PATHOPHYSIOLOGY 8TH EDITION MCCANCE TEST BANK
The incidence of SIDS is low during the first month of life but sharply increases in the
second month of life, peaking at 2 to 4 months and is unusual after 6 months of age.
PTS: 1 REF: Page 1313
23. Where in the respiratory tract do the majority of foreign objects aspirated by children
finally lodge?
a. Trachea c. Bronchus
b. Left lung d. Bronchioles
ANS: C
Approximately 75% of aspirated foreign bodies lodge in a bronchus. The other options are
not locations where children aspirate the majority of foreign objects.
PTS: 1 REF: Page 1298
24. What is the most common predisposing factor to obstructive sleep apnea in children?
a. Chronic respiratory infections c. Obligatory mouth breathing
b. Adenotonsillar hypertrophy d. Paradoxic breathing
ANS: B
In otherwise healthy children, the most common predisposing factor is adenotonsillar
hypertrophy, which causes physical impingement on the nasopharyngeal airway. The other
options are not associated with obstructive sleep apnea in children.
PTS: 1 REF: Page 1300
NURSINGTB.COM
MULTIPLE RESPONSE
25. Which statement is true regarding alveoli? (Select all that apply.)
a. The number of functioning alveoli is determined by birth.
b. The alveoli begin to increase in size starting at 8 years of age.
c. The complexity of the alveoli increases into adulthood.
d. These structures produce surfactant.
e. Capillaries are the origin of alveoli.
ANS: B, C, E
Capillaries grow into the distal respiratory units that keep subdividing (alveolarization) to
maximize the surface area for gas exchange. The number of alveoli continues to increase
during the first 5 to 8 years of life, after which the alveoli increase in size and complexity.
Surfactant is a lipid-protein mix that is produced by type II alveolar cells.
PTS: 1 REF: Page 1291
26. Children diagnosed with chronic asthma are likely to exhibit which symptoms? (Select all
that apply.)
a. Nasal flaring
b. Musical expiratory wheezing
c. Clubbing of fingers and toes
d. Substernal retractions
e. Diaphoresis
RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR NURSINGTB.COM
, PATHOPHYSIOLOGY 8TH EDITION MCCANCE TEST BANK
ANS: A, B, D, E
On physical examination, expiratory wheezing that is often described as high pitched and
musical is exhibited, along with prolongation of the expiratory phase of the respiratory
cycle. Hyperinflation is sometimes visible. The respiratory rate is elevated, as is the heart
rate. Nasal flaring and accessory muscle use are evident, with retractions in the substernal,
subcostal, intercostal, suprasternal, or sternocleidomastoid areas. Infants may appear to be
“head bobbing” because of sternocleidomastoid muscle use. Pulsus paradoxus may also be
present. The child may appear anxious or diaphoretic, which are important signs of
respiratory compromise. Clubbing of fingers and toes is not typically associated with
asthma.
PTS: 1 REF: Page 1309
27. Which symptom is not a clinical manifestation of croup?
a. Rhinorrhea
b. Sore throat
c. Low-grade fever
d. Barking cough
e. Coarse rhonchi
ANS: E
Typically, a prodrome of rhinorrhea, sore throat, and low-grade fever is exhibited for a few
days with croup. The child then develops the characteristic harsh (seal-like) barking
cough, hoarse voice, and inspiratory stridor. Rhonchi are associated with lower respiratory
diseases.
PTS: 1 REF: Page 1295
NURSINGTB.COM
28. What are the clinical manifestations of bacterial pneumonia in children? (Select all that
apply.)
a. Fever with chills
b. Productive cough
c. Dyspnea
d. Respiratory alkalosis
e. Malaise
ANS: A, B, C, E
The clinical presentation of bacterial pneumonia, particularly pneumococcal, may include
a preceding viral illness, followed by fever with chills and rigors, shortness of breath, and
an increasingly productive cough. Auscultation usually reveals such abnormalities as
crackles or decreased breath sounds. Other less specific findings may include malaise,
emesis, abdominal pain, and chest pain. Respiratory alkalosis is not usually associated
with bacterial pneumonia in children.
PTS: 1 REF: Page 1306
MATCHING
Match the sound of stridor with the location of the problem.
______ A. Sonorous snoring
RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR NURSINGTB.COM
The incidence of SIDS is low during the first month of life but sharply increases in the
second month of life, peaking at 2 to 4 months and is unusual after 6 months of age.
PTS: 1 REF: Page 1313
23. Where in the respiratory tract do the majority of foreign objects aspirated by children
finally lodge?
a. Trachea c. Bronchus
b. Left lung d. Bronchioles
ANS: C
Approximately 75% of aspirated foreign bodies lodge in a bronchus. The other options are
not locations where children aspirate the majority of foreign objects.
PTS: 1 REF: Page 1298
24. What is the most common predisposing factor to obstructive sleep apnea in children?
a. Chronic respiratory infections c. Obligatory mouth breathing
b. Adenotonsillar hypertrophy d. Paradoxic breathing
ANS: B
In otherwise healthy children, the most common predisposing factor is adenotonsillar
hypertrophy, which causes physical impingement on the nasopharyngeal airway. The other
options are not associated with obstructive sleep apnea in children.
PTS: 1 REF: Page 1300
NURSINGTB.COM
MULTIPLE RESPONSE
25. Which statement is true regarding alveoli? (Select all that apply.)
a. The number of functioning alveoli is determined by birth.
b. The alveoli begin to increase in size starting at 8 years of age.
c. The complexity of the alveoli increases into adulthood.
d. These structures produce surfactant.
e. Capillaries are the origin of alveoli.
ANS: B, C, E
Capillaries grow into the distal respiratory units that keep subdividing (alveolarization) to
maximize the surface area for gas exchange. The number of alveoli continues to increase
during the first 5 to 8 years of life, after which the alveoli increase in size and complexity.
Surfactant is a lipid-protein mix that is produced by type II alveolar cells.
PTS: 1 REF: Page 1291
26. Children diagnosed with chronic asthma are likely to exhibit which symptoms? (Select all
that apply.)
a. Nasal flaring
b. Musical expiratory wheezing
c. Clubbing of fingers and toes
d. Substernal retractions
e. Diaphoresis
RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR NURSINGTB.COM
, PATHOPHYSIOLOGY 8TH EDITION MCCANCE TEST BANK
ANS: A, B, D, E
On physical examination, expiratory wheezing that is often described as high pitched and
musical is exhibited, along with prolongation of the expiratory phase of the respiratory
cycle. Hyperinflation is sometimes visible. The respiratory rate is elevated, as is the heart
rate. Nasal flaring and accessory muscle use are evident, with retractions in the substernal,
subcostal, intercostal, suprasternal, or sternocleidomastoid areas. Infants may appear to be
“head bobbing” because of sternocleidomastoid muscle use. Pulsus paradoxus may also be
present. The child may appear anxious or diaphoretic, which are important signs of
respiratory compromise. Clubbing of fingers and toes is not typically associated with
asthma.
PTS: 1 REF: Page 1309
27. Which symptom is not a clinical manifestation of croup?
a. Rhinorrhea
b. Sore throat
c. Low-grade fever
d. Barking cough
e. Coarse rhonchi
ANS: E
Typically, a prodrome of rhinorrhea, sore throat, and low-grade fever is exhibited for a few
days with croup. The child then develops the characteristic harsh (seal-like) barking
cough, hoarse voice, and inspiratory stridor. Rhonchi are associated with lower respiratory
diseases.
PTS: 1 REF: Page 1295
NURSINGTB.COM
28. What are the clinical manifestations of bacterial pneumonia in children? (Select all that
apply.)
a. Fever with chills
b. Productive cough
c. Dyspnea
d. Respiratory alkalosis
e. Malaise
ANS: A, B, C, E
The clinical presentation of bacterial pneumonia, particularly pneumococcal, may include
a preceding viral illness, followed by fever with chills and rigors, shortness of breath, and
an increasingly productive cough. Auscultation usually reveals such abnormalities as
crackles or decreased breath sounds. Other less specific findings may include malaise,
emesis, abdominal pain, and chest pain. Respiratory alkalosis is not usually associated
with bacterial pneumonia in children.
PTS: 1 REF: Page 1306
MATCHING
Match the sound of stridor with the location of the problem.
______ A. Sonorous snoring
RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR NURSINGTB.COM
