TESTBANK !|
NEONATAL & PEDIATRIC
!| !|
RESPIRATORY CARE
!| !|
5th Edition, Walsh
! |
!|
TESTBANK !|
,Neonatal !|and !|Pediatric !|Respiratory !|Care, !|5th !|Edition, !|Brian !|K. !|Walsh !|Test !|Bank
Table !|of !|Contents
Chapter !|1. !|Fetal !|Lung !|Development
Chapter !|2. !|Fetal !|Gas !|Exchange !|and !|Circulation
Chapter !|3. !|Antenatal !|Assessment !|and !|High-Risk !|Delivery
Chapter !|4. !|Examination !|and !|Assessment !|of !|the !|Neonatal !|and !|Pediatric !|Patient
Chapter !|5. !|Pulmonary !|Function !|Testing !|and !|Bedside !|Pulmonary !|Mechanics
Chapter !|6. !|Radiographic !|Assessment
Chapter !|7. !|Pediatric !|Flexible !|Bronchoscopy
Chapter !|8. !|Invasive !|Blood !|Gas !|Analysis !|and !|Cardiovascular !|Monitoring
Chapter !|9. !|Noninvasive !|Monitoring !|in !|Neonatal !|and !|Pediatric !|Care
Chapter !|10. !|Oxygen !|Administration
Chapter !|11. !|Aerosols !|and !|Administration !|of !|Inhaled !|Medications
Chapter !|12. !|Airway !|Clearance !|Techniques !|and !|Hyperinflation !|Therapy
Chapter !|13. !|Airway !|Management
Chapter !|14. !|Surfactant !|Replacement !|Therapy
Chapter !|15. !|Noninvasive !|Mechanical !|Ventilation !|and !|Continuous !|Positive !|Pressure !|of !|the !|Neonate
Chapter !|16. !|Noninvasive !|Mechanical !|Ventilation !|of !|the !|Infant !|and !|Child
Chapter !|17. !|Invasive !|Mechanical !|Ventilation !|of !|the !|Neonate !|and !|Pediatric !|Patient
Chapter !|18. !|Administration !|o f !|Gas !|Mixtures
Chapter !|19. !|Extracorporeal !|Membrane !|Oxygenation
Chapter !|20. !|Pharmacology
Chapter !|21. !|Thoracic !|Organ !|Transplantation
Chapter !|22. !|Neonatal !|Pulmonary !|Disorders
Chapter !|23. !|Surgical !|Disorders !|in !|Childhood !|that !|Affect !|Respiratory !|Care
Chapter !|24. !|Congenital !|Cardiac !|Defects
Chapter !|25. !|Pediatric !|Sleep-Disordered !|Breathing
Chapter !|26. !|Pediatric !|Airway !|Disorders !|and !|Parenchymal !|Lung !|Diseases
Chapter !|27. !|Asthma
Chapter !|28. !|Cystic !|Fibrosis
Chapter !|29. !|Acute !|Respiratory !|Distress !|Syndrome
Chapter !|30. !|Shock
Chapter !|31. !|Pediatric !|Trauma
Chapter !|32. !|Disorders !|of !|the !|Pleura
Chapter !|33. !|Neurological !|and !|Neuromuscular !|Disorders
Chapter !|34. !|Pediatric !|Emergencies
Chapter !|35. !|Home !|Care !|of !|the !|Postpartum !|Family
Chapter !|36. !|Quality !|and !|Safety
,Chapter!|1: !|Fetal !|Lung !|Development
Walsh: !|Neonatal !|& !|Pediatric !|Respiratory !|Care !|5th !|Edition !|Test !|Bank !|(2020)
MULTIPLE !|CHOICE
1. Which !|of !|t he !|following !|phases !|o f !|human !|lung !|development !|is !|characterized !|by !|t he
formation !|of !|a !|capillary !|network !|around !|airway !|passages?
!|
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: ! | D
The !|canalicular !|phase !|follows !|the !|pseudoglandular !|phase, !|lasting !|from !|approximately !|17
!|weeks !|t o !|26 !|w eeks !|o f !|gestation. !|T his !|phase !|is !|so !|named !|because !|o f !|t he !|appearance !|o f
!|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 !|t o !|36 !|o f !|g estation, !|is !|characterized
!|by !|t he !|development !|o f !|sacs !|t hat !|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 !|o f !|the !|alveoli !|t hat
will !|be !|present !|in !|the !|lungs !|for !|life !|develop?
!|
a. 6 !|months
b. 1 !|year
c. 1.5 !|years
d. 2 !|years
ANS: ! | C
Most !|of !|the !|postnatal !|formation !|of !|alveoli !|in !|the !|infant !|occurs !|over !|the !|first !|1.5 !|years !|of
!|life. !|At !|2 !|years !|o f !|age, !|t he !|number !|o f !|a lveoli !|varies !|substantially !|a mong !|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
ANS: ! | 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, !|a n !|incomplete !|development !|o f !|t he !|lungs !|characterized !|by!|a n
!|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 !|t he !|possible !|association !|between
oligohydramnios !|and !|lung !|hypoplasia?
!|
I. Abnormal !|carbohydrate !|metabolism
II. Mechanical !|restriction !|o f !|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
ANS: ! | D
Oligohydramnios, !|a !|reduced !|quantity !|o f !|amniotic !|fluid !|present !|for !|an !|extended !|period !|o f
!|t ime, !|with !|or !|without !|renal !|anomalies, !|is !|associated !|with !|lung !|hypoplasia. !|The !|mechanisms
!|by !|which !|a mniotic !|fluid !|volume !|influences !|lung !|growth !|remain !|u nclear. !|Possible !|e xplanations
!|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 !|t he !|purpose !|of !|the !|substance !|secreted !|by!|the !|t ype !|II !|pneumocyte?
a. To !|increase !|t he !|gas !|exchange !|surface !|area
b. To !|reduce !|surface !|tension
c. To !|maintain !|lung !|elasticity
d. To !|preserve !|the !|volume !|of !|the !|amniotic !|fluid
NEONATAL & PEDIATRIC
!| !|
RESPIRATORY CARE
!| !|
5th Edition, Walsh
! |
!|
TESTBANK !|
,Neonatal !|and !|Pediatric !|Respiratory !|Care, !|5th !|Edition, !|Brian !|K. !|Walsh !|Test !|Bank
Table !|of !|Contents
Chapter !|1. !|Fetal !|Lung !|Development
Chapter !|2. !|Fetal !|Gas !|Exchange !|and !|Circulation
Chapter !|3. !|Antenatal !|Assessment !|and !|High-Risk !|Delivery
Chapter !|4. !|Examination !|and !|Assessment !|of !|the !|Neonatal !|and !|Pediatric !|Patient
Chapter !|5. !|Pulmonary !|Function !|Testing !|and !|Bedside !|Pulmonary !|Mechanics
Chapter !|6. !|Radiographic !|Assessment
Chapter !|7. !|Pediatric !|Flexible !|Bronchoscopy
Chapter !|8. !|Invasive !|Blood !|Gas !|Analysis !|and !|Cardiovascular !|Monitoring
Chapter !|9. !|Noninvasive !|Monitoring !|in !|Neonatal !|and !|Pediatric !|Care
Chapter !|10. !|Oxygen !|Administration
Chapter !|11. !|Aerosols !|and !|Administration !|of !|Inhaled !|Medications
Chapter !|12. !|Airway !|Clearance !|Techniques !|and !|Hyperinflation !|Therapy
Chapter !|13. !|Airway !|Management
Chapter !|14. !|Surfactant !|Replacement !|Therapy
Chapter !|15. !|Noninvasive !|Mechanical !|Ventilation !|and !|Continuous !|Positive !|Pressure !|of !|the !|Neonate
Chapter !|16. !|Noninvasive !|Mechanical !|Ventilation !|of !|the !|Infant !|and !|Child
Chapter !|17. !|Invasive !|Mechanical !|Ventilation !|of !|the !|Neonate !|and !|Pediatric !|Patient
Chapter !|18. !|Administration !|o f !|Gas !|Mixtures
Chapter !|19. !|Extracorporeal !|Membrane !|Oxygenation
Chapter !|20. !|Pharmacology
Chapter !|21. !|Thoracic !|Organ !|Transplantation
Chapter !|22. !|Neonatal !|Pulmonary !|Disorders
Chapter !|23. !|Surgical !|Disorders !|in !|Childhood !|that !|Affect !|Respiratory !|Care
Chapter !|24. !|Congenital !|Cardiac !|Defects
Chapter !|25. !|Pediatric !|Sleep-Disordered !|Breathing
Chapter !|26. !|Pediatric !|Airway !|Disorders !|and !|Parenchymal !|Lung !|Diseases
Chapter !|27. !|Asthma
Chapter !|28. !|Cystic !|Fibrosis
Chapter !|29. !|Acute !|Respiratory !|Distress !|Syndrome
Chapter !|30. !|Shock
Chapter !|31. !|Pediatric !|Trauma
Chapter !|32. !|Disorders !|of !|the !|Pleura
Chapter !|33. !|Neurological !|and !|Neuromuscular !|Disorders
Chapter !|34. !|Pediatric !|Emergencies
Chapter !|35. !|Home !|Care !|of !|the !|Postpartum !|Family
Chapter !|36. !|Quality !|and !|Safety
,Chapter!|1: !|Fetal !|Lung !|Development
Walsh: !|Neonatal !|& !|Pediatric !|Respiratory !|Care !|5th !|Edition !|Test !|Bank !|(2020)
MULTIPLE !|CHOICE
1. Which !|of !|t he !|following !|phases !|o f !|human !|lung !|development !|is !|characterized !|by !|t he
formation !|of !|a !|capillary !|network !|around !|airway !|passages?
!|
a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: ! | D
The !|canalicular !|phase !|follows !|the !|pseudoglandular !|phase, !|lasting !|from !|approximately !|17
!|weeks !|t o !|26 !|w eeks !|o f !|gestation. !|T his !|phase !|is !|so !|named !|because !|o f !|t he !|appearance !|o f
!|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 !|t o !|36 !|o f !|g estation, !|is !|characterized
!|by !|t he !|development !|o f !|sacs !|t hat !|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 !|o f !|the !|alveoli !|t hat
will !|be !|present !|in !|the !|lungs !|for !|life !|develop?
!|
a. 6 !|months
b. 1 !|year
c. 1.5 !|years
d. 2 !|years
ANS: ! | C
Most !|of !|the !|postnatal !|formation !|of !|alveoli !|in !|the !|infant !|occurs !|over !|the !|first !|1.5 !|years !|of
!|life. !|At !|2 !|years !|o f !|age, !|t he !|number !|o f !|a lveoli !|varies !|substantially !|a mong !|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
ANS: ! | 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, !|a n !|incomplete !|development !|o f !|t he !|lungs !|characterized !|by!|a n
!|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 !|t he !|possible !|association !|between
oligohydramnios !|and !|lung !|hypoplasia?
!|
I. Abnormal !|carbohydrate !|metabolism
II. Mechanical !|restriction !|o f !|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
ANS: ! | D
Oligohydramnios, !|a !|reduced !|quantity !|o f !|amniotic !|fluid !|present !|for !|an !|extended !|period !|o f
!|t ime, !|with !|or !|without !|renal !|anomalies, !|is !|associated !|with !|lung !|hypoplasia. !|The !|mechanisms
!|by !|which !|a mniotic !|fluid !|volume !|influences !|lung !|growth !|remain !|u nclear. !|Possible !|e xplanations
!|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 !|t he !|purpose !|of !|the !|substance !|secreted !|by!|the !|t ype !|II !|pneumocyte?
a. To !|increase !|t he !|gas !|exchange !|surface !|area
b. To !|reduce !|surface !|tension
c. To !|maintain !|lung !|elasticity
d. To !|preserve !|the !|volume !|of !|the !|amniotic !|fluid
