Deck 10: Fetal Development and the Cardiopulmonary System

Question 1

After birth,into what structure does the umbilical vein evolve?

A) ligamentum teres (round ligament) of the liver
B) lateral umbilical ligament
C) ligamentum venosum of the liver
D) ligamentum arteriosum

Answer 1

A

Question 2

At what gestational age does the placenta begin to develop?

A) at implantation of the fertilized egg
B) Day 3
C) Day 5
D) Day 7

Answer 2

A

Question 3

How many alveoli would be expected in a 12 year old child?

A) > 240 million
B) 24 million
C) 50 million
D) 100 million

Answer 3

A

Question 4

How is fetal lung fluid normally removed?
I)Squeezed out during vaginal delivery
II)Absorbed by the pulmonary capillaries
III)Absorbed by the lymphatic system
IV)Removed by vigorous endobronchial suctioning by the delivery room staff

A) I, II, and III only
B) I, II, III, and IV
C) I and II only
D) II and III only

Question 5

What of the following influence the oxygen transfer from maternal to fetal blood?
I)Maternal -fetal PO₂ gradient
II)Higher hemoglobin concentration in fetal blood
III)Lower affinity of HbF for oxygen

A) I and II only
B) I, II, and III
C) I and III only
D) II and III only

Question 6

Which of the following would be most likely to develop after delivery of a newborn at 27 weeks gestational age?

A) PPHN
B) meconium aspiration
C) Tetralogy of Fallot
D) Coarctation of the aorta

Question 7

What is the normal PO₂ in the umbilical arteries?

A) 20 mm Hg
B) 40 mm Hg
C) 55 mm Hg
D) 80 mm Hg

Question 8

At what gestational age do lung buds first appear?

A) 24th day
B) 28th day
C) 16th week
D) 21st week

Question 9

Where does fetal lung fluid originate?

A) from alveolar cells
B) from aspiration of amniotic fluid
C) from maternal lymph vessels
D) from the stomach and esophagus

Question 10

In the fetus,where does the majority of blood flow go after leaving the right atrium?

A) left atrium
B) right ventricle
C) left ventricle
D) pulmonary artery

Question 11

At what gestational age does the terminal sac period begin?

A) 24 weeks
B) 22 weeks
C) 20 weeks
D) 26 weeks

Question 12

Which of the following structure would compose the plavental cotyledons?
I)Fetal vessels
II)Chorionic villi
III)Intervillous spaces

A) I, II, and III
B) I only
C) II and III only
D) I and II only

Question 13

Which vessels transports oxygenated blood and nutrients from the placenta to the fetus?

A) umbilical vein
B) umbilical artery
C) placental vein
D) placental artery

Question 14

At what gestational age are all of the subsegmental bronchi present?

A) 16 weeks
B) 10 weeks
C) 5 weeks
D) 20 weeks

Question 15

Which of the following contribute to the wide variance between maternal and fetal P_O2 and P_CO2?
I.The placenta is an actively metabolizing organ
II.Regional variations occur in placental permeability
III.Maternal and fetal vascular shunts occur

A) I, II, and III
B) I and III only
C) I and II only
D) II and III only

Question 16

What is the term for the premature separation of the placenta from the uterine wall?

A) abruptio placentae
B) placenta previa
C) placenta accreta
D) placenta percreta

Question 17

In a full-term newborn,how many alveoli are present at birth?

A) 24 million
B) 200 million
C) 240 million
D) 50 million

Question 18

At what gestational age after fertilization do primitive lobar bronchi first appear?

A) 30-32 days
B) 24-26 days
C) 42-45 days
D) 38-40 days

Question 19

At what gestational age do primitive respiratory bronchioles appear?

A) 17-24 weeks
B) 12-16 weeks
C) 25-28 weeks
D) 8-12 weeks

Question 20

What is the term for the procedure in which a sample of the fluid surrounding a fetus is removed via a needle inserted through the uterine wall and the fluid sample is analyzed for abnormalities?

A) amniocentesis
B) thoracentesis
C) chorionic villi sampling
D) sonography

Question 21

What of the following factors cause a reduction in the pulmonary vascular resistance following the first breath?
I)Increased alveolar pressure of oxygen
II)Removal of lung fluid which reduces pressure on pulmonary vessels
III)Increase in lung volumewhich widens the caliber of extralveolar vessels

A) I, II, and III
B) I and II only
C) I only
D) II and III only

Question 22

Constriction of the ductus arteriosus occurs in response to

A) the newborn's increased PO₂
B) the newborn's decreased pH
C) the increase in blood pressure in the left atrium
D) the increase in blood pressure in the pulmonary artery

Question 23

Which of the following nerves,when stimulated,causes a decrease in the respiratory and heart rates of the newborn?

A) V cranial nerve (trigeminal)
B) phrenic
C) VII cranial nerve
D) IX cranial nerve

Question 24

What would you conclude regarding a fetus' lung maturity if the S:A ratio equaled 60?

A) fetal lung maturity
B) immature fetal lungs
C) uncertain lung maturity
D) Unable to make a conclusion since the S:A ratio does not assess lung maturity

Question 25

What does the presence of phosphatidyglycerol (PG)in the amniotic fluid indicate?

A) low risk of development of respiratory distress
B) high risk of development of respiratory distress
C) immature fetal lungs
D) uncertain fetal lung maturity

Question 26

What is the normal tidal volume and TLC of an average newborn?

A) Tidal volume 15 mL and TLC 155 mL
B) Tidal volume 40 mL and TLC 300 mL
C) Tidal volume 50 mL and TLC 400 mL
D) Tidal volume 75 mL and TLC 500 mL

Question 27

What response would be expected if a newborn of 28 weeks gestational age received endotracheal suctioning?

A) bradypnea or apnea would occur
B) tachypnea would occur followed by apnea
C) no change in respiratory rate rate would occur
D) the newborn would take a breath on top of a breath

Question 28

What is the average value for airway resistance in a newborn?

A) 30 cm H20/L/sec
B) 3 cm H20/L/sec
C) 0.005 /L/ sec/cm H20
D) 0.50 L/sec/cm H20

Question 29

If a registered repiratory therapist succesfully completes the NBRC's neonatal/pediatric specialty credential,what credential would be awarded?

A) RRT-NPS
B) CRT-NPS
C) NPRCS
D) None-no such credential exists

Question 30

What intrapleural pressure must be generated to initiate the first breath?

A) -40 cm H20
B) -400 cm H20
C) -4 cm H20
D) 40 cm H20

Question 31

What factor causes closure of the foramen ovale?

A) increased blood pressure in the left atrium
B) increased blood pressure in the right atrium
C) increased PCO₂ in the arterial blood
D) increased PO₂ in the arterial blood

Question 32

During the first 72 hours in the life of a healthy newborn,what changes would be expected in arterial blood gases?
I)pH would increase
II)PaCO₂ would decrease
III)HCO₃- would increase
IV)PaO₂ would increase

A) I, II, and IV only
B) I, II, III, and IV
C) I and IV only
D) II and IV only

Question 33

Which of the following factors contribute to stimulate the first breath?
I)Tactile stimulation
II)Stimulation of central chemoreceptors
III)Stimulation of peripheral chemoreceptors
IV)Thermal stimuli

A) I, II, III, IV
B) I, II, and III only
C) II and III only
D) I and IV only

Question 34

What is the most common cause of respiratory failure in preterm infants?

A) RDS
B) meconium aspiration
C) pneumonia
D) BPD

Question 35

What is the average lung compliance of a neonate?

A) 0.005 L/cm H20
B) 0.5 L/cm H20
C) 0.050 L/cm H20
D) 0.005 mL/cm H20