TESTBANK For Neonatal and Pediatric Respiratory Care 6th Edition by Brian K. Walsh all chapters complete newest edition updated 2025

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

,Chapter 1: Fetal Lung Developmen
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tTest Bank
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MULTIPLE CHOICE sm




1. Which of the following phases of human lung development is characterized by the formati
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onof a capillary network around airway passages?
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a. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: D sm



The canalicular phase follows the pseudoglandular phase, lasting from approximately 17 w
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eeks to 26 weeks of gestation. This phase is so named because of the appearance of vascular
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channels, or capillaries, which begin to grow by forming a capillary network around the ai
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r passages. During the pseudoglandular stage, which begins at day 52 and extends to week
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16 of gestation, the airway system subdivides extensively and the conducting airway syste
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m develops, ending with the terminal bronchioles. The saccular stage of development, whi
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ch takes place from weeks 29 to 36 of gestation, is characterized by the development of sac
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s thatlater become alveoli. During the saccular phase, a tremendous increase in the potenti
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al
gas-
exchanging surface area occurs. The distinction between the saccular stage and the alv
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eolar stage is arbitrary. The alveolar stage stretches from 39 weeks of gestation to term
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.This stage is represented by the establishment of alveoli.
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REF: pp. s m smsms m 3-5

2. Regarding postnatal lung growth, by approximately what age do most of the alveoli that
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willbe present in the lungs for life develop?
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a. 6 months sm



b. 1 year sm



c. 1.5 years sm



d. 2 years sm




ANS: C sm



Most of the postnatal formation of alveoli in the infant occurs over the first 1.5 years of li
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fe. At 2 years of age, the number of alveoli varies substantially among individuals. After 2
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yearsof age, males have more alveoli than do females. After alveolar multiplication ends, t
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he alveoli continue to increase in size until thoracic growth is completed.
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REF: p. 6 sm sm




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

, The initial structures of the pulmonary tree develop during the embryonal stage. Errors i
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n development during this time may result in laryngeal, tracheal, or esophageal atresia or
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mstenosis. Pulmonary hypoplasia, an incomplete development of the lungs characterized by
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anabnormally low number and/or size of bronchopulmonary segments and/or alveoli, can
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develop during the pseudoglandular phase. If the fetus is born during the canalicular pha
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se (i.e., prematurely), severe respiratory distress can be expected because the inadequately
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mdeveloped airways, along with insufficient and immature surfactant production by alveola
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r type II cells, gives rise to the constellation of problems known as infant respiratory distres
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s syndrome.
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REF: smsmsm p. 6 sm




4. Which of the following mechanisms is (are) responsible for the possible association betwe
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enoligohydramnios and lung hypoplasia?
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I. Abnormal carbohydrate metabolism sm sm



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



III. Interference with fetal breathing sm sm sm



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



a. I and III only sm sm sm



b. II and III only sm sm sm



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



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




ANS: D sm



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



with or without renal anomTaE
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, iB
sAasNsoKcS
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teLdLwEitR
h lu
. CnO
gMhypoplasia. The mechanisms by
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which amniotic fluid volume influences lung growth remain unclear. Possible explanations f
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or
reduced quantity of amniotic fluid include mechanical restriction of the chest wall, interfe
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rence with fetal breathing, or failure to produce fetal lung liquid. These clinical and expe
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rimental observations possibly point to a common denominator, lung stretch, as being a
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major growth stimulant. sm sm




REF: pp. 6-7 sm sm




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
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b. To reduce surface tension sm sm sm



c. To maintain lung elasticity sm sm sm



d. To preserve the volume of the amniotic fluid
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ANS: B sm



The primary role of mammalian surfactant is to lower the surface tension within the alveol
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us, specifically at the air–
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liquid interface. This allows the delicate structure of the alveolus to expand when filled wit
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h air. Without surfactant, the alveolus remains collapsed because of thehigh surface tension
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mof the moist alveolar surface. Surfactant is composed predominantly of an intricate blend o
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f phospholipids, neutral lipids, and proteins.
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REF: p. 8 sm sm

, 6. Which of the following tests of the amniotic fluid have been shown to be sensitive indicat
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orsof lung maturity?
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a. Levels of prednisone sm sm



b. Levels of epidermal growth factor sm sm sm sm



c. Levels of prostaglandins sm sm



d. Levels of phosphatidylglycerol and phosphatidylcholine
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ANS: D sm



Of clinical relevance during late gestation, analysis of amniotic fluid for the concentration
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ofphosphatidylglycerol and phosphatidylcholine has been shown to be a sensitive indicato
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r of the state of fetal lung maturity.
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REF: p. 8 sm sm




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 sm




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 sm




The embryonal phase includes primitive lung development and is generally regarded to encompass the first 2
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months of gestation. sm sm sm



The lung begins to emerge as a bud from the pharynx 26 days after conception.
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