PATHOPHYSIOLOGY 8TH EDITION MCCANCE TEST BANK
Chapter 37: 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 adult’s chest wall compliance is lower than an infant’s.
b. An adult’s chest wall compliance is higher than an infant’s.
c. An adult’s chest wall compliance is the same as an infant’s.
d. An adult’s chest wall compliance is dissimilar to that of an infant’s.
ANS: A
Chest wall compliance is higher in infants than it is in adults, particularly in premature
infants.
PTS: 1 REF: Page 1292
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 adult’s.
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 selection is the only option that accurately describes why nasal congestion is a serious
threat to young infants. NURSINGTB.COM
PTS: 1 REF: Page 1290
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.
PTS: 1 REF: Page 1292
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.
PTS: 1 REF: Pages 1295-1296
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, PATHOPHYSIOLOGY 8TH EDITION MCCANCE TEST BANK
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.
PTS: 1 REF: Page 1301
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.
PTS: 1 REF: Page 1301
7. What is the primary problem resulting from respiratory distress syndrome (RDS) of the
newborn? NURSINGTB.COM
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 associated with RDS.
PTS: 1 REF: Page 1301
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
hypercapnia. Hypoxia and hypercapnia cause pulmonary vasoconstriction, which increases
intrapulmonary resistance and shunting. This results in hypoperfusion of the lung and a
decrease in effective pulmonary blood flow. This selection is the only option that identifies
the correct sequence of events.
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, PATHOPHYSIOLOGY 8TH EDITION MCCANCE TEST BANK
PTS: 1 REF: Page 1301
9. Which statement about the advances in the treatment of respiratory distress syndrome
(RDS) of the newborn is incorrect?
a. Administering glucocorticoids to women in preterm labor accelerates the
maturation of the fetus’s lungs.
b. Administering oxygen to mothers during preterm labor increases their arterial
oxygen before the birth of the fetus.
c. Treatment includes the instillation of exogenous surfactant down an endotracheal
tube of infants weighing less than 1000 g.
d. Using continuous positive airway pressure (CPAP) supports the infant’s
respiratory function.
ANS: B
Administering oxygen to the mother is not a valid treatment of RDS. The other statements
provide correct information regarding RDS.
PTS: 1 REF: Pages 1301-1303
10. Bronchiolitis tends to occur during the first years of life and is most often caused by what
type of infection?
a. Respiratory syncytial virus (RSV) c. Adenoviruses
b. Influenzavirus d. Rhinovirus
ANS: A
The most common associated pathogen is RSV, but bronchiolitis may also be associated
with adenovirus, rhinovirus, influenza, parainfluenza virus (PIV), and Mycoplasma
NURSINGTB.COM
pneumoniae.
PTS: 1 REF: Page 1305
11. Which immunoglobulin (Ig) is present in childhood asthma?
a. IgM c. IgE
b. IgG d. IgA
ANS: C
Included in the long list of asthma-associated genes are those that code for increased levels
of immune and inflammatory mediators (e.g., interleukin [IL]–4, IgE, leukotrienes), nitric
oxide, and transmembrane proteins in the endoplasmic reticulum. None of the other
options are associated with childhood asthma.
PTS: 1 REF: Pages 1308-1309
12. Which T-lymphocyte phenotype is the key determinant of childhood asthma?
a. Cluster of differentiation (CD) 4 T-helper Th1 lymphocytes
b. CD4 T-helper Th2 lymphocytes
c. CD8 cytotoxic T lymphocytes
d. Memory T lymphocytes
ANS: B
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, PATHOPHYSIOLOGY 8TH EDITION MCCANCE TEST BANK
Asthma develops because the Th2 response (in which CD4 T-helper cells produce specific
cytokines, such as interleukin [IL]–4, IL-5, and IL-13) promotes an atopic and allergic
response in the airways. This selection is the only option that accurately identifies the
appropriate T-lymphocyte phenotype.
PTS: 1 REF: Page 1309
13. Which cytokines activated in childhood asthma produce an allergic response?
a. Interleukin (IL)–1, IL-2, and interferon-alpha (IFN- )
b. IL-8, IL-12, and tumor necrosis factor-alpha (TNF- )
c. IL-4, IL-10, and colony-stimulating factor (CSF)
d. IL-4, IL-5, and IL-13
ANS: D
Related to asthma, IL-4 and IL-13 are particularly important for B-cell switching to favor
immunoglobulin E (IgE) production, and IL-5 is crucial for local differentiation and
enhanced survival of eosinophils within the airways. This selection is the only option that
accurately describes how cytokines produce a childhood asthmatic response.
PTS: 1 REF: Page 1309
14. Which statement accurately describes childhood asthma?
a. An obstructive airway disease characterized by reversible airflow obstruction,
bronchial hyperreactivity, and inflammation
b. A pulmonary disease characterized by severe hypoxemia, decreased pulmonary
compliance, and diffuse densities on chest x-ray imaging
c. A pulmonary disorder involving an abnormal expression of a protein, producing
NURSINGTB.COM
viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens
d. An obstructive airway disease characterized by atelectasis and increased
pulmonary resistance as a result of a surfactant deficiency
ANS: A
Asthma is an obstructive airway disease characterized by reversible airflow obstruction,
bronchial hyperreactivity, and inflammation. This selection is the only option that
accurately describes childhood asthma.
PTS: 1 REF: Page 1308
15. Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child?
a. Parental history of asthma
b. Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil
levels
c. Reduced expiratory flow rates confirmed by spirometry testing
d. Improvement on a trial of asthma medication
ANS: C
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Chapter 37: 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 adult’s chest wall compliance is lower than an infant’s.
b. An adult’s chest wall compliance is higher than an infant’s.
c. An adult’s chest wall compliance is the same as an infant’s.
d. An adult’s chest wall compliance is dissimilar to that of an infant’s.
ANS: A
Chest wall compliance is higher in infants than it is in adults, particularly in premature
infants.
PTS: 1 REF: Page 1292
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 adult’s.
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 selection is the only option that accurately describes why nasal congestion is a serious
threat to young infants. NURSINGTB.COM
PTS: 1 REF: Page 1290
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.
PTS: 1 REF: Page 1292
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.
PTS: 1 REF: Pages 1295-1296
RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR NURSINGTB.COM
, PATHOPHYSIOLOGY 8TH EDITION MCCANCE TEST BANK
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.
PTS: 1 REF: Page 1301
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.
PTS: 1 REF: Page 1301
7. What is the primary problem resulting from respiratory distress syndrome (RDS) of the
newborn? NURSINGTB.COM
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 associated with RDS.
PTS: 1 REF: Page 1301
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
hypercapnia. Hypoxia and hypercapnia cause pulmonary vasoconstriction, which increases
intrapulmonary resistance and shunting. This results in hypoperfusion of the lung and a
decrease in effective pulmonary blood flow. This selection is the only option that identifies
the correct sequence of events.
RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR NURSINGTB.COM
, PATHOPHYSIOLOGY 8TH EDITION MCCANCE TEST BANK
PTS: 1 REF: Page 1301
9. Which statement about the advances in the treatment of respiratory distress syndrome
(RDS) of the newborn is incorrect?
a. Administering glucocorticoids to women in preterm labor accelerates the
maturation of the fetus’s lungs.
b. Administering oxygen to mothers during preterm labor increases their arterial
oxygen before the birth of the fetus.
c. Treatment includes the instillation of exogenous surfactant down an endotracheal
tube of infants weighing less than 1000 g.
d. Using continuous positive airway pressure (CPAP) supports the infant’s
respiratory function.
ANS: B
Administering oxygen to the mother is not a valid treatment of RDS. The other statements
provide correct information regarding RDS.
PTS: 1 REF: Pages 1301-1303
10. Bronchiolitis tends to occur during the first years of life and is most often caused by what
type of infection?
a. Respiratory syncytial virus (RSV) c. Adenoviruses
b. Influenzavirus d. Rhinovirus
ANS: A
The most common associated pathogen is RSV, but bronchiolitis may also be associated
with adenovirus, rhinovirus, influenza, parainfluenza virus (PIV), and Mycoplasma
NURSINGTB.COM
pneumoniae.
PTS: 1 REF: Page 1305
11. Which immunoglobulin (Ig) is present in childhood asthma?
a. IgM c. IgE
b. IgG d. IgA
ANS: C
Included in the long list of asthma-associated genes are those that code for increased levels
of immune and inflammatory mediators (e.g., interleukin [IL]–4, IgE, leukotrienes), nitric
oxide, and transmembrane proteins in the endoplasmic reticulum. None of the other
options are associated with childhood asthma.
PTS: 1 REF: Pages 1308-1309
12. Which T-lymphocyte phenotype is the key determinant of childhood asthma?
a. Cluster of differentiation (CD) 4 T-helper Th1 lymphocytes
b. CD4 T-helper Th2 lymphocytes
c. CD8 cytotoxic T lymphocytes
d. Memory T lymphocytes
ANS: B
RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR NURSINGTB.COM
, PATHOPHYSIOLOGY 8TH EDITION MCCANCE TEST BANK
Asthma develops because the Th2 response (in which CD4 T-helper cells produce specific
cytokines, such as interleukin [IL]–4, IL-5, and IL-13) promotes an atopic and allergic
response in the airways. This selection is the only option that accurately identifies the
appropriate T-lymphocyte phenotype.
PTS: 1 REF: Page 1309
13. Which cytokines activated in childhood asthma produce an allergic response?
a. Interleukin (IL)–1, IL-2, and interferon-alpha (IFN- )
b. IL-8, IL-12, and tumor necrosis factor-alpha (TNF- )
c. IL-4, IL-10, and colony-stimulating factor (CSF)
d. IL-4, IL-5, and IL-13
ANS: D
Related to asthma, IL-4 and IL-13 are particularly important for B-cell switching to favor
immunoglobulin E (IgE) production, and IL-5 is crucial for local differentiation and
enhanced survival of eosinophils within the airways. This selection is the only option that
accurately describes how cytokines produce a childhood asthmatic response.
PTS: 1 REF: Page 1309
14. Which statement accurately describes childhood asthma?
a. An obstructive airway disease characterized by reversible airflow obstruction,
bronchial hyperreactivity, and inflammation
b. A pulmonary disease characterized by severe hypoxemia, decreased pulmonary
compliance, and diffuse densities on chest x-ray imaging
c. A pulmonary disorder involving an abnormal expression of a protein, producing
NURSINGTB.COM
viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens
d. An obstructive airway disease characterized by atelectasis and increased
pulmonary resistance as a result of a surfactant deficiency
ANS: A
Asthma is an obstructive airway disease characterized by reversible airflow obstruction,
bronchial hyperreactivity, and inflammation. This selection is the only option that
accurately describes childhood asthma.
PTS: 1 REF: Page 1308
15. Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child?
a. Parental history of asthma
b. Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil
levels
c. Reduced expiratory flow rates confirmed by spirometry testing
d. Improvement on a trial of asthma medication
ANS: C
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