Test Bank
for NEONATAL and PEDIATRIC
RESPIRATORY CARE
5th Edition
By Brian K. Walsh
,Table of Contents
Section 1: Fetal Development Assessment, and Delivery
1. Fetal Lung Development
2. Fetal Gas Exchange and Circulation
3. Antenatal Assessment and High-Risk Delivery
Section 2: Assessment and Monitoring of the Neonatal and Pediatric Patient
4. Examination and Assessment of the Neonatal and Pediatric Patient
5. Pulmonary Function Testing and Bedside Pulmonary Mechanics
6. Radiographic Assessment
7. Pediatric Flexible Bronchoscopy
8. Invasive Blood Gas Analysis and Cardiovascular Monitoring
9. Noninvasive Monitoring in Neonatal and Pediatric Care
Section 3: Therapeutic Procedures for Treatment of Neonatal and Pediatric Disorders
10. Oxygen Administration
11. Aerosols and Administration of Inhaled Medications
12. Airway Clearance Techniques and Hyperinflation Therapy
13. Airway Management
14. Surfactant Replacement Therapy
15. Noninvasive Mechanical Ventilation and Continuous Positive Pressure of the Neonate
16. Noninvasive Mechanical Ventilation of the Infant and Child
17. Invasive Mechanical Ventilation of the Neonate and Pediatric Patient
18. Administration of Gas Mixtures
19. Extracorporeal Membrane Oxygenation
20. Pharmacology
21. Thoracic Organ Transplantation
Section 4: Neonatal and Pediatric Disorders: Presentation, Diagnosis, and Treatment
22. Neonatal Pulmonary Disorders
23. Surgical Disorders in Childhood that Affect Respiratory Care
24. Congenital Cardiac Defects
25. Pediatric Sleep-Disordered Breathing
26. Pediatric Airway Disorders and Parenchymal Lung Diseases
27. Asthma
28. Cystic Fibrosis
29. Acute Respiratory Distress Syndrome
30. Shock
31. Pediatric Trauma
32. Disorders of the Pleura
33. Neurological and Neuromuscular Disorders
Section 5: Neonatal and Pediatric Transient and Ambulatory Care
34. Transport of Infants and Children
35. Home Care
36. Quality and Safety
,Chapter 1: Fetal Lung Development
Walsh: Neonatal & Pediatric Respiratory Care 5th 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. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: D
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
ANS: C
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.
REF: p. 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
ANS: A
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
ANS: D
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
for NEONATAL and PEDIATRIC
RESPIRATORY CARE
5th Edition
By Brian K. Walsh
,Table of Contents
Section 1: Fetal Development Assessment, and Delivery
1. Fetal Lung Development
2. Fetal Gas Exchange and Circulation
3. Antenatal Assessment and High-Risk Delivery
Section 2: Assessment and Monitoring of the Neonatal and Pediatric Patient
4. Examination and Assessment of the Neonatal and Pediatric Patient
5. Pulmonary Function Testing and Bedside Pulmonary Mechanics
6. Radiographic Assessment
7. Pediatric Flexible Bronchoscopy
8. Invasive Blood Gas Analysis and Cardiovascular Monitoring
9. Noninvasive Monitoring in Neonatal and Pediatric Care
Section 3: Therapeutic Procedures for Treatment of Neonatal and Pediatric Disorders
10. Oxygen Administration
11. Aerosols and Administration of Inhaled Medications
12. Airway Clearance Techniques and Hyperinflation Therapy
13. Airway Management
14. Surfactant Replacement Therapy
15. Noninvasive Mechanical Ventilation and Continuous Positive Pressure of the Neonate
16. Noninvasive Mechanical Ventilation of the Infant and Child
17. Invasive Mechanical Ventilation of the Neonate and Pediatric Patient
18. Administration of Gas Mixtures
19. Extracorporeal Membrane Oxygenation
20. Pharmacology
21. Thoracic Organ Transplantation
Section 4: Neonatal and Pediatric Disorders: Presentation, Diagnosis, and Treatment
22. Neonatal Pulmonary Disorders
23. Surgical Disorders in Childhood that Affect Respiratory Care
24. Congenital Cardiac Defects
25. Pediatric Sleep-Disordered Breathing
26. Pediatric Airway Disorders and Parenchymal Lung Diseases
27. Asthma
28. Cystic Fibrosis
29. Acute Respiratory Distress Syndrome
30. Shock
31. Pediatric Trauma
32. Disorders of the Pleura
33. Neurological and Neuromuscular Disorders
Section 5: Neonatal and Pediatric Transient and Ambulatory Care
34. Transport of Infants and Children
35. Home Care
36. Quality and Safety
,Chapter 1: Fetal Lung Development
Walsh: Neonatal & Pediatric Respiratory Care 5th 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. Pseudoglandular
b. Saccular
c. Alveolar
d. Canalicular
ANS: D
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
ANS: C
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.
REF: p. 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
ANS: A
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
ANS: D
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
