthe Ramniotic Rfluid
ANS: R B
The Rprimary Rrole Rof Rmammalian Rsurfactant Ris Rto Rlower Rthe Rsurface Rtension Rwithin Rthe
Ralveolus, Rspecifically Rat Rthe Rair–liquid Rinterface. RThis Rallows Rthe Rdelicate Rstructure Rof
Rthe Ralveolus Rto Rexpand Rwhen Rfilled Rwith Rair. RWithout Rsurfactant, Rthe Ralveolus Rremains
Rcollapsed Rbecause Rof RtheRhigh Rsurface Rtension Rof Rthe Rmoist Ralveolar Rsurface. R Surfactant
Ris Rcomposed Rpredominantly Rof Ran Rintricate Rblend Rof Rphospholipids, Rneutral Rlipids, Rand
Rproteins.
REF: R p. R8
, 6. Which Rof Rthe Rfollowing Rtests Rof Rthe Ramniotic Rfluid Rhave Rbeen Rshown Rto Rbe Rsensitive
RindicatorsRof Rlung Rmaturity?
a. Levels Rof Rprednisone
b. Levels Rof Repidermal Rgrowth Rfactor
c. Levels Rof Rprostaglandins
d. Levels Rof Rphosphatidylglycerol Rand Rphosphatidylcholine
ANS: R D
Of Rclinical Rrelevance Rduring Rlate Rgestation, Ranalysis Rof Ramniotic Rfluid Rfor Rthe
Rconcentration RofRphosphatidylglycerol Rand Rphosphatidylcholine Rhas Rbeen Rshown Rto Rbe
Ra Rsensitive Rindicator Rof Rthe Rstate Rof Rfetal Rlung Rmaturity.
REF: R p. R8
7. RApproximately Rhow Rmuch Rfetal Rlung Rfluid Ris Rsecreted Rdaily?
a. RAbout R150 Rto R200 Rml
b. RAbout R250 Rto R300 Rml
c. RAbout R350 Rto R400 Rml
d. RAbout R450 Rto R500 Rml
ANS: RB
Fetal Rlungs Rare Rsecretory Rorgans Rthat Rmake Rbreathing-like Rmovements Rbut Rserve Rno Rrespiratory Rfunction
Rbefore Rbirth. RThey Rsecrete R
about R250 Rto R300 Rml Rof Rliquid Rper Rday.
R8. RThe Rlung Rbud Remerges Rfrom Rwhich Rof Rthe Rfollowing Rstructures?
a. RThe Rpharynx
b. RThe Rforegut
c. RThe Rmesenchyme
d. RThe Rtubular Repithelium
ANS: RA
The Rembryonal Rphase Rincludes Rprimitive Rlung Rdevelopment Rand Ris Rgenerally Rregarded Rto Rencompass Rthe
Rfirst R2 Rmonths Rof Rgestation. R
The Rlung Rbegins Rto Remerge Ras Ra Rbud Rfrom Rthe Rpharynx R26 Rdays Rafter Rconception.
R R R R R R
Care, 6th Edition
R R R
by Brian K. Walsh
R R R
,Chapter R1: RFetal RLung
RDevelopmentRTest RBank
MULTIPLE RCHOICE
1. Which Rof Rthe Rfollowing Rphases Rof Rhuman Rlung Rdevelopment Ris Rcharacterized Rby Rthe
RformationRof Ra Rcapillary Rnetwork Raround Rairway Rpassages?
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: R D
The Rcanalicular Rphase Rfollows Rthe Rpseudoglandular Rphase, Rlasting Rfrom Rapproximately
R17 Rweeks Rto R26 Rweeks Rof Rgestation. RThis Rphase Ris Rso Rnamed Rbecause Rof Rthe
Rappearance Rof RvascularRchannels, Ror Rcapillaries, Rwhich Rbegin Rto Rgrow Rby Rforming Ra
Rcapillary Rnetwork Raround Rthe Rair Rpassages. RDuring Rthe Rpseudoglandular Rstage, Rwhich
Rbegins Rat Rday R52 Rand Rextends Rto Rweek R16 Rof Rgestation, Rthe Rairway Rsystem Rsubdivides
Rextensively Rand Rthe Rconducting Rairway Rsystem Rdevelops, Rending Rwith Rthe Rterminal
Rbronchioles. RThe Rsaccular Rstage Rof Rdevelopment, Rwhich Rtakes Rplace Rfrom Rweeks R29 Rto
R36 Rof Rgestation, Ris Rcharacterized Rby Rthe Rdevelopment Rof Rsacs RthatRlater Rbecome Ralveoli.
RDuring Rthe Rsaccular Rphase, Ra Rtremendous Rincrease Rin Rthe Rpotential
gas-exchanging Rsurface Rarea Roccurs. RThe Rdistinction Rbetween Rthe Rsaccular Rstage Rand
Rthe Ralveolar Rstage Ris Rarbitrary. RThe Ralveolar Rstage Rstretches Rfrom R39 Rweeks Rof
Rgestation Rto Rterm.RThis Rstage Ris Rrepresented Rby Rthe Restablishment Rof Ralveoli.
REF: R pp. R R R 3-5
2. Regarding Rpostnatal Rlung Rgrowth, Rby Rapproximately Rwhat Rage Rdo Rmost Rof Rthe Ralveoli
R that RwillRbe Rpresent Rin Rthe Rlungs Rfor Rlife Rdevelop?
a. 6 Rmonths
b. 1 Ryear
c. 1.5 Ryears
d. 2 Ryears
ANS: R C
Most Rof Rthe Rpostnatal Rformation Rof Ralveoli Rin Rthe Rinfant Roccurs Rover Rthe Rfirst R1.5
Ryears Rof Rlife. RAt R2 Ryears Rof Rage, Rthe Rnumber Rof Ralveoli Rvaries Rsubstantially Ramong
Rindividuals. RAfter R2 RyearsRof Rage, Rmales Rhave Rmore Ralveoli Rthan Rdo Rfemales. RAfter
Ralveolar Rmultiplication Rends, Rthe Ralveoli Rcontinue Rto Rincrease Rin Rsize Runtil Rthoracic
Rgrowth Ris Rcompleted.
REF: R p. R6
3. The Rrespiratory Rtherapist Ris Revaluating Ra Rnewborn Rwith Rmild Rrespiratory Rdistress Rdue
Rto RtrachealRstenosis. RDuring Rwhich Rperiod Rof Rlung Rdevelopment Rdid Rthis Rproblem
Rdevelop?
a. Embryonal
b. Saccular
c. Canalicular
d. Alveolar
ANS: R A
, The Rinitial Rstructures Rof Rthe Rpulmonary Rtree Rdevelop Rduring Rthe Rembryonal Rstage.
RErrors Rin Rdevelopment Rduring Rthis Rtime Rmay Rresult Rin Rlaryngeal, Rtracheal, Ror
Resophageal Ratresia Ror Rstenosis. RPulmonary Rhypoplasia, Ran Rincomplete Rdevelopment Rof
Rthe Rlungs Rcharacterized Rby RanRabnormally Rlow Rnumber Rand/or Rsize Rof
Rbronchopulmonary Rsegments Rand/or Ralveoli, Rcan Rdevelop Rduring Rthe Rpseudoglandular
Rphase. RIf Rthe Rfetus Ris Rborn Rduring Rthe Rcanalicular Rphase R(i.e., Rprematurely), Rsevere
Rrespiratory Rdistress Rcan Rbe Rexpected Rbecause Rthe Rinadequately Rdeveloped Rairways,
Ralong Rwith Rinsufficient Rand Rimmature Rsurfactant Rproduction Rby Ralveolar Rtype RII Rcells,
Rgives Rrise Rto Rthe Rconstellation Rof Rproblems Rknown Ras Rinfant Rrespiratory Rdistress
Rsyndrome.
REF: R R R p. R6
4. Which Rof Rthe Rfollowing Rmechanisms Ris R(are) Rresponsible Rfor Rthe Rpossible Rassociation
RbetweenRoligohydramnios Rand Rlung Rhypoplasia?
I. Abnormal Rcarbohydrate Rmetabolism
II. Mechanical Rrestriction Rof Rthe Rchest Rwall
III. Interference Rwith Rfetal Rbreathing
IV. Failure Rto Rproduce Rfetal Rlung Rliquid
a. I Rand RIII Ronly
b. II Rand RIII Ronly
c. I, RII, Rand RIV Ronly
d. II, RIII, Rand RIV Ronly
ANS: R D
Oligohydramnios, Ra Rreduced Rquantity Rof Ramniotic Rfluid Rpresent Rfor Ran Rextended Rperiod Rof
Rtime,
with Ror Rwithout Rrenal RanomTaE lieSsT
, RiB
s RA
asNsoKcS
iaE
teLdLwEitR
hRlu
. CnO
gRM
hypoplasia. RThe Rmechanisms
Rby R Rwhich Ramniotic Rfluid Rvolume Rinfluences Rlung Rgrowth Rremain Runclear. RPossible
Rexplanations Rfor
reduced Rquantity Rof Ramniotic Rfluid Rinclude Rmechanical Rrestriction Rof Rthe Rchest Rwall,
Rinterference Rwith Rfetal Rbreathing, Ror Rfailure Rto Rproduce Rfetal Rlung Rliquid. RThese
Rclinical Rand Rexperimental Robservations Rpossibly Rpoint Rto Ra Rcommon Rdenominator,
Rlung Rstretch, Ras Rbeing RaRmajor Rgrowth Rstimulant.
REF: R pp. R6-7
5. What Ris Rthe Rpurpose Rof Rthe Rsubstance Rsecreted Rby Rthe Rtype RII Rpneumocyte?
a. To Rincrease Rthe Rgas Rexchange Rsurface Rarea
b. To Rreduce Rsurface Rtension
c. To Rmaintain Rlung Relasticity
d. To Rpreserve Rthe Rvolume Rof Rthe Ramniotic Rfluid
ANS: R B
The Rprimary Rrole Rof Rmammalian Rsurfactant Ris Rto Rlower Rthe Rsurface Rtension Rwithin Rthe
Ralveolus, Rspecifically Rat Rthe Rair–liquid Rinterface. RThis Rallows Rthe Rdelicate Rstructure Rof
Rthe Ralveolus Rto Rexpand Rwhen Rfilled Rwith Rair. RWithout Rsurfactant, Rthe Ralveolus Rremains
Rcollapsed Rbecause Rof RtheRhigh Rsurface Rtension Rof Rthe Rmoist Ralveolar Rsurface. R Surfactant
Ris Rcomposed Rpredominantly Rof Ran Rintricate Rblend Rof Rphospholipids, Rneutral Rlipids, Rand
Rproteins.
REF: R p. R8
, 6. Which Rof Rthe Rfollowing Rtests Rof Rthe Ramniotic Rfluid Rhave Rbeen Rshown Rto Rbe Rsensitive
RindicatorsRof Rlung Rmaturity?
a. Levels Rof Rprednisone
b. Levels Rof Repidermal Rgrowth Rfactor
c. Levels Rof Rprostaglandins
d. Levels Rof Rphosphatidylglycerol Rand Rphosphatidylcholine
ANS: R D
Of Rclinical Rrelevance Rduring Rlate Rgestation, Ranalysis Rof Ramniotic Rfluid Rfor Rthe
Rconcentration RofRphosphatidylglycerol Rand Rphosphatidylcholine Rhas Rbeen Rshown Rto Rbe
Ra Rsensitive Rindicator Rof Rthe Rstate Rof Rfetal Rlung Rmaturity.
REF: R p. R8
7. RApproximately Rhow Rmuch Rfetal Rlung Rfluid Ris Rsecreted Rdaily?
a. RAbout R150 Rto R200 Rml
b. RAbout R250 Rto R300 Rml
c. RAbout R350 Rto R400 Rml
d. RAbout R450 Rto R500 Rml
ANS: RB
Fetal Rlungs Rare Rsecretory Rorgans Rthat Rmake Rbreathing-like Rmovements Rbut Rserve Rno Rrespiratory Rfunction
Rbefore Rbirth. RThey Rsecrete R
about R250 Rto R300 Rml Rof Rliquid Rper Rday.
R8. RThe Rlung Rbud Remerges Rfrom Rwhich Rof Rthe Rfollowing Rstructures?
a. RThe Rpharynx
b. RThe Rforegut
c. RThe Rmesenchyme
d. RThe Rtubular Repithelium
ANS: RA
The Rembryonal Rphase Rincludes Rprimitive Rlung Rdevelopment Rand Ris Rgenerally Rregarded Rto Rencompass Rthe
Rfirst R2 Rmonths Rof Rgestation. R
The Rlung Rbegins Rto Remerge Ras Ra Rbud Rfrom Rthe Rpharynx R26 Rdays Rafter Rconception.
