Arterial Blood Gas (ABG) Analysis NCLEX Exam #1 (10 Questions)

1. Mrs. Johansson. who had undergone surgery in the post-anesthesia care unit (PACU). is difficult to arouse two hours following surgery. Nurse Florence in the PACU has been administering Morphine Sulfate intravenously to the client for complaints of post-surgical pain. The client's respiratory rate is 7 per minute and demonstrates shallow breathing. The patient does not respond to any stimuli! The nurse assesses the ABCs (remember Airway. Breathing. Circulation!) and obtains ABGs STAT! Measurement of arterial blood gas shows pH 7.10. PaCO2 70 mm Hg and HCO3 24 mEq/L. What does this mean?

Respiratory Alkalosis. Partially Compensated

Respiratory Acidosis. Uncompensated

Metabolic Alkalosis. Partially Compensated

Metabolic Acidosis. Uncompensated

The results show that Mrs. Johansson has respiratory acidosis because of decreased pH and increased PaCO2 which mean acidic in nature. Meanwhile. it is uncompensated because HCO3 is within the normal range.

Explanation

The results show that Mrs. Johansson has respiratory acidosis because of decreased pH and increased PaCO2 which mean acidic in nature. Meanwhile. it is uncompensated because HCO3 is within the normal range.

2. Carl. an elementary student. was rushed to the hospital due to vomiting and a decreased level of consciousness. The patient displays slow and deep (Kussmaul breathing). and he is lethargic and irritable in response to stimulation. He appears to be dehydrated—his eyes are sunken and mucous membranes are dry—and he has a two week history of polydipsia. polyuria. and weight loss. Measurement of arterial blood gas shows pH 7.0. PaO2 90 mm Hg. PaCO2 23 mm Hg. and HCO3 12 mmol/L; other results are Na+ 126 mmol/L. K+ 5 mmol/L. and Cl- 95 mmol/L. What is your assessment?

Respiratory Acidosis. Uncompensated

Respiratory Acidosis. Partially Compensated

Metabolic Alkalosis. Uncompensated

Metabolic Acidosis. Partially. Compensated

The student was diagnosed having diabetes mellitus. The results show that he has metabolic acidosis (low HCO3 -) with respiratory compensation (low CO2).

Explanation

The student was diagnosed having diabetes mellitus. The results show that he has metabolic acidosis (low HCO3 -) with respiratory compensation (low CO2).

3. A cigarette vendor was brought to the emergency department of a hospital after she fell into the ground and hurt her left leg. She is noted to be tachycardic and tachypneic. Painkillers were carried out to lessen her pain. Suddenly. she started complaining that she is still in pain and now experiencing muscle cramps. tingling. and paraesthesia. Measurement of arterial blood gas reveals pH 7.6. PaO2 120 mm Hg. PaCO2 31 mm Hg. and HCO3 25 mmol/L. What does this mean?

Respiratory Alkalosis. Uncompensated

Respiratory Acidosis. Partially Compensated

Metabolic Alkalosis. Uncompensated

Metabolic Alkalosis. Partially Compensated

The primary disorder is acute respiratory alkalosis (low CO2) due to the pain and anxiety causing her to hyperventilate. There has not been time for metabolic compensation.

Explanation

The primary disorder is acute respiratory alkalosis (low CO2) due to the pain and anxiety causing her to hyperventilate. There has not been time for metabolic compensation.

4. Client Z is admitted to the hospital and is to undergo brain surgery. The client is very anxious and scared of the upcoming surgery. He begins to hyperventilate and becomes very dizzy. The client loses consciousness and the STAT ABGs reveal pH 7.61. PaCO2 22 mmHg and HCO3 25 mEq/L. What is the ABG interpretation based on the findings?

Metabolic Acidosis. Uncompensated

Respiratory Alkalosis. Partially Compensated

Respiratory Alkalosis. Uncompensated

Metabolic Alkalosis. Partially Compensated

The results show that client Z has respiratory alkalosis since there is an increase in the pH value and a decrease in PaCO2 which are both basic. It is uncompensated due to the normal HCO3 which is within 22-26 mEq/L.

Explanation

The results show that client Z has respiratory alkalosis since there is an increase in the pH value and a decrease in PaCO2 which are both basic. It is uncompensated due to the normal HCO3 which is within 22-26 mEq/L.

5. Three-year-old Adrian is admitted to the hospital with a diagnosis of asthma and respiratory distress syndrome. The mother of the child reports to the nurse on duty that she has witnessed slight tremors and behavioral changes in her child over the past four days. The attending physician orders routine ABGs following an assessment of the ABCs. The ABG results are pH 7.35. PaCO2 72 mmHg and HCO3 38 mEq/L. What acid-base disorder is shown?

Respiratory Acidosis. Uncompensated

Respiratory Acidosis. Fully Compensated

Respiratory Alkalosis. Fully Compensated

Metabolic Alkalosis. Partially Compensated

The patient has respiratory acidosis (raised carbon dioxide) resulting from asthma and respiratory distress syndrome. with compensation having normal pH value within 7.35to 7.45. increased PaCO2 which is acidic and increased HCO3 which is basic.

Explanation

The patient has respiratory acidosis (raised carbon dioxide) resulting from asthma and respiratory distress syndrome. with compensation having normal pH value within 7.35to 7.45. increased PaCO2 which is acidic and increased HCO3 which is basic.

6. George Kent is a 54 year old widower with a history of chronic obstructive pulmonary disease and was rushed to the emergency department with increasing shortness of breath. pyrexia. and a productive cough with yellow-green sputum. He has difficulty in communicating because of his inability to complete a sentence. One of his sons. Jacob. says he has been unwell for three days. Upon examination. crackles and wheezes can be heard in the lower lobes; he has a tachycardia and a bounding pulse. Measurement of arterial blood gas shows pH 7.3. PaCO2 68 mm Hg. HCO3 28 mmol/L. and PaO2 60 mm Hg. How would you interpret this?

Respiratory Acidosis. Uncompensated

Respiratory Acidosis. Partially Compensated

Metabolic Alkalosis. Uncompensated

Metabolic Acidosis. Partially Compensated

The patient has respiratory acidosis (raised carbon dioxide) resulting from an acute exacerbation of chronic obstructive pulmonary disease. with partial compensation.

Explanation

The patient has respiratory acidosis (raised carbon dioxide) resulting from an acute exacerbation of chronic obstructive pulmonary disease. with partial compensation.

7. Ricky's grandmother is suffering from persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5. PaO2 85 mm Hg. PaCO2 40 mm Hg. and HCO3 34 mmol/L. What acid-base disorder is shown?

Respiratory Alkalosis. Uncompensated

Respiratory Acidosis. Partially Compensated

Metabolic Alkalosis. Uncompensated

Metabolic Alkalosis. Partially Compensated

The primary disorder is uncompensated metabolic alkalosis (high HCO3 -). As CO2 is the strongest driver of respiration. it generally will not allow hypoventilation as compensation for metabolic alkalosis.

Explanation

The primary disorder is uncompensated metabolic alkalosis (high HCO3 -). As CO2 is the strongest driver of respiration. it generally will not allow hypoventilation as compensation for metabolic alkalosis.

8. Mr. Wales. who underwent post-abdominal surgery. has a nasogastric tube. The nurse on duty notes that the nasogastric tube (NGT) is draining a large amount (900 cc in 2 hours) of coffee ground secretions. The client is not oriented to person. place. or time. The nurse contacts the attending physician and STAT ABGs are ordered. The results from the ABGs show pH 7.57. PaCO2 37 mmHg and HCO3 30 mEq/L. What is your assessment?

Metabolic Acidosis. Uncompensated

Metabolic Alkalosis. Uncompensated

Respiratory Alkalosis. Uncompensated

Metabolic Alkalosis. Partially Compensated

The postoperative client’s ABG results show that he has metabolic alkalosis because of an increased pH and HCO3. It is uncompensated due to the normal PaCO2 which is within 35 to 45 mmHg.

Explanation

The postoperative client’s ABG results show that he has metabolic alkalosis because of an increased pH and HCO3. It is uncompensated due to the normal PaCO2 which is within 35 to 45 mmHg.

9. Anne. who is drinking beer at a party. falls and hits her head on the ground. Her friend Liza dials "911" because Anne is unconscious. depressed ventilation (shallow and slow respirations). rapid heart rate. and is profusely bleeding from both ears. Which primary acid-base imbalance is Anne at risk for if medical attention is not provided?

Metabolic Acidosis

Metabolic Alkalosis

Respiratory Acidosis

Respiratory Alkalosis

One of the risk factors of having respiratory acidosis is hypoventilation which may be due to brain trauma. coma. and hypothyroidism or myxedema. Other risk factors include COPD. Respiratory conditions such as pneumothorax. pneumonia and status asthmaticus. Drugs such as Morphine and MgSO4 toxicity are also risk factors of respiratory acidosis.

Explanation

One of the risk factors of having respiratory acidosis is hypoventilation which may be due to brain trauma. coma. and hypothyroidism or myxedema. Other risk factors include COPD. Respiratory conditions such as pneumothorax. pneumonia and status asthmaticus. Drugs such as Morphine and MgSO4 toxicity are also risk factors of respiratory acidosis.

10. Which of the following values is a normal range for arterial oxygen partial pressure (PaO₂) in an Arterial Blood Gas (ABG) test?

80 - 100 mmHg

45 - 55 mmHg

35 - 45 mmHg

120 - 140 mmHg

In a normal Arterial Blood Gas (ABG) test, the PaO₂ (partial pressure of oxygen) typically ranges between 80 - 100 mmHg. This indicates the amount of oxygen dissolved in the blood and is used to assess how well oxygen is being transferred from the lungs to the bloodstream. Lower or higher values can indicate respiratory issues.

Explanation

In a normal Arterial Blood Gas (ABG) test, the PaO₂ (partial pressure of oxygen) typically ranges between 80 - 100 mmHg. This indicates the amount of oxygen dissolved in the blood and is used to assess how well oxygen is being transferred from the lungs to the bloodstream. Lower or higher values can indicate respiratory issues.