Nursing 101 Chapter 36 Alterations of Pulmonary Function in Children Test Bank

Chapter 36: Alterations of Pulmonary Function in Children

MULTIPLE CHOICE

1. How does chest wall compliance in an infant differ from that of an adult?
a.
An adultÕs chest wall compliance is lower than an infantÕs.
b.
An adultÕs chest wall compliance is higher than an infantÕs.
c.
An adultÕs chest wall compliance is the same as an infantÕs.
d.
An adultÕs chest wall compliance is dissimilar to that of an infantÕs.
ANS: A
Chest wall compliance is higher in infants than it is in adults, particularly in premature infants.

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2. Why is nasal congestion a serious threat to young infants?
a.
Infants are obligatory nose breathers.
b.
Their noses are small in diameter.
c.
Infants become dehydrated when mouth breathing.
d.
Their epiglottis is proportionally greater than the epiglottis of an adultÕs.
ANS: A
Infants up to 2 to 3 months of age are obligatory nose breathers and are unable to breathe in
through their mouths. Nasal congestion is therefore a serious threat to a young infant. This se-
lection is the only option that accurately describes why nasal congestion is a serious threat to
young infants.

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3. The risk for respiratory distress syndrome (RDS) decreases for premature infants when
they are born between how many weeks of gestation?
a.
16 and 20 c. 24 and 30
b.
20 and 24 d. 30 and 36

ANS: D
Surfactant is secreted into fetal airways between 30 and 36 weeks. The other options are not
true regarding the timeframe when the risk for RDS decreases.

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4. Which type of croup is most common?
a.
Bacterial c. Fungal
b.
Viral d. Autoimmune

ANS: B
In 85% of children with croup, a virus is the cause, most commonly parainfluenza. However,
other viruses such as influenza A or respiratory syncytial virus (RSV) also can cause croup.

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5. What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn?

, a.
Low birth weight
b.
Alcohol consumption during pregnancy
c.
Premature birth
d.
Smoking during pregnancy
ANS: C
RDS of the newborn, also known as hyaline membrane disease (HMD), is a major cause of
morbidity and mortality in premature newborns. None of the other options are considered the
chief predisposing factors for RDS.

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6. What is the primary cause of respiratory distress syndrome (RDS) of the newborn?
a.
Immature immune system c. Surfactant deficiency
b.
Small alveoli d. Anemia

ANS: C
RDS is primarily caused by surfactant deficiency and secondarily by a deficiency in alveolar
surface area for gas exchange. None of the other options are related to the cause of RDS.

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7. What is the primary problem resulting from respiratory distress syndrome (RDS) of the new-
born?
a.
Consolidation c. Atelectasis
b.
Pulmonary edema d. Bronchiolar plugging

ANS: C
The primary problem is atelectasis, which causes significant hypoxemia and is difficult for the
neonate to overcome because a significant negative inspiratory pressure is required to open
the alveoli with each breath. None of the other options are considered a primary problem asso-
ciated with RDS.

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8. Which option shows the correct sequence of events after atelectasis develops in
respiratory distress syndrome of the newborn?
a.
Increased pulmonary vascular resistance, atelectasis, hypoperfusion
b.
Hypoxic vasoconstriction, right-to-left shunt hypoperfusion
c.
Respiratory acidosis, hypoxemia, hypercapnia
d.
Right-to-left shunt, hypoxic vasoconstriction, hypoperfusion
ANS: B
Atelectasis results in a decrease in tidal volume, causing alveolar hypoventilation and hyper-
capnia. Hypoxia and hypercapnia cause pulmonary vasoconstriction, which increases intrapul-
monary resistance and shunting. This results in hypoperfusion of the lung and a decrease in
ef- fective pulmonary blood flow. This selection is the only option that identifies the correct
se- quence of events.

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