Arterial Blood Gas (ABG) Analysis NCLEX Exam #3 (20 Questions)

Want more of ABGs? Try this third set of practice exam and master the art of interpreting ABGs. So here’s a 20-question practice exam for your NCLEX.

Problems are not stop signs, they are guidelines.
— Robert H. Schuller

Topics

Included topics in this exam are:

  • ABG Analysis
  • Acid-Base Balance/Imbalance
  • Respiratory Acidosis/Alkalosis
  • Metabolic Acidosis/Alkalosis

Guidelines

Follow the guidelines below to make the most out of this exam:

  • Read each question carefully and choose the best answer.
  • You are given one minute per question. Spend your time wisely!
  • Answers and rationales are given below. Be sure to read them.
  • If you need more clarifications, please direct them to the comments section.

Questions

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ABG Analysis NCLEX Exam #3 (20 Questions)

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ABG Analysis NCLEX Exam #3 (20 Questions)

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In acid-base balance the normal plasma PCO2 and bicarbonate levels are disturbed. Match the changes in these parameters given below with the disorders in the given choices. 

1. Low plasma PaCO2

A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis

2. High plasma PaCO2

A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis

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3. Decreased plasma bicarbonate (HCO3-)

A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis

4. Increased plasma bicarbonate (HCO3-)

A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis

5. What two organs in the body serve as a compensatory function to maintain acid base balance?

A. Kidneys and Lungs
B. Lungs and Spleen
C. Heart and Liver
D. Gallbladder and Appendix

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6. Arterial blood gas (ABG) measurement will give the information needed to determine if the primary disturbance of acid-base balance is respiratory or metabolic in nature.

A. True
B. False
C. Both Carbonic Acid Excess and Deficit Only
D. Both Bicarbonate Excess and Deficit Only

7. The major effect of acidosis is overexcitement of the central nervous system.

A. True
B. False
C. Maybe
D. Both Acidosis and Alkalosis result in overexcitement of the central nervous system.

8. Alkalosis is characterized by overexcitement of the nervous system.

A. True
B. False
C. The major effect of Alkalosis is a depression of the central nervous system.
D. Both Acidosis and Alkalosis result in overexcitement of the central nervous system.

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9. The human body functions optimally in a state of homeostasis.

A. True
B. False
C. Maybe
D. Homeostasis has nothing to do with metabolic balance.

10. Acids have no hydrogen ions and are able to bind in a solution.

A. True
B. False
C. Acid is a substance that is not capable of donating hydrogen ions.
D. Acids and bases have nothing to do with hydrogen ions.

Match the acid-base status of the following blood samples to the disorders in the given choices. (PaCO2 values are in mm Hg and bicarbonate values in mmol/l).

11. pH 7.57, PaCO2 22, HCO3- 17

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A. Respiratory Acidosis, Partially Compensated
B. Respiratory Alkalosis, Uncompensated
C. Metabolic Acidosis, Partially Compensated
D. Respiratory Alkalosis, Partially Compensated

12. pH 7.39, PaCO2 44, HCO3- 26

A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Normal

13. pH 7.55, PaCO2 25, HCO3- 22

A. Respiratory Acidosis, Partially Compensated
B. Respiratory Alkalosis, Uncompensated
C. Metabolic Alkalosis, Partially Compensated
D. Metabolic Acidosis, Uncompensated

14. pH 7.17, PaCO2 48, HCO3- 36

A. Respiratory Acidosis, Uncompensated
B. Metabolic Acidosis, Partially Compensated
C. Respiratory Alkalosis, Partially Compensated
D. Respiratory Acidosis, Partially Compensated

15. pH 7.34, PaCO2 24, HCO3- 20

A. Respiratory Acidosis, Partially Compensated
B. Metabolic Acidosis, Partially Compensated
C. Metabolic Acidosis, Uncompensated
D. Metabolic Alkalosis, Partially Compensated

16. pH 7.64, PaCO2 25, HCO3- 19

A. Respiratory Acidosis, Uncompensated
B. Respiratory Alkalosis, Partially Compensated
C. Respiratory Alkalosis, Uncompensated
D. Metabolic Alkalosis, Partially Compensated

17. pH 7.45, PaCO2 50, HCO3- 30

A. Metabolic Alkalosis, Fully Compensated
B. Respiratory Alkalosis, Fully Compensated
C. Metabolic Alkalosis, Partially Compensated
D. Respiratory Acidosis, Partially Compensated

18. pH 7.6, PaCO2 53, HCO3- 38

A. Metabolic Alkalosis, Partially Compensated
B. Metabolic Alkalosis, Fully Compensated
C. Respiratory Acidosis, Partially Compensated
D. Respiratory Alkalosis, Fully Compensated

19. pH 7.5, PaCO2 19, HCO3- 22

A. Respiratory Alkalosis, Partially Compensated
B. Metabolic Alkalosis, Partially Compensated
C. Respiratory Acidosis, Uncompensated
D. Respiratory Alkalosis, Uncompensated

20. pH 7.4, PaCO2 59, HCO3- 35

A. Respiratory Acidosis, Uncompensated
B. Metabolic Alkalosis, Uncompensated
C. Respiratory Acidosis, Fully Compensated
D. Metabolic Alkalosis, Partially Compensated

Answers and Rationale

1. Answer: B. Respiratory Alkalosis

Excessive pulmonary ventilation decreases hydrogen ion concentration and thus causes respiratory alkalosis. It can become dangerous when it leads to cardiac dysrhythmias caused partly by a decrease in serum potassium levels.

2. Answer: D. Respiratory Acidosis

An excess of carbon dioxide (hypercapnia) can cause carbon dioxide narcosis. In this condition, carbon dioxide levels are so high that they no longer stimulate respirations but depress them.

3. Answer: A. Metabolic Acidosis

The body compensates by using body fat for energy, producing abnormal amounts of ketone bodies. In an effort to neutralize the ketones and maintain the acid-base balance of the body, plasma bicarbonate is exhausted. This condition can develop in anyone who does not eat an adequate diet and whose body fat must be burned for energy. Symptoms include headache and mental dullness.

4. Answer: C. Metabolic Alkalosis

In metabolic alkalosis, breathing becomes depressed in an effort to conserve carbon dioxide for combination with water in the blood to raise the blood level of carbonic acid. Symptoms include confusion, dizziness, numbness or tingling of fingers or toes.

5. Answer: A. Kidneys and Lungs

The carbonic acid concentration is controlled by the amount of carbon dioxide excreted by the lungs. The bicarbonate concentration is controlled by the kidneys, which selectively retain or excrete bicarbonate in response to the body’s needs.

6. Answer: A. True

ABG’s are blood tests that are useful in identifying the cause and extent of the acid-base disturbance and in guiding and monitoring treatment.

7. Answer: B. False

The major effect is a depression of the central nervous system, as evidenced by disorientation followed by coma.

8. Answer: A. True

The muscles may go into a state of tetany and convulsions.

9. Answer: A. True

The maintenance of acid-base balance, which in one part of homeostasis, is evidenced by an arterial plasma pH value of 7.35-7.45. Many mechanisms in the body work together to achieve and maintain this delicate narrow range of pH that is essential for normal cell function.

10. Answer: B. False

Acids are substances having one or more hydrogen ions that can be liberated into a solution.
Bases are substances that can bind hydrogen ions in a solution.

11. Answer: D. Respiratory Alkalosis, Partially Compensated

12. Answer: D. Normal

13. Answer: B. Respiratory Alkalosis, Uncompensated

14. Answer: D. Respiratory Acidosis, Partially Compensated

15. Answer: B. Metabolic Acidosis, Partially Compensated

16. Answer: B. Respiratory Alkalosis, Partially Compensated

17. Answer: A. Metabolic Alkalosis, Fully Compensated

18. Answer: A. Metabolic Alkalosis, Partially Compensated

19. Answer: D. Respiratory Alkalosis, Uncompensated

20. Answer: C. Respiratory Acidosis, Fully Compensated

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5 COMMENTS

  1. i am confused about #17, pH is in normal range=7.45, isn’t it? CO2 is 50 and HCO3 is 30. my answer is Respiratory Acidosis, Fully Compensated.

    • ph level is in normal range, correct
      CO2 is 50- Acidosis
      HCO3 is 30- Alkalosis

      if CO2 and HCO3 are contrast ( one is Alkalosis and the other one is Acidosis ), refer to your pH. although the pH is in normal range, you COULD identify still. the median for identifying if pH is Alka or Acid is 7.40. ph values of 7.41 and above are ALKALOSIS. 7.40 and below are ACIDOSIS. if ever you encounter the same question, try this ?

  2. Hi, I just want express my utmost gratitude to God for giving you the WISDOM to know and share this page on ABG. I thank for sharing this page in the BEST WAY EVER I have ever read, seen, studied and practiced. Finally, putting everything I have learnt so far about Arterial Blood Gas(ABG), everything you have presented here, from the beginning to the end of the ABG, has Helped me to understand and practice. YOU are a GIFT. My day ended with learning your ABG presentation, and I woke up after prayers, started again with your ABG presentation. I practiced the whole 3 Practice EXAMS, I got 36/40, and had extra time: 5 minutes left. Amazing!!! I am so thankful for the SIMPLEST WAY EVER you helped learned this topic. May God bless you and your team.
    Amby, FL. USA.

    • Hi Amby! Super happy with your comment and know that we are glad that you’ve learned the technique and even got a high score on the ABG exam! God bless you too!

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