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TESTBANK FOR NEONATAL AND PEDIATRIC RESPIRATORY CARE 6TH EDITION BY WALSH/ALL CHAPTERS COMPLETE 1-36
TESTBANK FOR NEONATAL AND PEDIATRIC RESPIRATORY CARE 6TH EDITION BY WALSH/ALL CHAPTERS COMPLETE 1-36
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TESTBANK FOR NEONATAL AND PEDIATRICRESPIRATORY CARE 6TH EDITION BY WALSH/ALL
CHAPTERS COMPLETE 1-36
,Chapter 1: Fetal Lung Development
Walsh: Neonatal & Pediatric Respiratory Care 6th Edition Test Bank (2020)
MULTIPLE CHOICE
1. Which of the following phases of human lung development is characterized by the formation
of a capillary network around airway passages?
a. Pseudo glandular
b. Saccular
c. Alveolar
d. Canalicular
PRECISE ANSWER:-D
Reasoning:->>>The canalicular phase follows the pseudoglandular phase, lasting from
approximately 17 weeks to 26 weeks of gestation. This phase is so named because of the
appearance of 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 to 36 of gestation, is characterized by the
development of sacs that 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 of the alveoli that will
be present in the lungs for life develop?
a. 6 months
b. 1 year
c. 1.5 years
d. 2 years
PRECISE ANSWER:-C
Reasoning:->>>Most of the postnatal formation of alveoli in the infant occurs over the first
1.5 years of life. At 2 years of age, the number of alveoli varies substantially among
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.
Reference page: 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
PRECISE ANSWER:-A
Reasoning:->>>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, an incomplete development of the lungs
characterized by an 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 the possible association between
oligohydramnios and lung hypoplasia?
I. Abnormal carbohydrate metabolism
II. Mechanical restriction of 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
PRECISE ANSWER:-D
Reasoning:->>>Oligohydramnios, a reduced quantity of amniotic fluid present for an
extended period of time, with or without renal anomalies, is associated with lung hypoplasia.
The mechanisms by which amniotic fluid volume influences lung growth remain unclear.
Possible explanations 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 the purpose of the substance secreted by the type II pneumocyte?
a. To increase the gas exchange surface area
b. To reduce surface tension
c. To maintain lung elasticity
d. To preserve the volume of the amniotic fluid
, PRECISE ANSWER:-B
Reasoning:->>>The primary role of mammalian surfactant is to lower the surface tension
within the alveolus, specifically at the air–liquid interface. This allows the delicate structure
of the alveolus to expand when filled with air. Without surfactant, the alveolus remains
collapsed because of the high surface tension of the moist alveolar surface. Surfactant is
composed predominantly of an intricate blend of phospholipids, neutral lipids, and proteins.
Reference page: 8
6. Which of the following tests of the amniotic fluid have been shown to be sensitive indicators
of lung maturity?
a. Levels of prednisone
b. Levels of epidermal growth factor
c. Levels of prostaglandins
d. Levels of phosphatidylglycerol and phosphatidylcholine
PRECISE ANSWER:-D
Reasoning:->>>Of clinical relevance during late gestation, analysis of amniotic fluid for the
concentration of phosphatidylglycerol and phosphatidylcholine has been shown to be a
sensitive indicator of the state of fetal lung maturity.
Reference page: 8
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